high bilirubin

At the end of April, I had blood tests done and labwork came out fine with exception of bilirubin which was 1.9. However, I was given high doses of Cipro and Flagyll for some colon inflammation found on CT Scan.  But all other organs looked fine.  After 10 days, I had a colonoscopy and the results were fine and 2 small polyps benign.  However, 3 days after the colonoscopy I developed C-difficel from the antibiotics and had 10 days of vancomyacin.  After all this I had lost about 15 pounds from 134 down to 117. I also developed intense thrush in my mouth which took alot of time to clear.  
I still did not feel right so went back to the doctor and they did blood work up and I asked for an ultrasound.  The liver tests were in normal range with exception of bilirubin again at 1.9.  However, on the follow up ultrasound they found a probable 1/2" hemangioma (echogenic focus) on my liver on the dome part.  The ultrasound was done about 2 weeks ago and have had followup blood work done.  
My liver blood tests were relatively normal with exception again of bilirubin total of 2.6 now. With such a high bilirubin, could I be going into aggressive liver disease and is high bilirubin indicative of hemangiomas?

[Kevin Pho, MD]

You have had an appropriate evaluation thus far.  The ultrasound and CT scan would rule out many of the major gallbladder and liver diseases that can cause the symptoms.  

The elevated bilirubin can be suggestive of biliary duct obstruction.  If there is no evidence of biliary duct dilatation on the ultrasound, this possibility is less likely.  However, an MRCP can be considered for further evaluation if this is still suspected.  

If every test continues to be normal except for the bilirubin, a benign hereditary disorder like Gilbert's Syndrome (a disorder of bilirubin metabolism) can be considered.

These options can be discussed with your personal physician.

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.
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