What to do if both direct and indirect bilirubin are elevated

Increased direct and indirect bilirubin may be seen in liver disease, hemolytic disease, or biliary tract obstruction. Liver disease should be treated with hepatoprotective drugs such as dicyclomine to address the cause of liver injury; hemolytic disease can be treated with glucocorticoids; and biliary tract obstruction often requires surgical treatment. 1. Liver disease: if the increase of direct bilirubin and indirect bilirubin is about the same, it is the possibility of liver disease, such as chronic hepatitis B, alcoholic hepatitis, drug liver injury, cirrhosis, etc., liver-protecting drugs can be given, such as bisabolol, magnesium isoglycyrrhizinate, etc., and should also be treated for the cause of the disease, for example, hepatitis B should be applied to entecavir, and the drug liver should stop using the drug to injure the liver. 2. Hemolytic disease: If the increase of indirect bilirubin is greater than the increase of direct bilirubin, the possibility of hemolytic disease, such as hemolytic anemia, treatment includes glucocorticoids, immunosuppressant, immunosuppressant is commonly used cyclophosphamide, splenectomy if necessary. 3. Biliary tract obstructive disease: If the increase of direct bilirubin is larger than that of direct bilirubin, it is considered that the possibility of biliary tract obstructive disease is large, such as gallstones, pancreatic head cancer, etc. The common treatment is surgery to relieve the obstruction. Patients with elevated direct and indirect bilirubin should go to the hospital to determine the cause of the elevation and be treated accordingly.