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What Causes High Bilirubin Levels?

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Posted on Tue, 30 Jun 2015
Question: What can high bilirubin mean in metastic colon cancer pt ?

Alt and alp are normal ?
doctor
Answered by Dr. Mohammed Taher Ali (34 minutes later)
Brief Answer:
High Bilirubin due to metastases.

Detailed Answer:
Dear Sir,

I appreciate your concern for the high bilirubin level along with cancer colon.

High bilirubin could be due obstructive or non-obstructive liver injury. In absence of intense itching and normal enzymes like ALT & Alkaline phosphatase it is more likely to be non-obstructive type. Probably secondary deposits (metastasis) from colon cancer leading to liver injury is reflected in the form of high bilirubin. It should be correlated with scan findings.

Cancer chemotherapy is found to be beneficial to treat high Bilirubine due to cancer metastases.

Hope I could answer your query.
Wishing you best of your health.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mohammed Taher Ali (26 minutes later)
Ok . Well that's the confusion here . He was on chemo . Had 3 sessions. Were 6 mets in liver , 3 small ones have gone and largest is 8 cm now ( there was a 9mm increase in 3 months ). So if disease fairly stable , why bilirubin increasing .

After 3 rounds he admitted in hosp with fever . On iv antibiotics 2 weeks . Ct can showed bowel
Inflammation severe and slight bowel obstruction only .

He can't eat , nausea and weakness and bilirubin going high . All
Since this bowel inflammation started .

Readings were
12
19
12
31
51
74

Cea
Also
Dropped in chemo . So is this meaning cancer bad now ?
doctor
Answered by Dr. Mohammed Taher Ali (1 hour later)
Brief Answer:
Increasing bilirubin level is a poor sign.

Detailed Answer:
Dear Sir, Hi
Thanks for your kind information about his condition which shows that he has he can not eat, has nausea and vomiting which are suggestive of inflammation of the bowel with obstruction.

Increasing levels of Serum Bilirubin definitely not a good sign as far as the response to chemotherapy is concerned.

I therefore, advise you to kindly take the opinion of his treating oncologist regarding future course of action.

Wishing him a quick recovery from his present illness.

Best regards.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Mohammed Taher Ali (12 hours later)
Thx . Scan showed disease stable after 3 rounds . 3 liver mets and largest one is 8 cm so can these b causing high bilirubin .

Is this end stage disease then ? Plus lack of apoetite n fatigue .
doctor
Answered by Dr. Mohammed Taher Ali (5 hours later)
Brief Answer:
It could also be due to other causes.

Detailed Answer:
Dear Sir, Hi
Thanks for your kind reply.

In addition to metastases, there may be other possibility of high bilirubin like infection that may be responsible for loss of appetite and fatigue.

As I advised earlier please take an opinion of the treating oncologist for better evaluation and of course the prognosis.

Best regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Mohammed Taher Ali

General & Family Physician

Practicing since :1988

Answered : 6261 Questions

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What Causes High Bilirubin Levels?

Brief Answer: High Bilirubin due to metastases. Detailed Answer: Dear Sir, I appreciate your concern for the high bilirubin level along with cancer colon. High bilirubin could be due obstructive or non-obstructive liver injury. In absence of intense itching and normal enzymes like ALT & Alkaline phosphatase it is more likely to be non-obstructive type. Probably secondary deposits (metastasis) from colon cancer leading to liver injury is reflected in the form of high bilirubin. It should be correlated with scan findings. Cancer chemotherapy is found to be beneficial to treat high Bilirubine due to cancer metastases. Hope I could answer your query. Wishing you best of your health.