Liver cirrhosis and Bilirubin levels

Dear Ask The Doctor:  In a patient suffering with Cirrohsis, who has came a very long way in the past 5 months i.e. all blood counts seem to be going in the right direction except for the bilirubin which was near 200 when first admitted to hospital the lowest it has dropped to is 47 but for the past few weeks it is slowly rising again. Why would the bilirubin be rsing if everything else seems to be getting better? Your help would be much aprreciated. Thank you
 
Dear Patient:  Liver cirrhosis is a chronic condition in which the liver cells get damaged and continue to deteriorate inspite of treatment. The only definitive treatment for the same is liver transplant or correcting the cause which is leading to the cirrhosis which in most cases is impossible .As liver cirrhosis progresses the livers capacity and capability to conjugate the indirect bilirubin and convert it into direct bilirubin which is then excreted by the kidneys decreases progressively. If the causative factor leading to the cirrhosis is not corrected ( for example alcohol intake, hepatitis , gall stones, pancreatic cancer) then the bilirubin will keep rising. I hope this helps answer your query. All the best.

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