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Viral hepatitis

Q: I have got my blood tested 3 times in about 2 weeks. The biluribin level is gradually increasing with each test. In first test it was 1.8 mg/dl, in 2nd test it was 2.0 mg/dl (Conjugated: 1.5 mg/dl, unconjugated: 0.5 mg/dl) and in 3rd test it was 4.0 mg/dl (conjugated: 1.6 mg/dl and unconjugated: 2.4 mg/dl). SGOT and SGPT are normal, Alkaline Phosphatase is also normal. I got the Hepatitis-B test done and it came negative. I am feeling slight pain in the abdomen (right part). I have also undergone Ultrasound examination. Ultrasound examination showed everything is normal (liver size, gall blader, no dilatation in common bile duct; spleen and kidneys all are normal). The increasing level of bilirubin is concerning me a lot. I have been taking the easily digestable diet. No fats at all. My doctor is also confused with the above test results. Do the symptoms show Gilberts syndrome?. Please suggest the appropriate treatment.

A:Your symptoms of poor appetite and passage of dark urine suggests acute hepatitis but the normal levels of SGOT and SGPT is very unusual. Gilberts syndrome is not associated with any symptoms. The diagnosis is made by finding high levels of unconjugated bilirubin but normal conjugated bilirubin (which is not the situation in your case). I suggest you stop all medications. Since the most common cause of your problem is viral hepatitis, you should recover spontaneously in a few weeks. If these problems persist, you will need more tests to rule out other causes of liver disease and you should then see a liver specialist.

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