Question 1

I have been undergoing treatment for jaundice for the past 1.5 months, but my bilirubin levels are increasing. My current results are: Total bilirubin 20.0, Direct 9.9, Indirect 10.1. On May 30, my levels were: Total 7.8, Direct 3.0, Indirect 4.8. I am taking the following medications: Heptral once a day, Udiliv three times a day, Silybon syrup three times a day, Zevet two times a day, Pan D once a day, Atrax once a day. What should I do next?

Question 2

I have been suffering from acute Hepatitis E infection for the past 3 weeks. My liver enzymes have decreased significantly but are still above the normal range. However, my bilirubin has remained very high at 18 for the past 2 weeks, having risen from 2.13 to 6.23 to 18.77. My attending physician has suggested steroids to help reduce bilirubin. Are steroids safe to use in this situation, and if taken, is there a risk of a rebound increase in bilirubin after a few days or weeks? My PT/INR had also increased but is now normal. Please advise on whether I should take steroids.

Question 3

Hi, I am very tense as my report shows high PDW, high RDW, low PCT, and high bilirubin. Please see the report and tell me whether this is very serious. I had a kidney stone problem, and most stones were expelled through urine; only one small stone is left. I am having gastric issues. Three months ago, I had severe gastric problems, but after taking rabeprazole for 45 days, the symptoms decreased. My KFT and iron reports are normal. Please advise?

Mildly elevated bilirubin (mainly indirect) may suggest Gilberts syndrome or transient liver stress. Its not serious if liver enzymes are normal and there are no symptoms. Stay hydrated and avoid alcohol.

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