The presence of bilirubin in the urine is usually indicative of liver problems and can be noticed due to the dark yellow to orange color of the pee, being confirmed through urine examination.
Bilirubin is a product of hemoglobin degradation, becomes soluble in the liver, receiving the name of direct bilirubin, is transported to the bile ducts and intestine, where it undergoes a degradation process, and is eliminated in the stool in the form of sterobilinogen and in the urine in the form of urobilinogen. When there are problems with the liver or bile ducts, the direct bilirubin returns to the circulation and can be filtered through the kidneys and eliminated in the urine. Learn more about bilirubin.
The main causes of bilirubin in the urine are:
1. Hepatitis
Hepatitis is one of the main causes of bilirubin in the urine, because due to inflammation of the liver, conjugated bilirubin cannot follow the normal elimination route, returning to the circulation and can be filtered through the kidneys and eliminated in the urine.
Hepatitis is an inflammation of the liver that can happen due to virus infection, recurrent use of medications or due to autoimmune disease, with fever, headache, abdominal swelling and light stools. In addition, when the disease is not identified and treated, there may be jaundice, in which the eyes and skin turn yellow. Here's how to recognize types of hepatitis.
What to do: If hepatitis is suspected, it is important to go to the general practitioner or hepatologist to order diagnostic tests, such as serology for hepatitis viruses, assessment of liver enzymes and urine test. When confirming hepatitis, the doctor can indicate the best treatment according to the type of hepatitis, which can vary from rest and increased fluid intake, to the use of medications, such as Interferon, for example. Understand how hepatitis is treated.
2. Cirrhosis
In cirrhosis there is a chronic and progressive inflammation of the liver, which stops this organ from performing its functions properly. Thus, as the liver is in the process of degeneration, bilirubin cannot get into the bile ducts and intestines to be eliminated, returning to the circulation and being eliminated in the urine.
Liver cirrhosis can happen as a consequence of hepatitis, but it is usually related to the frequent and excessive use of alcoholic beverages, resulting in symptoms such as weakness, excessive tiredness, weight loss without apparent cause, lack of appetite, muscular atrophy and renal failure. Know other symptoms of liver cirrhosis.
What to do: The treatment indicated by the general practitioner or hepatologist for cirrhosis varies according to the cause, and most of the time it is indicated to suspend the consumption of alcoholic beverages and to adopt an adequate one that includes vitamin supplementation so that there are nutritional deficiencies. It is important that cirrhosis is identified and treated as soon as possible so that disease progression and, consequently, liver transplantation can be prevented.
3. Liver cancer
As in hepatitis and cirrhosis, in liver cancer the organ is in the process of inflammation of chronic degeneration, which favors the elimination of direct bilirubin in the urine.
This type of cancer is more frequent in people who have fat in the liver or who use anabolic steroids frequently and the symptoms appear when the disease is already in more advanced stages, such as pain in the belly, loss of appetite without apparent cause, excessive tiredness, skin and yellow eyes and constant nausea. Learn how to identify liver cancer.
What to do: If liver cancer is suspected, it is important to go to the hepatologist for diagnostic tests, such as abdominal ultrasound and CT scan, for example. In addition, some laboratory tests may be indicated, such as the measurement of liver enzymes. In case of confirmation of liver cancer, the doctor may indicate the surgical removal of the entire affected area and chemotherapy.
4. Gallstones
The presence of stones in the gallbladder can also lead to the appearance of bilirubin in the urine. This is because due to the presence of stones, direct bilirubin cannot pass into the intestine, returning to the circulation, where it is filtered by the kidneys and is eliminated in the urine.
Gallstones or gallstones arise due to changes in the composition of bile, which may be related to diet, lifestyle and prolonged use of contraceptives. The main sign of gallbladder stone is biliary colic, which corresponds to severe pain in the right side of the belly, in addition to loss of appetite, diarrhea and yellow eyes and skin. Know the signs and symptoms of gallstones.
What to do: The treatment most often indicated in the case of gallstones is the removal of the gallbladder through a surgical procedure. Then, it is important the person should have a proper diet, rich in fruits, vegetables and whole foods and low in fats and fried foods.
