What is bilirubin?
The bilirubin test measures blood bilirubin levels. Bilirubin, the orange-yellow pigment, is a waste product from the red blood cell remodeling. Bilirubin is filtered by the liver and out of the body - usually passing through the feces and a little in the urine.
Before reaching the liver, the bilirubin is still unconjugated or not joined. In the liver, bilirubin joins with certain sugars into water-soluble conjugated bilirubin. Bilirubin is conjugated out of the liver, intestine and returns to unconjugated bilirubin on the way before the body is excreted.
Some laboratories use tests that detect conjugated bilirubin, which is also called direct. By reducing direct bilirubin from total bilirubin, unconjugated bilirubin will be obtained, namely bilirubin indirect.
Levels of direct or indirect bilirubin that can be above average can indicate some abnormalities in the liver. Usually high levels of bilirubin can indicate an increase in the rate of change of red blood cells (hemolysis).
When do I have to undergo bilirubin?
Doctors usually apply for a bilirubin test along with other laboratory tests (alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase) if symptoms of abnormal liver function are found. Bilirubin levels are needed if:
- the presence of symptoms of jaundice
- a history of excessive alcohol consumption
- have experienced symptoms of drug poisoning
- ever been exposed to the hepatitis virus
Other symptoms such as:
- concentrated urine color
- nausea or vomiting
- abdominal pain or swelling
- fatigue or symptoms that indicate chronic liver disease.
Determining bilirubin levels in newborns with jaundice is the standard of medical care.
This test can also be submitted if the patient is suspected of having or having had anemia with hemosis as a cause of anemia. Usually other tests are also needed to evaluate hemolysis, such as complete blood count, calculation of reticulocyte, haptoglobin and LDH.
Prevention & amp; warning
What should I know before undergoing bilirubin?
Usually bilirubin is measured as a "panel" from the test. Usually the liver is evaluated by several tests, which include bilirubin, alanine transaminase (ALT), asparate transaminase (AST), alkaline phosphatase (ALP), albumin, total protein and others.
Bilirubin can be measured in amniotic fluid if the doctor suspects that the unborn baby has a condition that damages red blood cells (erythroblastosis fetalis). For more information, see the topic Amniocentesis.
Bilirubin is also measured in the urine in certain cases. Usually, urine does not contain bilirubin. But if bilirubin is found in urine, other tests will be carried out to determine the cause. High levels of bilirubin in the urine can indicate that bilirubin is not removed from the body with the liver.
What should I do before undergoing bilirubin?
You must not eat or drink at least 4 hours before the test. The doctor will instruct you to stop taking drugs that can affect the test results. No special preparation is needed for children before undergoing tests.
Some drugs can affect blood bilirubin levels. Make sure the doctor knows the medicines you are taking.
Inform your doctor if you:
- is taking drugs
- allergic to drugs
- had problems with blood or consumed blood thinners, such as Aspirin, clopidogrel (Plavix), or warfarin (Coumadin)
- under pregnancy
What is the process of bilirubin?
Blood samples are needed for this test. Blood samples are taken at venipuncture, where a needle is injected into a vein in your arm, which is then stored in a test tube.
What should I do after undergoing bilirubin?
Bandages will be installed for 10 to 20 minutes. Avoid using the injected arm to remove heavy objects after undergoing the test.
Explanation of Test Results
What do the test results mean to me?
Normal results :
In children and adults, normal levels of direct (conjugated) bilirubin range from 0 to 0.3 mg /dL. Normal levels of total bilirubin (direct and indirect) range from 0.3 to 1.9 mg /dL.
In newborns, higher bilirubin levels are usually caused by stress from labor. Normal bilirubin levels in infants are generally below 5 mg /dL, but more than 60% of babies experience jaundice and bilirubin levels above 5 mg /dL. Test results can vary slightly in different laboratories, and are typical of adult men. Test results differ slightly in women and children, and results can be influenced by certain foods, medications or strenuous exercise.
Inform the doctor of the food and medicine you are taking, as well as your activities so that the test can be correctly interpreted.
High level :
High blood bilirubin levels can be caused:
- infections, such as gallbladder infections or cholecystitis
- hereditary diseases, such as Gilbert's syndrome, a condition that affects the liver in processing bilirubin. Although jaundice can occur along with Gilbert's syndrome, this condition is not dangerous.
- a disease that causes liver damage, such as hepatitis, cirrhosis or mononucleosis
- a disease that causes blockages in the bile duct, such as gallstones or pancreatic cancer
- red blood cell destruction, such as sickle cell disease or allergic blood from transfusion (transfusion reaction)
- drugs that increase bilirubin levels, such as some antibiotics, birth control pills, diazepam (Valium), flurazepam, indomethacin (Indocin), and phenytoin (Dilantin)
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