raised bilirubin levels

My daughter, now 35, had a splenectomy at aged 5 years because of inherited spherocytosis.  For the last few years she has had undiagnosed abdominal pain, nausea, and fatigue periodically.  Recently she has had raied bilirubin levels. Could there be a connection, do you think, to her blood disease?   The doctor is not doing any more blood tests or follow up.

[Thomas D Schiano, MD]

there could still be some hemolysis going on or there could be gallstones present.  Very often the gall bladder is removed at the time of the splenectomy. the bilirubin level should be fractionated--a raised indirect fraction suggests hemolysis.