Urobilinogen in Urine

What is a Urobilinogen in Urine Test?

A urobilinogen in urine test measures the amount of urobilinogen in your urine (pee). Normal urine contains some urobilinogen. Too much urobilinogen in urine may be a sign of a liver disease, such as hepatitis or cirrhosis, or certain types of anemia. Little or no urobilinogen may be a sign of other problems with your liver, gallbladder, or bile ducts.

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

Good bacteria in your intestines breaks down the bilirubin in your bile and makes urobilinogen. Some of the urobilinogen leaves your body in your stool (poop). Some of it enters your bloodstream and returns to your liver, where it's "recycled" into bile. A small amount of urobilinogen leaves your body in urine.

Little or no urobilinogen in urine may mean that something is blocking bile from flowing into your intestines. High levels of urobilinogen in urine may be a sign that:

• Your liver is making too much bilirubin because your body breaks down red blood cells faster than it can make them. This condition is called hemolytic anemia.
• Your liver can't recycle urobilinogen into bile because of liver disease.

Other names: urine test; urine analysis; UA, chemical urinalysis

What is it used for?

A urobilinogen in urine test may part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. A urinalysis is often used to check your general health. It can also help diagnose diseases that affect the liver and many other medical conditions.

Why do I need a urobilinogen in urine test?

Your health care provider may order this test as part of your regular checkup or to monitor an existing liver condition. You may also have this test if you have symptoms of a liver disease or hemolytic anemia.

The symptoms of liver disease 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

The symptoms of hemolytic anemia may include:

• Fatigue
• Dizziness
• Heart palpitations (feeling that your heart is skipping a beat, fluttering, or beating too hard or too fast)
• Headache
• Confusion
• Jaundice
• Larger than normal liver or spleen

What happens during a urobilinogen 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. 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 this test.

What do the results mean?

If your test results show too little or no urobilinogen in your urine, it may be a sign of:

• A blockage in the ducts that carry bile from your liver or gallbladder to your intestines
• A blockage in the blood flow through the liver
• A problem with liver function

If your test results show a higher-than-normal level of urobilinogen, it may be a sign of:

• Hepatitis
• Cirrhosis
• Liver damage due to medicines
• Hemolytic anemia

If your test results aren't normal, it doesn't always mean you have a medical condition that needs treatment. Certain medicines and supplements can affect your results, so be sure to let your provider know what you are taking.

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

Is there anything else I need to know about a urobilinogen in urine test?

A urobilinogen in urine test alone cannot diagnose a specific condition. If your test results aren't normal, your provider may order other tests to help diagnose liver disease or hemolytic anemia.