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Gastroenterology (Expert Forum)
Bilirubin
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Bilirubin
by kjjinmd, Jun 18, 2004 12:00AM
My mom who is 77 years old went to E.R. on May 25 for severe pains and has been in the hospital since. They were going to remove her gall bladder the next day but it was determined that a stone was blocking her bile duct and the next day they surgically went in to remove the stone. the following day they performed the gallbladder surgery and determined that it had burst and toxins had poisoned her body. Her bilirubin was over 20 and she spent 12 days in ICU under sedation. We feared she wouild not wake up but she did. She is not herself and sometimes does not know where she is, who people are, dates, etc. The problem is she is still extremely yellow and her Bilirubin No. is 19 and the Critical care doctor, gastro(sp) doctor and 1 other doctor are totally perplexed over her situation. They said they have never had a situation like this. My question is, is there a specialist in the Washington DC/Maryland suburbs on Bilirubin and liver diseases that we can get involved in this situation as she is not getting any better and until her E.R. visit, she was extremely healthy and had an extremely healthy heart. She has never been sick and for her not to respond is perplexing to us. The doctors have admittedly said they are confused and bewildered at her situation. She is on a feeding tube and has no strength or energy for lack of food. She sleeps so much, has become very itchy and like I said very yellow. Please provide me with any suggestions we desperately need. Thank you.
Doctor's Answer
by Kevin Pho, MD, Jun 19, 2004 12:00AM
, Jun 19, 2004 12:00AM
Certainly a transfer or referral to a major academic medical center should be considered for another opinion. There are plenty in the DC/Maryland area (i.e. George Washington University, University of Maryland medical center).
The itchiness and jaundice is very likely due to the elevated bilirubin. I'm sure that these are being considered, but an MRCP/ERCP should be repeated to ensure there is no bile leak, as well as further imaging of the liver and gallbladder (i.e. with an ultrasound or CT scan) should be considered.
Other causes of elevated bilirubin would be hemolysis (i.e. breakdown of red blood cells). If the GI causes have been ruled out (i.e. with aforementioned tests being normal), then this can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
The itchiness and jaundice is very likely due to the elevated bilirubin. I'm sure that these are being considered, but an MRCP/ERCP should be repeated to ensure there is no bile leak, as well as further imaging of the liver and gallbladder (i.e. with an ultrasound or CT scan) should be considered.
Other causes of elevated bilirubin would be hemolysis (i.e. breakdown of red blood cells). If the GI causes have been ruled out (i.e. with aforementioned tests being normal), then this can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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Get her on colonic hydrotherapy treatments which will aid in removing excess biliurbin in her body and help remove other excess toxins and take a lot of the pressure off of her liver. Get her to take milk thistle (a natural option) to aid her liver and you may want to consider adding a supplement such as wild rose lower body tonic to speed up the process (www.wildrose.com). There will be a colonic hydrotherapist in your area, it will likely cost between 50-80USD/treatment, you'll probably want her to have at least 12 treatments, the first few could be done a couple days a part, after that 1 week apart. This will also help remove all those prescription drugs from her body so that she can have some proper brain/bowel function and eventually hopefully restoring her immune system..
Oh and lots of water and lots of fiber.
I hope everything turns out.