### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i am 23 year old male i have had jaundice once when i was born and 2nd time at the age of 14 and now again i am suffering from jaundice i have done my blood test in which serum bilirubin total and direct are above the normal levels AL-T(SGPT) is 2245 out of 30-65 ,gamma gt (ggt)149 and alkaline phosphatase 151 .my current doc has kept my case under observation i wanted to have a second opinion i am currently suffering from nausea which makes me really uncomfortable .

### output:

Hi there, thanks for putting your faith in Chat Doctor. I would rather appreciate you for a more concise and detailed note of your history. However, I would have preferred to know the bilirubin levels though, as well as any associated symptoms like itching, decreased appetite or vomiting you experience along with increased levels of bilirubin as jaundice is a symptom which is basically the rise of the yellowish pigments (bilirubin in your body) which are normally converted by liver in soluble forms and excreted into your gut to be excreted out of your body with the stools. The first such incidence of its rise which you experienced in your neonatal life which resolved itself is a type called physiological jaundice, and it is not considered to be a disease, so you need not worry about that, but the second incidence in your adolescence might be because of acute hepatitis which in the majority of cases is viral. But its recurrence is a bigger concern for me as it needs a detailed evaluation to rule out any other cause of chronic liver disease. Though such higher levels of ALT are usually present in Hepatitis A or E which resolves by itself between 1-2 weeks approximately. Your GGT levels indicate around 5 times of the normal levels of your age group which is suggestive of intrahepatic homeostasis or inflammatory hepatitis again favoring an acute inflammatory cause which is likely viral mostly and is water born disease with self remission. If these levels were as high as 10-30 times we would have suspected any obstruction of bilirubin outflow (aka biliary tract diseases) which are unlikely in your case. Also, that there are some diseases which interfere in conversion of insoluble bilirubin into soluble ones or in the excretion inside liver cells due to enzyme deficiencies, which when present or detected in adolescence or afterwards is Gilbert's disease in most of the cases which needs monitoring only along with symptomatic care with no long term treatment need. If I were your physician I would have ordered viral sexologies for hepatitis, along with an ultrasound for liver size and structure as well as outflow tracts from liver and their patency, along with an albumin globulin ratios. I would also have been interested to know synthetic functions of your liver by monitoring INR to see for any need of vitamin K supplementation. The ideal treatment is rest, Fluids, HY Chat Doctor.  Also, that if you were experiencing and symptoms of itching, decreased intake, severe vomiting or 