What is a Bilirubin in Urine Test?
A bilirubin in urine test measures the levels of bilirubin in your urine. Normally, urine doesn't have any bilirubin. If there is bilirubin n your urine, it may be an early sign of a liver condition.
Bilirubin is a yellow substance that 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.
A healthy liver removes most of the bilirubin from your body. But if there is a problem with your liver, 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, a test that measures different cells, chemicals, and other substances in your urine (pee). Urinalysis is often used to check your general health. 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 regular checkup. The test may also be ordered if you have symptoms of a liver condition, gallbladder disease, or a problem with your bile ducts (the small tubes that carry bile out of your liver). These symptoms may include:
- Nausea and vomiting
- Lack of appetite
- 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 because of:
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:
- Wash your hands with soap and water and dry them.
- Open the container without touching the inside.
- 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.
- 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.
- Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
- Finish urinating into the toilet.
- 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?subtitle
You don't need any special preparations to test for bilirubin in urine. 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. 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
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.
- American Liver Foundation. [Internet]. New York: American Liver Foundation; c2017. Diagnosing Liver Disease – Liver Biopsy and Liver Function Tests; [updated 2020 Feb 17; cited 2022 Feb 16]; [about 3 screens]. Available from: https://liverfoundation.org/for-patients/about-the-liver/diagnosing-liver-disease/
- Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2022.Bilirubin; [reviewed 2018 Jun 14; cited 2022 Mar 15]; [about 6 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/17845-bilirubin
- Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Bilirubin (Urine); 86–87 p.
- Hoilat GJ, John S. Bilirubinuria. [Updated 2021 Nov 7; cited 2022 Mar15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557439/
- Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Urinalysis; [cited 2022 Mar 13]; [about 1 screens]. Available from: https://www.mayoclinic.org/tests-procedures/urinalysis/about/pac-20384907
- Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2022. Urinalysis and Urine Culture; [reviewed 2020 May; cited 2022 Mar 13 ]; [about 3 screens]. Available from: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/diagnosis-of-kidney-and-urinary-tract-disorders/urinalysis-and-urine-culture
- Saint Francis Health System [Internet]. Tulsa (OK): Saint Francis Health System; c2010. Patient Information: Collecting a Clean Catch Urine Sample; [cited 2022 Mar 15]; [about 1 screen]. Available from: https://www.saintfrancis.com/assets/documents/lab/collecting-a-clean-catch-urine.pdf
- Testing.com [Internet]. Seattle (WA).: OneCare Media; c2022. Bilirubin; [modified 2021 Nov 9; cited 2022 Mar 15]; [about 10 screens]. Available from: https://www.testing.com/tests/bilirubin/
- Testing.com [Internet]. Seattle (WA).: OneCare Media; c2022. Liver Panel; [modified 2021 Nov 9; cited 2022 Mar 15]; [about 13 screens]. Available from: https://www.testing.com/tests/liver-panel/
- Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. Urinalysis; [modified 2022 Jan 1; cited 2022 Mar 15]; [about 12 screens]. Available from: https://www.testing.com/tests/urinalysis/
- The Johns Hopkins Lupus Center [Internet]. Johns Hopkins Medicine; c2022. Urinalysis; [cited 2022 Mar 15]; [about 10 screens]. Available from: https://www.hopkinslupus.org/lupus-tests/screening-laboratory-tests/urinalysis/
- University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Direct Bilirubin [cited 2022 Mar 15]; [about 4 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=bilirubin_direct