Have High Total Bilirubin. Feel Fatigue And Jaundice In Eyes. Cause And Treatment?
May be suffering from liver or biliary disea
Detailed Answer:
Hello,
Thanks for posting on XXXXXXX
Given the description of the above symptoms, it is possible that your problem might either of liver or gall bladder origin with liver diseases the most likely. Hepatitis (viral or non-viral) can result to the above symptoms and laboratory results. Gall bladder obstruction (maybe due to gallstones) can also result to similar clinical presentation. If I was to treat you as one of my patients, I will order for a liver function tests (by doing the following tests: ASAT, ALAT, Alkaline phosphatase), serum bilirubin (which has already been done), viral hepatitis (B,C,D) serologies, abdominal scan etc. These tests are aimed at evaluating the liver and gall bladder condition and at the same time determining the possible cause.
I will recommend you see a gastroenterologist for subsequent follow-up (if you are not yet already seeing one).
Hope this helps and wish you the best.
Dr. Nsah
liver/gallbladder disorders present cholestasis
Detailed Answer:
Hello,
Given the new update you have provided, I will say, the onset of your problem might have originated from your gall bladder and you could have been suffering from bile obstruction or collapse, bile stones, or cholecysteitis.
Another likely liver condition that can cause those symptoms are fatty liver with less likelihood of liver cirrhosis and liver cancer (as AST and ALT would have been very elevated).
Please do not say I am beating around the bush here, but I can not come to any definite conclusion with only the details you have provided. Evaluating the liver goes beyond just some tests for bilirubin or liver function.
You will require an abdominal scan in order to determine the morphology or structure of the gall bladder, bile duct, liver etc, which can then tell us what type of diseases was responsible for your cholestatic syndrome or cholestasis (elevated bilirubin).
Note: AST=ASAT, ALT=ALAT
Other rare cases are primary biliary cirrhosis (an autoimmune disorder), Cystic fibrosis, abdominal mass (cancer?), drugs etc.
Given that your hyperammonemia was already being treated with the medication hepa merz (which is good for treat such conditions), I believe that you are in good hands already.
I think the list is long and it will be best to see a gastroenterologist for further follow-up.
Hope that this helps further.
Dr. Nsah
No not necessarily
Detailed Answer:
Your welcome.
I believe your doctor should be able to schedule appointments for control of bilirubin levels and liver function tests. Ones they are stabilized, you might be able to be taken off hepa merz for a while then do the control tests again on scheduled visits (by your treating doctor) just to make sure that they do not rise again.
Please feel free to contact me anytime if you have any further questions.
Dr. Nsah
On my CT scans taken recently (8/23/2013) they observed "small low-density lesion in the inferior right hepatic lobe measures 4mm, and remains too small to adequately characterize. Otherwise unremarkable appearance of the liver." however "The gall bladder, bile ducts, pancreas, spleen, adrenal glands and kidneys are within normal limits"
The final diagnosis of all the tests that day including blood work was
1. hyperbilirubinemia (which we have discussed)
2. icterus
3. headache
4. gastroesophageal reflux disease
What I am wondering is if the results from the CT scan about the lesion in the liver was significant. If so how? I was also wondering if any of the other things I was diagnosed with have any bearing to the hyperbilirubinemia.
I am sorry I keep giving you new information each time. I have over one hundred pages of results and something are only coming to mind as we speak. Please let me know what you think.
Thanks.
good to know
Detailed Answer:
Thanks for updating.
Thr result given is very unspecific and could suspect that you might be having liver cyst which is ususally benign and harmless and would hardly cause the symptoms you presented. Fatty liver diseases can also be the lesion found on CT.
Given they the scan came normal except for the unspecific lesiom found on scan.
I believe the problem is liver related but unfortunately i am unable to deduce further that the info i have already provided.
Hope this helps further.
Dr. Nsah