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I Want To Give You Full Story. I Have Been

Posted on Sat, 17 Oct 2020

Question: I want to give you full story. I have been my whole life with gerd, i had recently went to hospital as it was very severe. Upoer gi showed chronic esophagitis and negative biopsy. Also labs at that time showed total bilirubin of 2.2 as I also want to mention intermittent nausea and inability to eat so lost maybe 6 lbs within a yr. Still have intermittent nausea and most recently had labs for coag due to ct with contrast showing mild fatty infiltrate of liver at 13 cm at this time in May everything else was normal. Dr may have tested
Possibly because my labs from hospital were total bilirubin 2.2, albumin 4.9, and nausea combined with inability to eat loss of 6lbs in a yr, but as mentioned ct scan normal aside from what i mentioned. Now ca 19.9 71 now what does this mean? I would like to mention i have 3 auto immune disease and have a hx of high monocytes can be up to 15 sometimes since i am a kid. I also have a hx of my bilirubin total waxing and waning sometimes going up to.1.5 and 1.7 on all bloodwork from.being a child. I am worried. Should i be concernes about ca 19.9? Thank you

Answered by Dr. Ramesh Kumar (8 hours later)

Brief Answer:
Please go through detailed answer dear.

Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query.
Have seen your details and i appreciate your concerns.
I would like to answer your query from Gastroenterology point of view-
Firstly Bilirubin level less then 3mg/dl has no clinical significance which means that until and unless bilirubin is more then 3mg per dl it has no significance from a doctors point of view.
Your Albumin is perfect.
Weight loss and persistent nausea is explained by esophagitis. 6lbs in a year is not malignancy as that is associated with severe weight loss(drastic).

Now as per CA 19.9 is concerned firstly its not a very accurate marker....Secondly the levels are less then 100..So i don't think that its something to worry about.
Follow ups are welcome.
Thanks!

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (29 minutes later)

Thank you so much for.tour response Dr. I am very scared. My dr now wants to get a pet scan and i am terrified. If i can ask you a question dr. I just had a ct scan with contrast in May and just received ca 19 level this month. God forbid there was something would they have seen it through ct scan? It waa all negative aside from mild fatty liver. Should I follow up with this lab work or what would you recommend? Thank you Dr

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again my dear,
Firstly i would say there in no need to panic.
Secondly see in todays world we have technology,Various kind of tests like CT,PET etc to find out even the smallest of masses or abnormalities; So if your doctor has suggested you to go for a PET there is absolutely nothing wrong with it.Its a highly sensitive gold standard test to find out any carcinoma or suspected abnormality(When we have the technology why not to use it though CT scan is an.advanced test yet PET is something very specific and sensitive).
99.9℅ PET would be normal and in case if some finding is there the earlier it is detected the better it could be treated;So there is absolutely nothing to panic about...Just go for the test and rest assured everything would be ok.
Good luck and Regards!

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (19 minutes later)

Thank you dr for putting me a little at ease. I am very scared. I only weigh now 94 lbs. But i have been thin my whole life being 101 XXXXXXX

Answered by Dr. Ramesh Kumar (21 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Don't worry and just go for the test and follow up with reports...Very likely every thing would be ok!
Thanks!

Above answer was peer-reviewed by : Dr. Yogesh D