Q: My question is a bit lengthy but I am sure you will sort out my problem. I am 28, and suffering from hyperbilirubinaemia for at least four years now. In fact it started with typhoid four years ago. I recovered from typhoid but jaundice kept fluctuating between 2-3 mg% otherwise all other liver function tests such as SGPT, SGOT, alkaline phosphatase, globulin etc are normal. TLC & DLC are normal, my utrasonography is normal and haemoglobin is 14%. I took a second opinion and the doctor said that this is congenital hyperbilirubinaemia. But I wonder if it is congetital then one should recover. Doctor I really am in a fix that what exactly is wrong with me. I am also suffering from indigetion, poor appetite and stomach feels heavy sometime. Please help me out as this problem is now four years old. I will be anxiosly waiting for your reply.

A:Hyperbilirubinaemia causes jaundice if the levels of bilirubin are raised above about 3 mg/dL. It can be due to breaking down of your blood cells (haemolytic anaemia), a congenital problem or a problem with the liver/obstruction of the bile ducts. If, as you say, all your other blood tests are normal (including other liver function tests), then the cause is probably congenital. The commonest cause of this is Gilbert's syndrome, a congenital hyperbilirubinaemia affecting up to 7% of the population. It is not serious and often the bilirubin goes up incidentally if you have a cold or a mild infection. Occasionally there is a family history of jaundice. There are no symptoms related to it and the only sign is looking a bit yellow. There is no need to worry about having Gilberts syndrome as it is not associated with any long term problems. Your symptoms of indigestion, poor appetite and heavy stomach are not due to Gilberts and may be due to an irritable bowel syndrome if you are otherwise well. Hope this has been helpful.