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Does A High Bilirubin Count With IBS Symptoms Indicate Gilbert's Syndrome?
Question: I've had a very stressful 2 months, not getting enough sleep, or drinking enough water. I've had stomach upsets pop up during times of stress since I was a kid.
2.5 weeks ago I had a bad epigastric stomach ache that lasted all night. I had eaten a a spicy quesadilla from a drive through earlier that evening. No relief from antiacids.
Went to urgent care but it seemed to resolve pretty quickly that morning just before going.
Drs thought gallbladder could be probable and ordered bloodwork and an abdominal ultrasound. My bloodwork from that day (fasting at just over 12 hours) showed a bilirubin of 1.0. Dr wanted to investigate "high" bilirubin.
Abdominal ultrasound was completely normal except they couldn't see my gallbladder. All other organs looked normal and measured normally.
I had a follow up set of labs from my primary care and was fasting at around 17 hours for that bloodwork. My bilirubin was 2.1 and that was about 5 days after first set of bloodwork. All other bloodwork in normal ranges including other liver related ones.
No dark urine, no light stools, no yellow eyes or skin.
I've been extremely anxious and having some ibs type symptoms (diarrhea/soft stools and then constipation and then soft stool again. No repeat on the actual original stomach ache though. Mostly, just worrying something serious is going on. Unfortunately not sleeping great either, partly due to anxiety, partly due to young kids and partly due to a crazy work schedule.
I just had a repeat liver panel non fasting today to see if that changes things and to ensure it's not increasing still. Haven't heard results yet.
Does this sound like it could be Gilbert's Syndrome? If it was gallbladder wouldn't I have other liver tests high or still have pain?
2.5 weeks ago I had a bad epigastric stomach ache that lasted all night. I had eaten a a spicy quesadilla from a drive through earlier that evening. No relief from antiacids.
Went to urgent care but it seemed to resolve pretty quickly that morning just before going.
Drs thought gallbladder could be probable and ordered bloodwork and an abdominal ultrasound. My bloodwork from that day (fasting at just over 12 hours) showed a bilirubin of 1.0. Dr wanted to investigate "high" bilirubin.
Abdominal ultrasound was completely normal except they couldn't see my gallbladder. All other organs looked normal and measured normally.
I had a follow up set of labs from my primary care and was fasting at around 17 hours for that bloodwork. My bilirubin was 2.1 and that was about 5 days after first set of bloodwork. All other bloodwork in normal ranges including other liver related ones.
No dark urine, no light stools, no yellow eyes or skin.
I've been extremely anxious and having some ibs type symptoms (diarrhea/soft stools and then constipation and then soft stool again. No repeat on the actual original stomach ache though. Mostly, just worrying something serious is going on. Unfortunately not sleeping great either, partly due to anxiety, partly due to young kids and partly due to a crazy work schedule.
I just had a repeat liver panel non fasting today to see if that changes things and to ensure it's not increasing still. Haven't heard results yet.
Does this sound like it could be Gilbert's Syndrome? If it was gallbladder wouldn't I have other liver tests high or still have pain?
Brief Answer:
Can be Gilberts.
Detailed Answer:
Hi,
Thanks for query dear patient.
Usually a patient might not know they have the condition called gilberts until it's discovered by accident, such as when a blood test shows elevated bilirubin levels.There are two types of bilirubin in your blood i.e conjugated and unconjugated bilirubin.In case of gilberts there is unconjugated bilirubinemia with normal liver function tests.As per the narration given by you your bilirubin 2.1 is elevated but it has no clinical significance as bilirubin levels less then 3mg/dl are not significant.
Now to diagnose gilberts you should go for serum indirect bilirubin test with liver function test.
If serum indirect bilirubin is higher with normal liver functions as per standard text you have gilberts syndrome and no further evaluation is required.
However genetic mapping can be done to confirm it.
Aa per query regarding gallbladder-
Bilirubin and the enzyme alkaline phosphatase are usually elevated in acute cholecystitis, and especially in choledocholithiasis.Levels of liver enzymes known as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are elevated when common bile duct stones are present.Jaundice is also usually clinical i.e bilirubin is more then 3 mg/dl.So i don't feel its your case.
Suggestion-
Go for a CT abdomen any gallbladder pathology would be apparant in it.
Repeat a liver function test and serum total direct and indirect bilirubin.
You will get your answer as soon as we have the results!
Hope i was helpful my dear.
Warm regards.
Can be Gilberts.
Detailed Answer:
Hi,
Thanks for query dear patient.
Usually a patient might not know they have the condition called gilberts until it's discovered by accident, such as when a blood test shows elevated bilirubin levels.There are two types of bilirubin in your blood i.e conjugated and unconjugated bilirubin.In case of gilberts there is unconjugated bilirubinemia with normal liver function tests.As per the narration given by you your bilirubin 2.1 is elevated but it has no clinical significance as bilirubin levels less then 3mg/dl are not significant.
Now to diagnose gilberts you should go for serum indirect bilirubin test with liver function test.
If serum indirect bilirubin is higher with normal liver functions as per standard text you have gilberts syndrome and no further evaluation is required.
However genetic mapping can be done to confirm it.
Aa per query regarding gallbladder-
Bilirubin and the enzyme alkaline phosphatase are usually elevated in acute cholecystitis, and especially in choledocholithiasis.Levels of liver enzymes known as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are elevated when common bile duct stones are present.Jaundice is also usually clinical i.e bilirubin is more then 3 mg/dl.So i don't feel its your case.
Suggestion-
Go for a CT abdomen any gallbladder pathology would be apparant in it.
Repeat a liver function test and serum total direct and indirect bilirubin.
You will get your answer as soon as we have the results!
Hope i was helpful my dear.
Warm regards.
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Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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