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Bilirubin total increasing, 3.1, direct 0.7

My total bilirubin has been elevated and increasing for the past 6 weeks.  It started out around 2.1 with direct 0.6 and has progressed to 3.1 while direct is still around 0.7

I do have itching but no visible jaundice at this point.  Lighter brown floating bowel movements for the past month.  Although I do take in quite a fit of fiber as well.  Minor pain in the liver/gallbladder area for the past few months, always exactly the same 2 places, but very minor.

All other tests such as AST/ALT/Alkaline phosphatase, GGT, Ammonia, and a number of others are in normal range.  Negative HPA/B/C etc.  Had an abdominal ultrasound 9 months ago that was clear (maybe dated at this point), and abdominal CT also clear 3.5 months ago.  I'm not certain about my bilirubin levels at the time I had those scans though.

I don't believe this is Gilbert's but the doctors seem to think the direct/indirect at these levels is splitting hairs.  

Any thoughts?  Any causes for this other than biliary obstruction/cirrhosis/cancer?  
1 Responses
Avatar universal
COMMUNITY LEADER
Becoming jaundice is right around the threshold levels that your are measured at, 2.5 or higher. The floating stools, RUQ pain and itching are certainly related to bile flow problems but your direct bilirubin doesn't seem to be very elevated, maybe a partial obstruction? Given that your liver enzymes are normal, this means the blockage possibilities are limited.

The other possibility is the source of the bilirubin itself - destruction of red blood cells. How are your CBC blood work numbers? Any indications of anemia? Any unusual cell shapes that would cause the spleen to destroy the red blood cells prematurely? It seems that there is normal processing of the indirect bilirubin, but the incoming supply is just too high and the liver can't quite keep up.

Let us know how your doctors make out. Take care.
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