Bilirubin - urine

Definition:
This is test measures the amount of bilirubin in the urine. Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. Large amounts of bilirubin in the body can lead to jaundice.

Alternative Names
Conjugated bilirubin-urine; Direct bilirubin-urine

Why the Test is Performed

This test may be performed when liver or gallbladder problems are suspected.

How the Test is Performed

For this test, you must urinate into a special bag or container every time you use the bathroom for 24-hour period.

On day 1, urinate into the toilet when you wake up in the morning. Close the container tightly. Keep it in the refrigerator or a cool place during the collection period. Urinate into the special container every time you use the bathroom for the next 24 hours. On day 2, urinate into the container in the morning again when you wake up. Label the container with your name, the date, the time of completion, and return it as instructed.

For an infant: Thoroughly wash the area around the urethra (the hole where urine flows out). Open a urine collection bag (a plastic bag with an adhesive paper on one end). For males, place the entire penis in the bag and attach the adhesive to the skin. For females, place the bag over the two folds of skin on either side of the vagina (labia). Put a diaper on the baby (over the bag). The infant should be checked frequently and the bag changed after the infant has urinated. Empty the urine from the bag into the container provided by your doctor. Because lively infants can cause the bag to move, this procedure may take a couple of attempts. Extra collection bags may be necessary. When finished, label and return the container as instructed.

How to Prepare for the Test

No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary. A health care provider will tell you whether or not to discontinue any drugs or activities that may interfere with the test. (See "Special Considerations," below.)

How the Test Will Feel

The test involves only normal urination, and there is no discomfort.

Risks
There are no risks.

Considerations
Bilirubin can breakdown in the presence of light. That's why babies with jaundice are sometimes placed under blue fluorescent lamps. See Bili Lights. Drugs than can falsely elevate the test result include allopurinol, some antibiotics, barbiturates, chlorpromazine, diuretics, ethoxazene, oral contraceptives, phenazopyridine, steroids, and sulfonamides. Drugs that can cause false negative results include indomethacin and ascorbic acid.

Normal Results
Bilirubin is not normally found in the urine.

What Abnormal Results Mean

If the bile ducts are obstructed, direct bilirubin will build up to a high enough level that some of it will escape from the liver into the blood. If the levels are high enough, some of it will also appear in the urine. Only direct bilirubin appears in the urine. Increased direct bilirubin usually means that the biliary (liver secretion) ducts are obstructed. Increased urinary bilirubin may indicate:

biliary strictures cirrhosis gallstones in the biliary tract hepatitis with associated biliary obstruction surgical trauma affecting the biliary tract tumors of the liver or gall bladder