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High bilirubin levels, chances of strictures, liver compression - 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 : 2008
Answered : 3622 Questions
User :   Hello, I'm a 27 yr old male. I haven't had alcohol since i finished school two years ago. Last week I started to notice yellowing of my eyes and skin. Blood work was done and I was told my bilirubin level was around 6. Yesterday I had a more indepth test Bilirubin Total - 4.8....Bilirubin Direct- 3.30...AST - 52...ALT- 126..all of these readings were flagged and the hepatitis tests were all Negative...since last week, the jaundice appearance has significantly subsided. i discontinued fatty foods and have started drinking much more water than i used to..I am wondering if I could get a little more insight to the current readings?
Doctor :   Hi,
User :   hello
Doctor :   Let me read your query for sometime to be able to have a good discussion here
User :   ok..also i have the results from the blood screen available with me in case you need any more information
Doctor :   Can you present the LFT report i little bit more detail.
User :   protein, Total, Serum -- 6.9
User :   albumin, serum 4.5
User :   Bilirubin total 4.8
User :   bilirubin direct 3.30
User :   alkaline phosphatase, S 75
User :   LDH 179
User :   AST (SGOT) 52
User :   ALT (SGPT) 126
User :   GGT 42
User :   Total cholesterol 122
Doctor :   Thanks a lot ,
User :   no problem
Doctor :   May i know what color your stools and urine are ?
User :   last week my urine was colored and my stool was really light colored..the past few days my urine is clearing up and my stool has returned to a darker color
Doctor :   Good , What other investigations other than blood check have you gone through ?
User :   None so far. would you recommend a certain test?
Doctor :   yes, first i would like to explain you, your condition
Doctor :   Bilirubin is a waste product after the death of the blood
Doctor :   this is converted into to simple form in the liver so as to be excreted ( thrown out of body )
Doctor :   Total bilirubin =direct +indirect bilirubin
Doctor :   based on above equation i see there is increase in the direct bilirubin in you
Doctor :   direct bilirubin is the amount of simplified bilirubin
Doctor :   indirect bilirubin is non simplified raw bilirubin
Doctor :   to conclude the liver is able to produce simplified bilirubin , but unable to throw it out of the body , which can happen in conditions where there is block to the out flow from the liver
Doctor :   hence now in you i would ask to get a ULTRASOUND abdomen scan to rule out there s any block to the out flow of the simplified bilirubin from the liver
Doctor :   most commonest causes are , stones in the out flow canals , strictures ( narrowing due to frequent subclinical infections), any external compression over the out flow tract by any swollen organ around the liver specially pancreas etc
Doctor :   Did you follow me , ?
User :   yes sir
Doctor :   So the next investigation needed would be a USG scan of the abdomen , and it would be better if its CT scan if you can afford
User :   well i greaty appreciate your time.
Doctor :   You are welcome
Doctor :   Thanks for consulting me
User :   thanks again and have a good day
Doctor :   kindly provide your feedback
User :   will do!
Doctor :   Wish you al good health
Doctor :   Bye
User :   bye
Doctor :   take care
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