The way foci cause these three disorders must be nearly identical. A chronic single or impacted sieve-like mass of foci could cause partial ampullary obstruction. This obstruction could occur over long periods of time because the pressures across the obstruction are balanced so the obstruction is not broken down. This results in chronic stasis causing elevated liver enzymes and CBD calculi formation and/or cholangitis. Foci cause transient fluctuating elevation of liver enzymes. About 50% of elevated LFT’s of unkown etiology had pain.