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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated Bilirubin And Alkaline Phosphatase Levels While Diagnosed With Cholangiocarcinoma?

My daughter has bile duct cancer. Recently, her bilirubin has escalated and alkaline phosphatase (ALP) has also increased. She has been having a feeling of fullness in her lower back, and she has had difficulty with bowel movements even though her stool is soft. She is going to see a gastroenterologist for further tests. Can you tell me what type of tests? Also, how high can the bili get before there is permanent damage sustained? Please advise. Thanks!
Sat, 17 Oct 2015
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Pathologist and Microbiologist,  's  Response
Hello and welcome to HCM,
Bilirubin is pigment produced in liver and is drained into the biliary tract and then into duodenum.
Any obstruction will lead to elevated bilirubin level.
Bile duct cancer is definitely going to obstruct the passage of bile from liver into the duodenum.
Alkaline phosphatase is an enzyme present in the epithelium of biliary tract.
Thus, cancer of the bile duct epithelium is going to elevate the level of alkaline phosphatase.
Treatment of bile duct cancer which is surgical excision of the tumor is only way of decreasing the level of bilirubin and alkaline phosphatase.
I suggest you to consult your gastroenterologist for surgical excision of the tumor and other palliative care.

Thanks and take care
Dr Shailja Puri

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What Causes Elevated Bilirubin And Alkaline Phosphatase Levels While Diagnosed With Cholangiocarcinoma?

Hello and welcome to HCM, Bilirubin is pigment produced in liver and is drained into the biliary tract and then into duodenum. Any obstruction will lead to elevated bilirubin level. Bile duct cancer is definitely going to obstruct the passage of bile from liver into the duodenum. Alkaline phosphatase is an enzyme present in the epithelium of biliary tract. Thus, cancer of the bile duct epithelium is going to elevate the level of alkaline phosphatase. Treatment of bile duct cancer which is surgical excision of the tumor is only way of decreasing the level of bilirubin and alkaline phosphatase. I suggest you to consult your gastroenterologist for surgical excision of the tumor and other palliative care. Thanks and take care Dr Shailja Puri