What is the bilirubin test used to detect?

x

Definition

What is bilirubin?

Bilirubin is a yellow-brown substance found in bile. This compound is produced when the liver breaks down blood cells and is excreted from the body through feces. This is what gives the stool its normal color.

This compound also functions to regulate iron levels in various types of protein. Even though it has the potential to be a poisonous compound, the body can excrete these substances so they don't accumulate and interfere with the body's health.

What is the normal amount of bilirubin?

Although formed normally, sometimes bilirubin indicates certain diseases. The total bilirubin level which is considered normal in adults is 0.1 - 1.2 mg / dL or 1.71 - 20.5 µmol / L.

If you exceed this number, there is a possibility that you have problems with your liver or bile ducts.

That is why, it takes a special examination to find out how many levels are in the body. This aims to detect whether the number exceeds the normal limit or not, so that it can get immediate treatment

How is the process of metabolism of bilirubin?

The compound that gives stool its color comes from the breakdown of hemoglobin in red blood cells and damaged erythroid cells. Every day, the body will produce 4 mg / kg of bilirubin.

Once formed, this substance will circulate in the bloodstream in two forms, namely as follows.

Indirect bilirubin

Indirect or unconjugated bilirubin is a water-insoluble form of the compound.

Later, this substance will circulate through the bloodstream to the liver, where it changes into a soluble form.

Direct bilirubin

After reaching the liver, this substance will turn into a conjugated compound, aka it can dissolve in water.

These compounds then leave the liver, intestines, and return to unconjugated substances on their way before being secreted by the body.

Signs and symptoms

What are the signs and symptoms of high bilirubin?

If your bilirubin levels are high, the effects will depend on the cause. Some people may have no symptoms at all, while most have signs such as:

• jaundice (jaundice),
• yellow color of the eyes and skin,
• fever,
• body shivering,
• stomach ache,
• flu-like symptoms,
• nausea or vomiting,
• dark colored urine, as well
• discoloration of the stool to become clay-like.

When to see a doctor?

If you have any of the symptoms above, consult a doctor immediately. The various symptoms above can indicate a certain disease.

Doctors will usually order a bilirubin test along with other laboratory tests, namely:

• alkaline phosphatase,
• aspartate aminotransferase, and
• alanine aminotransferase.

The third is done to detect symptoms of liver dysfunction and is needed if you experience conditions such as:

• a history of excessive alcohol consumption,
• have experienced symptoms of drug poisoning, and
• history of hepatitis.

Cause

What causes high bilirubin levels?

The following are some of the causes of high bilirubin levels that exceed normal numbers.

Gallstones

Gallstone formation occurs when compounds such as bilirubin and cholesterol harden in the gallbladder. This organ is responsible for producing bile, which is a digestive fluid that helps break down fat before it enters the intestines.

Gallstones can also form when the body has produced too much of these compounds. This can occur when the condition of the liver (liver) produces too much cholesterol.

As a result, these yellowish-brown compounds accumulate and clog the gallbladder, so it can't drain properly.

Liver disfunction

High levels of bilirubin can also indicate liver dysfunction or liver disease. This buildup of substances that can also come out of the urine occurs due to liver function not working normally.

As a result, these toxic substances cannot be removed and processed from the body's bloodstream. There are several liver diseases that cause levels of these stool coloring compounds to increase, including:

• cirrhosis of the liver,
• liver cancer, and
• autoimmune hepatitis.

Gilbert's Syndrome

People who have Gilbert's syndrome usually have elevated levels of bilirubin or hyperbilirubinemia. This occurs due to decreased levels of liver enzymes needed to remove these substances.

Some people who experience this disease experience no symptoms. However, not a few also have the characteristic of yellowing skin.

Red blood cell disorders

Conditions that cause damage to red blood cells, such as hemolytic anemia, can also cause high bilirubin. Damage to the red blood cells can increase this orange compound because the body gets rid of too many red blood cells.

When it occurs in infants, this condition is known as erythroblastosis fetalis. This condition can destroy the baby's blood cells because it is affected by the mother's immune system. As a result, the levels of this fecal dye have increased.

Effects of certain drugs

Apart from health conditions, the increase in bilirubin can also be affected by the use of drugs such as:

• antibiotics,
• family planning pills,
• indomethacin,
• phenytoin, and
• diazepam.

How about low levels?

Generally, low bilirubin levels are nothing to worry about. However, this condition can be caused by the use of drugs, such as:

• theophylline,
• phenobarbital, and
• vitamin C.

Diagnosis

What needs to be prepared before the bilirubin test?

Before undergoing the test, you will be asked not to eat or drink for 4 hours. The doctor will also instruct you to stop taking medications that can affect bilirubin levels.

Tell your doctor if you have conditions:

• are taking drugs,
• allergies to drugs,
• a history of blood disorders or taking blood thinners, as well
• is pregnant.

Bilirubin examination procedure

The bilirubin test is usually done using a blood sample. Your blood will be drawn through a small needle that is inserted into a vein in the arm and stored in a test tube.

After that, the arm will be bandaged for 10 - 20 minutes. Avoid using the injected arm to lift items after the test.

You may feel a little pain when the needle is injected into your arm. In rare cases, the vein will swell after blood is drawn.

Bilirubin test with heel stick

Apart from a blood sample, a bilirubin test can also be done with heel stick . It's just that this method is more often used to detect bilirubin levels in babies.

This procedure will then collect a blood sample that is collected from the baby's heel with steps including the following.

1. The skin of the heel was cleaned with alcohol and stabbed with a scalpel.
2. A few drops of blood will be collected in a tube.
3. After the blood has collected, the area will be covered with gauze.
4. Then, the baby's heel will be wrapped with a bandage.

Some hospitals now also use a bilirubin measuring device called transcutaneous. Transcutaneous is a tool used to check the levels of this orange-brown compound in newborns.

Instead of sticking a knife into the baby's heel, it will only measure the compounds needed in their skin.

If you have further questions, please contact your doctor to get the right solution for your condition.