elevated alkaline phosphatase, PSC, and IBD - oh my!

Gee, the first thing to ask, is how high is high? A modest elevation may not be too meaningful. Also, how are your other liver enzymes? 

You are doing the right thing by following up with further tests, but until those are done, it's anyone's guess in regard to what this all means.

That said, I had elevations of AST and ALT enzymes (about 3 times the upper limit of normal). PSC was ruled out with an MRCP, and the assumption was non-alcoholic fatty liver disease (also associated with UC). Now my enzymes are normal. No particular treatment other than some weight loss and treatment of my underlying disease (pouchitis and enteropathic arthritis).

Jan

Yes I have PSC.  UC also.  PSC and UC dignosed in 2002.  enzymes were up then and stayed up.WAY WAY UP. I get what's called an ERCP once every 9 months or so to clean out bile ducts. Get a liver Dr. to do Bi-opsies test ect. ect. I pray DJH you are PSC free !

Thanks for the replies! So far the AST and ALT are not high (though the ratio isn't ideal), it is the alkaline phosphatase that is elevated over the high end of the normal range.  I have the ultrasounds in a couple weeks so I'll reply back when I know more after that.

I broke my foot in oct 2016. In surgery I believe I'm not positive they gave me IV anti biotics keflex maybe. Well my enzymes went back to NORMAL my dr was like no way. He later found out that some recent studies indicated IV keflex helped PSC  So I'll check and ill make sure it's keflex

I've also had elevated ALP results going on for the past year... I had an mrcp done which resulted in an "inconclusive test". they recommended repeating the test in a year. its been very disheartening finding out about needing the proctocolectomy + jpouch surgery last year and also trying not to worry too much about the possibility of having PSC.

In April 2013, I went to the ER with abdominal pains that radiated to my back, reminiscent of pancreatitis. The blood work showed the pancreas was ok but my liver enzymes were high. I had an ERCP the next day that showed psc.

My ALP levels have been in the 300-500 range since, but the more important component of the Liver function test  is the bilirubin levels. If they are above 1.0, I get worried; they are a better indicator of liver trouble than the ALP. When I have a blocked bile duct, the bilirubin will usually be above 2.5 or so, most commonly above 5.0.

MIN, be glad that if you have psc, your UC has been dealt with. You won't have to deal with both at the same time, and that would be a relief. I understand the disheartening part.