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Fluctuating bilirubin levels - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2248 Questions
User :   high bilirubin
User :   hello
Doctor :   Hi
User :   i am very worried
User :   i have had fluctuating bilirubin for a few months
Doctor :   ok
Doctor :   provide me the detail of of your symptoms
User :   i an otherwise fit and healthy 19 yr old male
User :   i have very mild jaundice in my eyes
Doctor :   ok
User :   and feel very tired
Doctor :   ok
Doctor :   from how many days ?
User :   i have had ultrasound, mri scan, many blood tests and an eye test
Doctor :   ok
User :   i first found out about the high bilirubin abou 6 months ago
User :   all the above tests were clear
User :   bilirubin has reacher 81
Doctor :   ok
User :   reached*
User :   i am very worried that i have liver disease
User :   due to return to consultant next month
Doctor :   can you provide me the recent liver function test report?
User :   no i'm sorry
User :   i'm in the and they don't provide me with those details
User :   all i know is that my bilirubin level was 81 umol
User :   and my liver enzymes were slightly deranged
Doctor :   ok
Doctor :   what did the doctor say about the cause for the increased bilirubin levels ?
User :   they dont know what is causing it
User :   all my tests have been clear
User :   they are contemplating a liver biopsy
Doctor :   ok
User :   they say that gilberts is a possibility but my bilirubin is higher than expected for this disease
Doctor :   do you know the values of the direct bilirubin and indirect bilirubin ?
User :   no, very sorry
Doctor :   what treatment you are on for the varying levels of the bilirubin ?
User :   none at the moment
User :   i am still awaiting a diagnosis
Doctor :   if the cause is suspected to be gilberts disease than you need not worry
Doctor :   since the tests have been done are ruled out of any liver cell damage or obstruction to the flow of bile
Doctor :   it is most likely that the cause for the hyperbilirubin is some enzyme deficiency
Doctor :   like the gilberts disease
Doctor :   for that to make a diagnosis a liver biopsy is necessary
User :   ok
User :   is it still a possibility that i have liver disease?
User :   since i am feeling very drowsy during the day and now suffer mild jaundice?
User :   or would liver disease have been picked up by the above tests?
Doctor :   yes the above tests would have definitely picked up the liver cell damage
Doctor :   the present symptom is also a liver related but it is more so a hereditary in nature
Doctor :   here the only problem is inability of the liver to excrete the bilirubin from blood
Doctor :   it requires one enzyme for the bilirubin in the blood to excrete into the bile juice.
Doctor :   this is present in the liver
Doctor :   in the deficiency of this enzyme the bilirubin will not get excreted and it will increase in the blood
Doctor :   causing yellow of the eye and urine
User :   ok i understand
User :   should i expect a biopsy at my next visit?
Doctor :   it is the only way to confirm the diagnosis of deficient enzymes
User :   ok is this painful?
Doctor :   liver biopsy is quite painful,but it is performed under anesthesia
User :   local?
Doctor :   yes local
User :   ok thankyou
User :   is there any treatment options for the symptoms?
User :   or the deficiency in general?
Doctor :   stress is the main cause for the increase in the bilirubin in the gilberts disease
Doctor :   if yo avoid that than the bilirubin levels will fall
Doctor :   even a medication is available for the reduction in the bilirubin levels, before that confirmation of the gilberts disease is done
User :   ok thankyou
User :   so from what i have described i have nothing to worry about?
Doctor :   yes you should not worry
Doctor :   as worry will increase the stress levels and worsen the bilirubin levels
User :   thankyou so much for taking the time to explain everything
User :   i feel a lot better
Doctor :   thanks for consulting health care magic
Doctor :   bye for now
User :   goodbye
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