Bilirubin in Urine - Normal Range, Causes, Color, Symptoms

Bilirubin is not supposed to appear in the urine. The appearance of bilirubin in urine is called Bilirubinuria. The presence of bilirubin crystals in urine or bilirubin in urine is not regular and indicates a liver problem. 

A bilirubin test is usually done to check whether the liver is healthy. It may also be done to check for any blockage in the liver, gallbladder and bile ducts, diagnose jaundice and anaemia, and monitor if the treatment works effectively. 

The lab technician or nurse will provide the patient with a container and a cleansing wipe to perform a bilirubin urine test. Before collecting urine, the hands are to be washed properly, and the genital area is to be cleaned with a cleansing wipe. Then the patient has to urinate in the toilet for a few seconds, hold their pee, place the container close to the genital and urinate in it.

An ounce or two of urine is to be collected in the container. After urinating, the container will be handed over to the technician or nurse for further testing. A healthy person should not have any bilirubin in the urine. If bilirubin in urine is found, the patient will have to undergo blood tests to check their level and liver function. An adult's normal range of conjugated bilirubin is from 0–0.4 milligrams per deciliter (mg/dL). 

Unconjugated bilirubin (indirect) and conjugated bilirubin (direct) are the two types of bilirubin. Since unconjugated bilirubin solubilises in fat but is insoluble in water, it cannot be excreted by the kidneys and cannot be found in urine. Conjugated bilirubin, on the other hand, is soluble in water, making its excretion by the kidneys possible. Hence, the bilirubin seen in urine is mostly in its conjugated form, i.e., Bilirubinuria is the presence of conjugated bilirubin in the urine. 

Bilirubinuria usually indicates an underlying cause that has led to conjugated hyperbilirubinemia (a condition with excessive accumulation of conjugated bilirubin in the blood). Some of the reasons for bilirubin in urine include the following:

1. Viral Hepatitis
2. Alcoholic hepatitis 
3. Drug-induced hepatitis 
4. Autoimmune hepatitis
5. Ischaemic hepatitis 
6. Wilson disease
7. Liver Cirrhosis
8. Biliary stricture
9. Gallstones
10. Biliary atresia
11. Intrahepatic or extrahepatic malignancy
12. Hereditary syndromes like Dubin-Johnson syndrome or Rotor syndrome

Certain risk factors may cause an increase in a person’s risk of developing a liver condition or liver damage. The appearance of bilirubin in urine or the presence of bilirubin crystals in the urine may be because of these risk factors:

1. A family history of liver conditions 
2. Being obese 
3. Being diabetic 
4. Consumption of medications that might induce liver damage 

A bilirubin in urine test is usually prescribed after the patient complains of darkened urine or as a part of the patient’s routine check-up. A urine bilirubin test may also be defined if the patient shows some other symptoms apart from dark-coloured urine that might indicate a severe liver, gallbladder, or bile duct condition or problem. Some of these symptoms include the following:

1. Jaundice (yellowing of whites of the eyes and the skin)
2. Light-coloured stools 
3. Fatigue 
4. Weakness 
5. Pain in the abdomen 
6. Abdominal swelling 
7. Nausea and vomiting 
8. Repeated itching 
9. Swollen ankles and legs 

A urine bilirubin test is performed to measure the total bilirubin levels in urine. In normal conditions, there is no bilirubin present in the urine. If the urine bilirubin test shows the presence of bilirubin in urine, it might be a sign of a liver condition or disease. 

The treatment approaches for bilirubin in urine or Bilirubinuria depend upon the cause responsible for the abnormality. Depending upon the laboratory urine bilirubin test and other diagnostic test results, the healthcare provider will devise a treatment approach to treat bilirubin in urine or Bilirubinuria. 

For example, if the appearance of bilirubin in urine is due to viral hepatitis, then the healthcare provider will prescribe antiviral medications to treat it.

Bilirubin in urine is called Bilirubinuria. The presence of bilirubin crystals in urine or bilirubin in urine is not usual and indicates a liver problem. Viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, liver cirrhosis, etc., are some causes that might be responsible for the presence of bilirubin in urine.  

A urine bilirubin test is performed to measure the total bilirubin levels in urine. Treatment for bilirubin in urine or Bilirubinuria depends upon the cause responsible for the appearance of bilirubin in urine. 

If you notice any changes in the colour of the urine, do not take it lightly, as it might be due to underlying liver pathology. Reach out to a doctor right away! Our excellent team of doctors at HexaHealth will help manage your condition and treat you without hassle. So get in touch with us right now!

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