Bilirubin in Urine: What Test Results Mean

Bilirubin in urine test is a routine test that is usually included in a regular urinalysis. However, having high levels of it is anything but routine.

Bilirubin in Urine

Your physician might have specifically requested for bilirubin in a urine test.  This is a routine test that is usually included in a regular urinalysis. However, having high levels of it is anything but routine.  Read more to know about this test and what the results could possibly mean.


What Bilirubin Is

Bilirubin are remnants of the natural breakdown of red blood cells.  Yellowish orange pigment in appearance, it is excreted during bowel movement.  Having bilirubin in urine could spell trouble. This might mean that you red blood cells are not breaking down at the ideal rate.  It could also mean that your liver is not working properly. Both may be symptoms of serious conditions that is why once bilirubin is detected in urine, more tests will be requested to pinpoint the actual cause of such situation.

Bilirubin comes in different forms:

  • Indirect or Unconjugated.  This is bilirubin coming straight from red blood cells once they are broken down.  
  • Direct or conjugated.  This is bilirubin found in the liver.  It moves to your intestines ready for expelling.  


Why Get a Bilirubin Test

Bilirubin in urine test, as said earlier, is part of any regular urinalysis.  However, if it is specifically requested by your doctor, it might mean that you are exhibiting signs of liver concerns.  Bilirubin in urine test is usually required if a patient shows the following signs:

  • Persistent fatigue or lethargy
  • Incessant abdominal pain
  • Yellowing of eyes and skin (jaundice)
  • Dizziness
  • Vomiting
  • Dark-colored urine

It could also be prescribed by your physician if any of these conditions apply to you with or without exhibiting symptoms:

  • Hepatitis virus exposure
  • Liver disease in genetic history
  • Alcoholism
  • Obesity
  • Maintenance of medication known to negatively affect the liver
  • Diabetes
  • Stool that look like clay

All these are risk factors of developing liver problems.  Since presence of bilirubin in the urine signal possible liver problems without symptoms manifesting yet, you can definitely get a step ahead and gain access to appropriate medical intervention.  This way, you can properly address the problem even before symptoms worsen and become more difficult to treat.

A bilirubin in urine test is also asked for the following situations:

  • Determine if treatment is working
  • Identify if there is block particularly in the bile ducts of your liver
  • Determine if there is a problem with your red blood cells
  • Monitor progression of certain conditions particularly that which affect the liver
  • Identify the severity of toxicity of whatever drug or medication that has been taken in
  • Rule out or confirm hepatitis, cirrhosis, sickle cell disease, hemolytic anemia, and gallstones


The Test

Preparing for the test

Bilirubin in urine tests are quite easy to take.  This is because you do not have to do much to complete it.  You might be requested to fast, however. Check with your physician regarding the needed preparation for the test you are about to undertake.  

What happens during the test

Testing for bilirubin in urine follows the same procedure as a regular urinalysis:

  • Patient is requested to clean the urinary opening.  
  • He or She should then urinate into the toilet.
  • By midstream, collect urine with a container.  About one to two ounces will do.
  • Once done, continue urinating into the toilet until finished.
  • Submit container with freshly collected urine to the doctor.
  • Urine will be sent to a laboratory for analysis.  This will include bilirubin in urine.


High Bilirubin in Urine

To identify whether there is a bilirubin level that exceeds the normal range, the doctor compares results with the following standard count:

  • For adults, not more than 1.2 mg/dL
  • For children, not more than 1 mg/dL

If there are elevated levels of bilirubin in your urine, it could mean any of the following conditions:

  • Gallstone development
  • Toxicity in drugs
  • Hepatitis
  • Liver disease caused by too much drinking
  • Blood transfusion problems
  • Anemia
  • Cirrhosis
  • Hemolytic anemia
  • Gallbladder or Pancreatic cancer

One also has to note regarding Gilbert syndrome.  This genetic condition inhibits the production of the enzyme that spurs bilirubin breakdown.  

For infants, high level of bilirubin might mean:

  • Infection
  • Problems with the liver
  • Lack of oxygen
  • Incompatibility of blood type between mother and child


Other Tests

Once there are elevated levels of bilirubin in urine, you might be asked to do further confirmatory tests.  These include the following:

  • Liver biopsy
  • Imaging tests with an MRI scan, ultrasound, and/or CT scan
  • Endoscopy
  • Blood tests (these are more reliable than urine tests)
  • Complete physical exam


What You Can Do

A low level of bilirubin in urine does not have any significant impact.  If it is high, it is a completely different story. More tests will have to be made (as specified above).  Treatment would largely depend on the cause of the bilirubin spike. This is usually a combination of medication and a major lifestyle change.  Surgery might be needed for more serious cases.

Some infants might experience high levels of bilirubin.  This is called hyperbilirubinemia. For some cases, this condition is not so severe and in due time, it subsides.  However, if it persists, you have to tell your doctor right away especially since high bilirubin can cause brain failure among infants.  Intervention might include medication, phototherapy, and lactation adjustment.

Bilirubin in urine tests is one essential test everyone should take periodically.  Since it is primarily diagnostic in nature, through it, you can already identify the presence of certain conditions.  This way you can already address the problem even before it begins.

It is essential, however, to keep your doctor in the loop.  He/She will be the one diagnose after all battery of tests have been undergone by the patient.  Your doctor will also be the one to identify the appropriate medical intervention to take. By understanding the results of your bilirubin in urine test, you can now chart your path towards complete healing and recovery.

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