Q. Why the bilirubin level is not decreasing after jaundice attack?
Hello doctor,
My father is 72 years old and he is suffering from jaundice. Initially, he was admitted to hospital five months back due to dengue and his platelet count had dropped down to 15,000. Now, he has recovered from dengue but his bilirubin is not decreasing. While getting discharged from the hospital, the bilirubin count was 17.64 mg/dl. It had dropped down to 8.33 but later, it got increased to 10.33 and the current count is 9.74.
The doctor has prescribed him Silymarin 140 mg, Ursocol 300 mg, Pantocid 40 mg, A-Z vitamin and Duphalac. How can I help my father to recover quickly from jaundice?
Hello,
Welcome to icliniq.com.
I saw the report (attachment removed to protect patient identity), and in your history, you did not mention about alcoholic history of your father. Is he hypertensive? Is he on any drugs? What about hepatitis A, B and E status? What about ultrasound abdomen status and urine examination?
The possibilities are:
- Dengue hepatitis.
- Concurrent infection with dengue and hepatitis A.
- Alcoholic hepatitis with hypoproteinemia.
- Hemolytic jaundice.
It will take time to recover in old age with anemia. It may decrease immunity status and thus, will take more time to recover. Continue the above medications and get ultrasound abdomen, serum LDH (lactate dehydrogenase), Hb and viral markers status tests done. Please consult your doctor. He will examine and treat you accordingly.
Hello doctor,
The test which you have asked are all negative. The consultant doctor had told about chronic liver disease and fatty liver as my father used to drink every day but it has been more than a decade that he has left alcohol. Why is the bilirubin count sometimes increasing and sometimes decreasing? Kindly suggest.
Hello,
Welcome back to icliniq.com.
Yes, alcoholic patients are prone to develop a fatty liver disease. This fat accumulation leads to liver hepatitis. Then, this may lead to cirrhosis of liver.
I do not know the stage of fatty liver but the underlying fatty liver/chronic liver disease with dengue may be more prone to developing high bilirubin with liver cell failure. At the same time meet a gastroenterologist and continue the above medicine with low salt diet, avoid non-vegetarian diet, eat fruits with fiber diet. Let him pass stools at least 2 to 3 times a day.
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