<s>[INST] 30 year old female. Elevated ALT AST enzymes sharp pain off and on for two months under left rib cage, sharp burning pain left lower abdomen, yellow diarrhea and now green, frequent urination , CT scan unremarkable except a fat deposit on liver 1.3cm? Nausea. ER diagnosed with acute abdominal pain but still hurting! I know something is wrong. I have gained 50lbs in one year and constant bloating feeling. My medical history is ovarian cysts and now on 125mcg synthroid . Not a heavy drinker but now obese. Please help!! [/INST] Thanks for the question, your laboratory results with increased enzymes called liver transaminase, coupled with a pain under the rib cage are suggestive an acute hepatitis. This could either be infectious (Hepatitis B or C most commonly), due an intoxication (Chat Doctor.  An abdominal ultrasound and a Chest X-ray might be very useful in making things clear and guiding further evaluations. Other specific markers of liver lesions like Alpha photo proteins, gamma amino boutique acid and 5 Nucleotide exams, shall be asked based on these preliminary results. Excess urination deserves an urinalysis to screen for a urinary tract infection and detect ketones or glucose for diabetes. A urine cast, culture and sensitivity tests would be interesting to exclude a urinary tract infection. I suggest you book an appointment with a gastroenterologist for a proper evaluation and management. Thanks and this helps, Best regards, Luchuo, MD. </s>