High Bilirubin: What Elevated Bilirubin Means
Elevated bilirubin could mean there is liver damage or another disorder that makes it hard for the body to break down bilirubin.
Doctors usually use blood tests to measure the amount of bilirubin in the body. Blood tests can also help find the cause of high bilirubin levels.
Read on to learn more about elevated bilirubin, including how doctors diagnose and treat it.
When hemoglobin, the oxygen-carrying part of red blood cells, grows old, it breaks down naturally and releases its byproducts into the bloodstream. Bilirubin is one such byproduct and at high levels, it can be potentially toxic.
Blood carries most bilirubin to the liver, where it combines with bile, a digestive fluid that the liver makes. From the liver, bilirubin enters the digestive system, where it is eventually eliminated through urine and stool.
Conditions such as liver dysfunction, gallbladder problems, and hepatitis can disrupt the excretion of bilirubin. This leads to elevated bilirubin levels in the blood. The body tries to secrete the excess bilirubin by depositing it in the skin, causing jaundice.
A healthy adult usually has a total bilirubin level of about 1.2 milligrams per deciliter (mg/dl) of blood. Anything above that may be considered elevated.
Elevated bilirubin can also occur in infants. This is because the liver of an infant is usually not mature enough to break down bilirubin. However, the liver normally adapts within a few weeks after birth.
Symptoms of elevated bilirubin vary depending on the underlying condition. However, some symptoms appear to be universal. They include symptoms of jaundice, including:
- yellow in the whites of the eyes
- yellowish tint on the skin
- light or clay-colored stools
If elevated bilirubin is due to an infection, symptoms may include:
- abdominal pain
- swelling in the abdomen, legs, or ankle
- itchy skin
- easy bruising
- prolonged bleeding
Symptoms that may indicate a life threatening or serious condition
Occasionally, symptoms may indicate a life threatening or serious condition. If you experience any of these symptoms along with jaundice, seek immediate medical care (call 911):
- sudden onset of symptoms without warning
- dark, tarry stools
- confusion and disorientation
- fever higher than 101°F (38°C)
Elevated bilirubin may occur due to liver diseases and gallbladder problems. Here is a breakdown:
- Gallstones: Gallstones can lodge in the bile duct, which can slow or keep the bile from emptying into the small intestines. Bilirubin needs to combine with bile to be excreted with stool. If bile cannot freely leave the gallbladder, bilirubin may build up.
- Gallbladder disease: Infections, tumors, or congenital irregularities can affect how well the gallbladder works. If the gallbladder does not function properly, elevated bilirubin may occur.
- Liver disease: Liver diseases may reduce the liver’s ability to process bilirubin. Duct blockages can also cause excess bilirubin to stay in the body.
- Pancreatitis or pancreatic cancer: Problems with the pancreas may also lead to elevated bilirubin levels.
Other causes of elevated bilirubin
Women can also experience elevated bilirubin levels during pregnancy. Pregnancy hormones affect how the gallbladder and liver excrete bile. This can cause bilirubin to clump together, causing jaundice and itchy skin. These symptoms usually go away within a few days of giving birth.
Newborns can also have elevated bilirubin levels. In fact, 6 in 10 full-term newborns develop jaundice. This occurs due to the fact that the liver of a newborn is not mature enough to aid in bilirubin excretion.
The test measures the amounts of direct bilirubin and total bilirubin in the blood. Direct or conjugated bilirubin is water soluble and easy to excrete. However, indirect or unconjugated bilirubin is hard to break down and is toxic. Total bilirubin is the sum of direct bilirubin and indirect bilirubin.
Your doctor will know you have elevated bilirubin if your total bilirubin count is too high.
If a bilirubin blood test indicates elevated bilirubin, your doctor may order additional tests to determine what is causing the high bilirubin. These tests may include:
- Blood tests: Other blood tests can check for hepatitis infection, liver disease, liver damage, copper deficiencies, Wilson’s disease, and general screen with a full blood count.
- Urine tests: These tests can measure the volume of bilirubin in your urine. A healthy person’s urine contains insignificant amounts of bilirubin. So, a high amount of bilirubin in urine is a sign of an anomaly.
- Imaging tests: An ultrasound, a CT scan, or MRI can check the size and shape of your liver, pancreas, and gallbladder. These scans can also detect disorders, such as liver dysfunction and gallstones.
- Liver biopsy: This test analyzes samples of your liver tissue to look for unusual cells related to liver disease or damage.
To diagnose the cause of elevated bilirubin, your doctor may ask you several questions:
- When did symptoms first appear?
- Have your symptoms gotten worse?
- What medications do you take?
- What type of diet do you eat?
- How much alcohol do you consume?
Treatment for elevated bilirubin levels depends on the cause.
For a newborn infant, until the liver matures, treatment may include:
- increased feeding
- phototherapy, also called light therapy
- immunoglobulin transfusion
- blood transfusion
Treatments for elevated bilirubin in adults involves treating the cause and complications, such as:
- antibiotics to treat infection
- corticosteroids to reduce liver inflammation
- changing medications if they caused the elevated levels
- surgery to remove gallstones or the gallbladder
- surgery to clear obstructions in the ducts of the liver or pancreas
- liver transplant if the liver is severely damaged
Left untreated, elevated bilirubin may lead to complications. These complications include:
- encephalopathy, declining brain function
- increased bleeding
- slower clotting time
- sepsis, a body-wide infection
- kidney failure
- liver failure
If you have any symptoms that occur with high bilirubin, seek medical care. Early diagnosis and treatment can reduce your risk for complications.
Elevated bilirubin is when there are higher-than-normal levels of bilirubin in the blood. The liver is responsible for filtering bilirubin from the blood, combining it with bile, and moving it into the digestive system to excrete it in stool and urine.
High bilirubin levels may be a sign of liver disease and gallbladder problems. Symptoms of elevated bilirubin include jaundice, possibly with fever, chills, and abdominal pain.
Bilirubin testing measures bilirubin levels in your blood. Elevated bilirubin could mean there is liver damage or another disorder that makes it hard for the body to break down bilirubin. Treatment depends on the underlying condition that is making it hard for the body to break down bilirubin.
Elevated bilirubin can also occur in infants when the liver has not fully matured. Treatment is available while the liver becomes fully functioning, usually within a week.