Causes include gall stones, tumors, or scarring of the bile ducts. Nursing Tip: Conjugated bilirubin is water soluble. If there is some sort of blockage of the bile ducts, excess conjugated bilirubin can be removed from the body through urine.
This is why bilirubin is tested for in the standard urinalysis. To learn more, view our Advanced Bladder Management course. Web MD. Lab Tests Online. Welcome to Pedagogy Sign In. Search for:. Account Policies More Pedagogy Campuses. Bilirubin - Conjugated Versus Unconjugated. Bilirubin Lab Tests When patients are extremely jaundiced, one of the common lab tests that is performed is a bilirubin test.
What is Bilirubin? Why Would It Be Elevated? Figure 3. In the intestines, conjugated bilirubin is hydrolyzed by bacterial enzymes to produce unconjugated bilirubin and ultimately urobilinogen, which can be excreted in urine after binding to albumin.
In the intestines, some urobilinogen is converted to stercobilinogen and excreted in the stool. Thus, in normal urine, only urobilinogen is present; in normal stool, only stercobilinogen is present. Figure 4. Urobilinogen in the intestines can also be converted to stercobilinogen, which is then excreted in the stool.
Cholestatic or obstructive jaundice occurs when liver cells are unable to transport bilirubin through the hepatic-bile capillary membrane because of damage in the liver.
Obstructive jaundice can also occur when transport through the biliary tract is blocked because of anatomical obstructions such as gallstones or cancer. In obstructive jaundice, conjugated bilirubin regurgitates into the blood. Because it is water-soluble, bilirubin is excreted into the urine. This is called choluria, or the presence of bile in the urine. As well, less conjugated bilirubin is taken up by the intestines in obstructive jaundice. As a result, less stercobilinogen is found in the stool and the stool appears pale.
Table 1. Under normal conditions, only urobilinogen is present in the urine, and stercobilinogen is present in the stool. Kim E. Gastrointestinal Physiology, 2e.
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Username Error: Please enter User Name. Password Error: Please enter Password. Forgot Password? This causes higher levels. The bile duct is a tube that carries bile to the small intestine. Bilirubin or cholesterol can form stones that block the duct. This causes bilirubin—mostly direct bilirubin—to rise in your bloodstream.
Inflammation of the bile duct. Higher levels of direct bilirubin in your blood may stem from inflammation in the tube that carries bile to the small intestine. You will likely have this test as part of a liver panel, or group of related liver tests.
A total bilirubin level may also be done. When your liver is damaged, liver enzymes may leak into your blood. You may need other blood tests, such as:. Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
Normal results of the blood test range from 0 to 0. If your results on the blood test are higher, bilirubin may also show up in your urine.
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