Conversation: The conversation between human and AI assistant.
[|Human|] My 17 year old has an elevated direct bilirubin level of 0.4. Additionally, in the past 2 months, he has experienced 3 different episodes of a few hours of severe vomiting and diarrhea, no fever, feels fine after episode is over. Each time it begins in the very early morning hours (3 - 5 am). Thoughts or ideas?
[|AI|]  Welcome to Chat Doctor. Thank you for posting your query. I can understand your concern for your son. A direct bilirubin of 0.4 is not a thing to worry. The recurrent episodes of vomiting and diarrhea are a thing to be concerned of. He could have Gastroesophageal reflux disease, gastritis or gall stone disease. It is difficult to point out a diagnosis without actually examining him. I would suggest you to - not worry-Get an ultrasound of the abdomen done-Get his blood Liver function test, Hemoglobin, total count, ESR, amylase, lipase done-Get an upper GI endoscopy donged him to visit a gastroenterologist. He/she can examine him and correlate clinically. Hope this helps. Have a nice day. Regards.