If your high bilirubin is related to Choledocholithiasis or presence of gall stones in the bile duct or
A very large obstruction in the bile duct,
I might also have some type of bile duct problem due to high bile acids level.
"Diseases of the biliary tract system, which transports bile to the gallbladder, can cause obstruction of bile flow with a resultant buildup of circulating bilirubin. Obstruction of bile flow is termed cholestasis. Possible causes of cholestasis within the liver include primary biliary cirrhosis, primary sclerosing Cholangitis , sarcoidosis, Sjögren's syndrome and pregnancy. Bile flow obstruction can also occur outside the liver. Possible causes include Gallstones blocking the release of bile into the intestine, gallbladder or bile duct cancer, cysts, Cholangitis , pancreatitis, pancreatic tumors and narrowing of the bile transport ducts, or bile duct strictures."
Causes of elevated bilirubin in adults are as follows:
Tumors affecting the gall bladder, liver or bile ducts could be responsible for elevated levels.
An allergic reaction to the blood received during a transfusion can also cause the levels of bilirubin to rise in adults.
Cirrhosis of the liver is another reason for elevated bilirubin levels.
Acute hepatitis caused by Hepatitis A and Hepatitis B is another reason.
Hemolysis - red blood cell destruction.
Liver failure or any liver disease that worsens over a period of time.
Choledocholithiasis or presence of gall stones in the bile duct
A very large obstruction in the bile duct.
Blood related disorders like sickle cell anemia can cause rapid destruction of the red blood cells and thus cause elevated levels.
Chronic liver disease such as chronic hepatitis C, hemochromatosis, nonalcoholic steatohepatitis, autoimmune hepatitis, alcoholic hepatitis also cause elevated bilirubin levels.
Dubin-Johnson syndrome, Gilbert's syndrome, Rotor's syndrome and other inherited disorders of bilirubin metabolism cause the levels to rise as well.
Crigler Najjar syndrome or another rarely found disorder which affects the metabolism of bilirubin. Antibiotics and some medicines like phenytoin, indomethacin, flurazepam, diazepam and some kinds of birth control pills can also give rise to elevated levels.