My bilirubin level is high and I feel nauseous. Why?

Hi,

Welcome to icliniq.com.

Symptoms you have mentioned may occur due to liver disease, stomach problem or esophagus related. For differentiation in these entities, we need detail discussion by message or by phone.

Apart from the discussion, your bilirubin is elevated but the liver function test is incomplete, we need more information (e.g.) SGOT, SGPT, ALP, proteins, PT, APTT, and INR.

I need answers for the following questions: You are afraid of eating all the time, but why? It is due to difficulty in swallowing? Or it is due to burning epigastrium? Pain in abdomen or vomiting? What is the onset of these symptoms? Do you take alcohol? Dou you have constipation? jaundice? family history of constipation or similar illness?

Advice.

1. Continue Pentate (Pantoprazole and Domperidone) 40 mg half an hour before meals once a day.

2. Avoid fatty meals.

3. Take syrup Gelusil 5 ml with each feed intake. Take syrup Zeva (multivitamin) 5 ml two times a day. Avoid milk for sometime especially do not take in the morning hours.

4. Do regular exercise.

5. Get done LFT (liver function test) with the above mentioned tests, if there is abnormality then we will plan further tests.

Provide details about question marked symptoms. Report back with the report and detailed information or can discuss by phone.

Hi,

Welcome back to icliniq.com.

I have seen your reports. (attachment removed to protect patient identity).

Your report is normal except for the mild elevation of bilirubin, otherwise, liver enzymes and proteins are normal. We will follow it furtherly. This kind of symptom occurs due to acidity or infection in the stomach (common is H.Pylori) or due to ulcer in the stomach or duodenum. For this, we need to give PPI (proton pump inhibitors) and antibiotics for three week duration and the success rate will be good. If it does not respond then we will plan a further investigation. I will advice first line appetite stimulators. If appetite does not increase, furtherly we can start on second line appetite stimulators. Advice.

1. Tablet Lansaprazole 30 mg half an hour before the meal two times a day for eight weeks, then we will decrease the dose of this medicine and stop.

2. Tablet Amoxicillin 1000 mg, one tablet two times a day for three weeks.

3. Tablet Clarithromycin 500 mg two times a day for three weeks.

4. Avoid fatty meal, spicy meal and alcohol.

5. Take syrup Gelusil 5 ml with each feed intake. Take syrup Zeva 5 ml two times a day. Avoid milk for sometime especially do not take in the morning hours.

6. Do regular exercise.

Report back after two weeks with detailed information. Provide any other reports if available.