Severe pain in upper abdomen has many causes: the combination of deranged Liver enzymes and raised CRP can be seen in Pancreatitis, although you don’t have Gall stones: further steps to determine the possible diagnosis would be 1. Pancreatitis tests Se Amylase and lipase 2. CT Scan abdomen with IV contrast Further management as per reports If all reports are normal then conservative treatment 3. Acid reflux is a different problem and will need its own investigations like Manometey and 24 hour pH

Your reports and symptoms suggest a transient inflammatory or hepatocellular reaction, likely secondary to acute gastritis, viral infection, or drug-induced hepatic stress, rather than a structural liver or gastric disease. Interpretation of findings: • Liver enzymes: AST (115 U/L), ALT (79 U/L), and GGT (108 U/L) are mildly to moderately elevated → indicating a hepatocellular or mixed pattern of liver irritation. Bilirubin, albumin, and alkaline phosphatase are normal → liver function is preserved. • Inflammatory markers: CRP (9 mg/L) and neutrophilia (82%) with relative lymphopenia indicate an acute inflammatory or infective response. ESR (42 mm/hr) further supports the same. • Pancreatic enzymes (amylase/lipase) are normal → pancreatitis is excluded. • USG and endoscopy being normal rule out structural or ulcerative lesions. This overall pattern fits with a reactive or viral hepatitis picture, or sometimes post-infectious gastritis with transient hepatic inflammation, rather than a chronic or serious pathology.