Elevated Liver Enzymes

Hi guys,

22 y/o female with ulcerative colitis here. A week ago I had some blood drawn before starting a new drug for UC (entyvio.) My doctor then called and informed me that my liver enzymes (AST & ALT) were mildly elevated. This is very strange for me as I’ve never had high liver enzymes before, so he sent me to get another test, which, of course, also came back elevated. I still have to be tested for viral hepatitis B & C, as well as untreated celiac’s disease and/or a possible side effect of the UC drug I’ve used for the past few years—Lialda (meslamine, 2x a day.)

However, I am completely freaking out. (Just spent an hour sobbing, actually. TMI, sorry.) I don’t think Lialda would cause side effects after years of use and I think viral hep and celiac’s are pretty unlikely as well. I don’t have the right readings for PSC and I don’t match a lot of the criteria for fatty liver...so all of this points to autoimmune hep to me. I’m very scared right now...and because the tests are going to take so long to do, get results from, etc., I am just feeling absurd amounts of stress regarding a possible future filled with not one autoimmune disease, but two...

Would any of you guys be willing to share your experiences with me? How were your diagnosed? What were your liver enzymes levels? How likely is it for me to have developed autoimmune hep after only having UC for 4 years??

Beyond that, I am also interested in possible treatments. Can I refuse long term pred treatment? I hate the stuff & honestly would rather refuse it than take it for over a few weeks...which I know may seem dramatic, but what is the likelihood of a new patient refusing steroid treatment? Could it be treated with another drug instead? I have a very severe reaction (nothing life threatening, but horrible mood swings, bad fluid retention) to high doses of pred and would literally rather take anything but that. Do they do short doses? Like two weeks? That’s about the max I can take of pred without losing my mind.

I am currently on seasonique BC pills, entyvio...and I just stopped taking Lialda. I also occasionally took tramadol for pain, but my doctor has asked me to refrain from using that and Tylenol or alcohol.

Please! Any information you can provide would be much appreciated. Especially if it can hopefully set my mind at ease. I just started grad school and I don’t know how much stress I can take on right now.

Thanks,

Liz