Q: My wife was suffering from jaundice last year. She was alright after one month and started to attend office. Now after one year, again she is affected with jaundice and is now on bed rest. We have taken some herbal medicine and tested her bilirubin after 15 days, surprisingly the count of the bilirubin was constant (beginning it was 3.2, now it is 3.1). The surprising factor is that direct bilirubin is somewhat normal but the indirect bilirubin is comparatively very high. Last year also her indirect bilirubin was high compare to direct. We are under tremendous pressure that why it is coming again and again and why it is not reducing even after one month of complete bed rest and all care. We conducted ultrasound, the report is normal, blood and urine culture is also normal. She is suffering from thyroid problem for the last few years, will it be a reason for jaundice? Please advise what shall we do or what is the basic reason for occurring jaundice coming again and again.

A:It is difficult to determine the cause of jaundice in your wife from the data that you have provided. There are essentially three causes of jaundice: 1. Haemolysis - destruction of red blood cells 2. Liver disease 3. Obstruction of bile ducts. It is usually possible to determine the exact cause by performing blood tests and screening studies such as ultrasound. Since her ultrasound is normal and only the indirect bilirubin is high, it is possible that she has haemolysis. You should consult a competent liver specialist who will be able to make the correct diagnosis.