Bilirubin in Urine

What is a bilirubin in urine test?

A bilirubin in urine test measures the levels of bilirubin in your urine. Normally, bilirubin isn't found in urine. If there is bilirubin in your urine (called bilirubinuria), it may be an early sign of a liver condition.

Bilirubin is a yellow substance your body makes during the normal process of breaking down red blood cells. Your liver uses bilirubin to make bile, a fluid that helps you digest food in your intestines. Some bile flows through bile ducts (small tubes) from your liver directly into your intestines. The rest is stored in your gallbladder for when you need it.

A healthy liver removes most of the bilirubin from your body. But if there is a problem with your liver or bile ducts, bilirubin can build up in your blood and get into your urine.

Other names: urine test, urine analysis, UA, chemical urinalysis, direct bilirubin

What is it used for?

A bilirubin in urine test is often part of a urinalysis, which may include a visual check of your urine (pee) sample, tests for certain chemicals, and an examination under a microscope to look for certain types of cells. A urinalysis is often used to check your general health, including the health of your urinary tract (which includes your kidneys, ureters, bladder, and urethra). It can also help diagnose liver problems and many other medical conditions.

Why do I need a bilirubin in urine test?

Your health care provider may have ordered a bilirubin in urine test as part of your routine checkup. The test may also be ordered if you have symptoms of a liver condition, gallbladder disease, or a problem with your bile ducts. These symptoms may include:

• Nausea and vomiting
• Lack of appetite
• Fatigue
• Weakness
• Jaundice, a condition that causes your skin and eyes to turn yellow
• Swelling and/or pain in your abdomen (belly)
• Swelling in your ankles and legs
• Dark-colored urine (pee) and/or light-colored stool (poop)
• Frequent itching

Bilirubin in urine can be an early sign of liver damage. It may even show up before you have symptoms. So, your provider may order a bilirubin in urine test if you have a high risk for liver damage or disease. Reasons for an increased risk may include the following:

• A family history of liver disease
• Alcohol use disorder (AUD)
• Obesity
• Diabetes
• Taking certain medicines that can cause liver damage
• Hepatitis or exposure to hepatitis

What happens during a bilirubin in urine test?

You will need to give a urine sample for the test. A health care professional may give you a cleansing wipe, a small container, and instructions for how to use the "clean catch" method to collect your urine sample. It's important to follow these instructions so that germs from your skin don't get into the sample:

1. Wash your hands with soap and water and dry them.
2. Open the container without touching the inside.
3. Clean your genital area with the cleansing wipe:
   • For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
   • For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
4. Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don't let the container touch your body.
5. Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
6. Finish urinating into the toilet.
7. Put the cap on the container and return it as instructed.

If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a bilirubin in urine test. If your provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test.

Certain medicines and supplements may affect your results, so let your provider know what you are taking. But don't stop taking any medicines unless your provider tells you to. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?

There is no known risk to having a urinalysis or a bilirubin in urine test.

What do the results mean?

If bilirubin is found in your urine, it may be a sign that you have:

• A liver disease, such as hepatitis or cirrhosis
• A blockage in your bile ducts, the small tubes that carry bile out of your liver

To learn what your results mean, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I should know about a bilirubin in urine test?

A bilirubin in urine test is only one measure of your liver health. If your test results aren't normal, your provider may order other tests, including a liver panel. A liver panel is a group of blood tests that measures many different enzymes, proteins, and other substances in the liver. It is often used to help find and diagnose liver disease.

Some at-home urine tests that you buy without a prescription may measure bilirubin in urine. These tests usually involve dipping a test strip in a cup of urine or placing a few drops of urine on the strip. If you do an at-home bilirubin in urine test, talk with your provider about your results.