Anyone who has hepatitis (liver inflammation from any of 40+ different
reasons), or hepatitis virus (like Hepatitis A,B,C,Etc) should have
more blood testing done on a scheduled basis.
You see, when the liver cells become damaged, the immune system
of the body will respond to this damage and cause inflammation
to develop inside the liver. This is hepatitis. The only way to be
sure that the liver is no longer enlarged because of this inflammation
is with blood testing and possibly ultrasound or Ct scan.
Bilirubin is a substance that is made from our dead red blood cells.
This is usually done by the spleen and transported to the liver on
a protein. The liver takes this substance and converts it to a
soluble form to become part of the bile. The bile/bilirubin then
flows through tube like structures, known as ducts, from inside
the liver to the gallbladder and then to the common bile duct
to the intestines to help emulsify the fats we eat so they can be
digested and absorbed. This bilirubin is known as a pigment
( a greenish/brownish substance) that tend to color other things.
When the liver cells are so damaged, it may not get converted or
if there is an obstruction/malformation/infection of the bile
ducts, it may back up into the liver. Then it goes out into
the blood and has to reach a certain level before
Jaundice would occur (yellowing of the whites of the eyes
Even though, the bilirubin level went down some into the
normal range...it is at the higher end of normal and also
your labs results (are not 100% accurate and chance
constantly) and only give the doctor an idea of how you are doing.
You should be with a gastroenterologist or hepatologist
now and have blood tests that check for the virus
(if that is the cause) or the hepatitis (inflammation of
the liver cells). This is preventive method of being
sure that it hasn't turned into death of the liver cells
and scar tissue formation developing inside the liver
(Cirrhosis of the liver).
A liver biopsy is the best test to have done. The doctors
look directly at the tissue of the liver itself to tell how
far advanced a patient may be in this disease and
not just blood tests results or films (pictures) of the liver.
Best wishes to you.
caregiver to a liver transplant patient