Bilirubin levels are high

[viveksincos]

Hello,

I just happen to get some blood tests done on the 25th of Jan 2015, as we had a camp in our society.

25th Jan 2015
Direct Bilirubin:0.4 mg/dl
Indirect Bilirubin: 1.4 mg/dl
SGOT: 37.8 u/l
SGPT: 31.8 u/l
LDL Cholestrol: 149 mg%

16th Feb 2015
Direct Bilirubin:1.5 mg/dl
Indirect Bilirubin: 0.9 mg/dl
SGOT: 80.0 u/l
SGPT: 99.0 u/l

On 16th Feb 2015, I got Whole abdomen Ultrasound done, and all was well except that Liver was found to be mildly enlarged, Grade I fatty infiltration.
On 17th Feb 2015, I got myself tested for Hepatitis A, C and Australia Antigen, and all were negative.

13th Mar 2015
Direct Bilirubin:1.2 mg/dl
Indirect Bilirubin: 0.8 mg/dl
SGOT: 80.3 u/l
SGPT: 52.2 u/l

21st Mar 2015
Direct Bilirubin:0.33 mg/dl
Indirect Bilirubin: 0.81 mg/dl
SGOT: 35.9 u/l
SGPT: 28.2 u/l

09th April 2015
Direct Bilirubin:1.21 mg/dl
Indirect Bilirubin: 0.20 mg/dl
SGOT: 52.6 u/l
SGPT: 35.7 u/l

Since mid February 2015, I have been doing walk of around 3-4 kms daily and taking minimum oily food, and having fruits (papaya/banana/apple) only for lunch.

With your experience, what can be the issue with raised levels.
Thanks for the help,
Vivek (Delhi-NCR)

[viveksincos]

Thank you sir for the quick reply, just wanted to add that I am taking 2 tablets of Hepamerz 3 times a day, and 2 tablets of Liv 52 2 times a day as the same has been prescribed by my doctor.

[fntn]

Clearly you have some type of a partially impeded bile flow issue. Your indirect bilirubin levels are staying normal, which means your liver is doing it's job. But the problem arises after the bile leaves your hepatocytes and before your bile makes it to your GI tract (duodomen). And, the obstruction is mild since your directed bilirubin levels are relatively modest in elevation and as well as your liver enzymes.

Since they didn't see anything with the US other than a mildly enlarged liver (which is expected with fatty livers), and if it's a stone, then it has to be a small one. Another benign possibility would be a sphincter of Oddi problem. There's no way of knowing what it is of course, so work with your doctors, and hopefully they'll be able to finish tracking things down for you. Be well!