<s>[INST] i had an pacemaker implant in 2001, aortic and mitral valve relacement in 1983 and gall bladder operation in 1993.now i have developed lower abdomen pain with enlargement of liver(haemoglobin 10gm/dl,rbc count 3.66mil/cmm,inr 2.14,sgot 64iu/l,alkaline phospatase 354iu/l,bilurubbin total 1.63mg/dlsgpt 50 iu/l bilurubin direct .69mg/dl indirect bilurubin .94 mg/dl,serum amalase 147u/l,creatinine 1.3 mg/dl medicines i am taking now 1)udiliv 300mg twice daily,rablet d once at morn.creone 10000 2 tbs.daily.Unfortnately,after 10 days,i could not get any relief . persistent pain in the centre and right side of abdomen is causing enormous discomfort to me .seeking your advice m.k.nath.(68 years) email  YYYY@YYYY best regards. [/INST] No relationship to both these conditions ..liver enlargement in some individuals is normal, about ur pain its look like appendicitis mostly rarely other causes like kidney stones etc..previous surgery can also cause adhesions causing intestinal partial obstruction cause pain..simple ultrasound of ur abdomen can rule out..hope i am helpful..liver enlargement is not the cause of your pain </s>