### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello Dr. Could you please comment on my wife s LFT that is as below: S. Total Bilirubin ----- 0.5 mg/dl S. Direct Bilirubin ------ 0.2 mg/dl S. Indirect Bilirubin --------- 0.3 mg/dl Gamma GT ------- 146 SGPT ( ALT ) -------- 198 IU/L Alkaline Phosphatase -------- 331 IU/L This is the most recent report. Similar test done a few days ago had a worse Alkaline status. She is reporting nausea, pain in around liver and stomach area with vertigo incidents occasionally. Her stool D/R shows 2-4 hpf, acidic in chemical reaction with occasional Macrophages reported. Full abdominal ultrasound does not show any stones but sonologist recommended a re-visit because there was swelling around gall bladder and liver. Thank YOU.

### output:

Dear Sir, these tests and symptoms u ve described definitely means something (liver or intestinal disorder) and it needs to be evaluated. Most common disorders which raise liver enzymes parameters are, alcohol, metabolic syn Chat Doctor.  So these 4 should be ruled out.  The best way is to further tests. So I recommend doing viral hepatitis analysis, abdominal CT(more specific than ultrasound) and liver biopsy. Also, she needs to avoid fat food and alcohol, lose weight if adipose and do hepatology work ups at least 2x a year. Also, this stool finding can mean someone or nothing, if she wants to be sure she can do colonoscopy. Wish you good health.