Brief Answer:
A genetic test can confirm XXXXXXX

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
I am a Gastroenterologist and would be addressing your query.


Firstly the phase of jaundice you are having is called as a subclinical phase. Serum total bilirubin less then 3mg/dl has no clinical importance.

I would like to give you a briefing about bilirubin and how body deals with it normally to give you a better idea-

Bilirubin is the normal by-product of the breakdown of hemoglobin (a component of red blood cell).

Bilirubin circulates in the blood bound to albumin and is taken up by hepatocytes(cells) in the liver. Within hepatocytes, bilirubin is conjugated. Conjugated bilirubin is secreted into bile which is further broken down in intestines and is excreted in urine and stool.

The diagnosis of XXXXXXX syndrome as the cause of hyperbilirubinemia should only be made after excluding other liver and hematologic disorders.

In XXXXXXX syndrome, the degree of hyperbilirubinemia is typically less than 5 mg/dL and the conjugated bilirubin is typically less than 20% of the total bilirubin fraction.This scenario fits into your case.

However, for confirmation of the diagnosis of XXXXXXX UGT1A1 gene analysis should be done by a genetic expert.
XXXXXXX syndrome is the most likely cause of the unconjugated hyperbilirubinemia in the setting of normal liver enzymes so your concerns are correct. However, initially, the presence of hemolysis should be evaluated with a peripheral blood smear and levels of lactate dehydrogenase and haptoglobin.
XXXXXXX is a diagnosis of exclusion so we need to exclude all other possibilities initially and when all other causes are excluded we could consider it as XXXXXXX

Investigation suggested are
Ultra sound abdomen(to rule out fatty liver as you are alcoholic and alcohol intake can be a cause of mild elevation of bilirubin).
Stool routine and microscopy test.
Peripheral smear of blood to rule out minor hemolysis.

Initially, these tests should be done.
Just labeling you as XXXXXXX because you are having subclinical jaundice with normal liver enzymes is not good.

Answer 2-
See frankly speaking if alcohol would have been the culprit then apart from increasing levels of bilirubin it would have also affected your liver functions significantly.However in medical sciences rule of thumb is every patient is different so a doctor should consider all possibilities. We know that alcohol is the enemy of the liver. So to exclude this possibility its good to avoid alcohol for few weeks and see if anything changes.

Strong suggestions-
Please don't panic because all your tests are normal even icterus elevated bilirubin) is also subclinical.

We have to exclude possibilities as per the standard protocol.

Even in case its XXXXXXX you need not worry. Patients of XXXXXXX are just as normal as any other persons.

Have faith and keep my words.
You will be fine soon.

Best of luck and get well soon.
Regards

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Brief Answer:
Go for the genetic test.

Detailed Answer:
Hi again dear,

As all other tests are normal. Most likely it appears to be XXXXXXX only. However, only a genetic test could help establish a correct diagnosis.

Yes, Hemolytic anemia ia a type of anemia but bilirubin levels are usually quiet high in this due to the destruction of Red blood cells, so most likely it's not your case. However, you can go for a simple peripheral smear of blood to rule out this possibility.

If you want to ask any other specific question please feel free to ask.

Best wishes.

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