Elevated Bilirubin

Bilirubin is a waste product obtained during the process of recycling of worn-out RBCs. While the spleen promotes removal of worn-out red blood cells (RBCs), liver helps in the recycling process. Bilirubin works as a cellular antioxidant. Normal levels of direct or conjugated bilirubin in blood are 0 to 0.3 mg/dL (milligram per deciliter). Total bilirubin should be between 0.3 to 1.9 mg/dL. Increased level of bilirubin in urine is also an indication of a health problem which requires prompt medical attention.

Causes of High Bilirubin

• Large obstruction in the bile duct can affect the bilirubin level seriously. In some cases, narrowing of bile duct can lead to moderate rise in bilirubin levels.

• Liver cirrhosis can affect the functioning of liver seriously, leading to abnormal bilirubin levels.
• Apart from cirrhosis of the liver, the function of the liver can get affected by various liver problems like liver failure, liver cyst, etc.

• Increased break down of RBCs or a genetic disorder of bilirubin metabolism can result in mild rise in bilirubin levels.
• Viral hepatitis is one of the main causes of high bilirubin levels.
• Crigler Najjar syndrome, a rarely found disorder which affects the metabolism of bilirubin can lead to increased bilirubin in blood.

• Choledocholithiasis or presence of gallstones in the bile duct is one of the main causes of high bilirubin.
• Dublin Johnson Syndrome or increase of conjugated bilirubin without elevation of liver enzymes can lead to higher than normal levels of bilirubin.
• 'Jaundice' is the condition when one suffers from excessive bilirubin in blood.

• Drug-induced liver disease can affect liver function seriously and can be the cause of elevated levels of bilirubin.
• Hemolysis or abnormal destruction of red blood cells in the blood can be the cause of excessive bilirubin in blood.
• Any cancer can spread into the liver and can affect liver function seriously.

• Alcoholic hepatitis is a common cause of high blood bilirubin.
• Tumors affecting the liver, bile ducts or gallbladder can be the cause of build up of bilirubin in blood.
• Some drugs and medication, especially antipsychotic drugs or drugs containing sex hormones, drugs used during chemotherapy can cause high bilirubin levels.

• Elevated bilirubin levels are noticed if one is suffering from Gilbert's syndrome, benign familial disorders of bilirubin metabolism.
• Primary sclerosing cholangitis (progressive inflammation of the bile ducts inside and outside the liver, followed by scarring and destruction of the duct) is responsible for an increase in bilirubin levels.

• Decreased food intake, loss of appetite
• Frequent fever
• Nausea, vomiting
• Abdominal swelling or pain
• Dark yellow, amber-colored or brownish urine
• Urine may have strong smell

• Low energy level, excessive fatigue and general malaise
• Pale or clay colored stools
• Abnormal itching sensation
• Skin and whites of the eyes turn yellow

'Yellowish skin' is one of the main symptoms of elevated levels of bilirubin in newborns. High pitched cries and poor feeding can be observed when high bilirubin levels disturb the body mechanism. Raised bilirubin levels are common in premature babies at the time of birth.

In adults, it can be a sign of serious liver disease and can result in fatigue, swelling of the ankles, muscle wasting, ascites (fluid accumulation in the abdominal cavity), mental confusion or even coma and bleeding into the intestines.

Dogs and cats also can suffer from increased level of bilirubin. In that case, pet-lovers have to rush to veterinarians for consultation and prompt treatment.

• No medical treatment is required for hepatitis A. It generally resolves on its own.
• Gallstones and stones in the liver can be removed surgically. Liver transplant can be the option to treat dysfunction of liver, in severe cases.

• Treatment for cancer or for metastatic liver cancer depends upon the severity of the condition and overall health of the person.

• Doctors need to study the history of the patient. Alcohol abuse or use of injectable drugs leading to viral hepatitis, history of gallstones, narrowing of bile duct can be confirmed by the doctor, after performing several tests. The doctor can plan the treatment accordingly.

• Elevated levels of bilirubin can be treated with the help of home remedies, if the condition is not much serious. One should drink 'barley water' several times during a day. It is the easiest and the best remedy for this disorder.

• Here is a simple way of making barley water at home. Make 'barley water' by boiling one cup of barley in three liters of water for three hours, on a low flame. This magic potion works great for high bilirubin levels.

• There is no need of any special treatment for mild rise in bilirubin levels or mild hyperbilirubinemia in newborns. To treat moderate hyperbilirubinemia, undressed newborns are required to be placed under bilirubin lights where only the eyes are shielded with a blindfold to avoid damage.

• These days, fiber-optic bilirubin blankets which help expose the skin of the newborns to the light are available in the market.
• In case of newborns, if phototherapy does not lower the level of bilirubin in the blood, then blood transfusion is the option which helps bring back the bilirubin levels to normal position. But, this is rarely required.
  
  

Most of the time, patients do not experience any symptoms of elevated bilirubin levels. Patients are usually surprised to see high levels of bilirubin levels in their reports, as there is no yellowing of skin or eyes. Regular medical checkup helps detect abnormal bilirubin levels at an early stage.

Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.