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Bilirubin Direct

Also Known as: Direct Bilirubin, Conjugated Bilirubin

What is a direct bilirubin test?

This test examines your blood for bilirubin. When your body breaks down old red blood cells, bilirubin is produced. This is a common phenomenon. Bilirubin is a component of bile, which your liver produces to assist in the digestion process. It's normal to have a small level of bilirubin in your blood. Each day, healthy adults produce 250 to 350 milligrams (mg) of bilirubin. Some bilirubin in the blood is attached to a protein called albumin and is known as Unconjugated, or indirect bilirubin. Bilirubin is converted to a form that your body can eliminate which is called Conjugated bilirubin or direct bilirubin that passes from the liver to the small intestine. A very tiny amount is eliminated in your urine after passing through your kidneys. This bilirubin is also responsible for the yellow color of urine. This test is frequently used to check for liver diseases like hepatitis or obstructions like gallstones.

What is the test used for?

A bilirubin blood test is performed to assess the health of your liver. The bilirubin blood test can also assist your healthcare provider in diagnosing other conditions such as liver cirrhosis, gallbladder disease, hemolytic anemia, and metabolic disorders including hepatitis and gall bladder obstruction. The measurement of direct bilirubin can help to differentiate between hepatic disorders. The direct (conjugated) fraction accounts for the majority of the rise in total bilirubin associated with obstructive jaundice. Hepatitis causes a rise in both direct and indirect bilirubin in the blood.

Why and when do you need this test?

You may need this test if your liver doesn't seem to be functioning properly.  The following are some of the signs and symptoms:

  • Skin and the whites of your eyes turning yellow (jaundice)
  • Urine that is dark yellow in color.
  • light grey or clay-colored stools
  • Nausea & Vomiting 
  • Fatigue ( feeling tired) 
  • Swelling or pain in the abdomen

This test may also be required if your healthcare provider suspects that you might have:

Hepatitis: Inflammation of the liver can occur for a variety of reasons, including hepatitis viral infection or excessive drug or alcohol consumption. Hepatitis damages liver cells, causing the liver to release both indirect and direct bilirubin into the bloodstream as a result which the bilirubin level rises.

Gallstones: A bile duct is a tube that transports bile from the liver to the small intestine. Stones made of bilirubin or cholesterol might obstruct the duct. Bilirubin—mostly direct bilirubin—increases in your bloodstream as a result of this.
Alcohol abuse: If you drink a lot of alcohol on a regular basis, you may have this test to check for probable liver damage as drinking too much alcohol over time can harm the liver.

Inflammation of bile duct: If the bile duct (the tube that transports bile from the liver to the small intestine) is inflamed higher levels of direct bilirubin circulates in the blood.  

What kind of sample is required for the test?

A small needle will be used by a healthcare provider to obtain a blood sample from a vein in your arm.  A small amount of blood will be collected into a test tube or vial once the needle is inserted. When the needle goes in or out, it may sting a little. It normally takes less than five minutes to complete this process.

Do you need to prepare for the test?

A bilirubin blood test does not require any specific preparation. You may need to fast (not eat or drink) for several hours before the test as directed by your healthcare provider if he has ordered other blood tests along. If there are any special instructions to follow, your health care provider will inform you.

Are there any risks to this test?

Having a blood test carries relatively little risk. You may experience little pain or bruising where the needle was inserted, but most symptoms disappear quickly.

What do the test results mean?

Although normal findings can vary, excessive bilirubin levels can indicate that your liver isn't functioning properly. Abnormal results, on the other hand, may not always indicate a medical issue that requires treatment. Medication, certain meals, and strenuous exercise can all induce higher-than-normal bilirubin levels. 
Higher levels could indicate that you may have:

  • Liver Disease 
  • An infection of the blood (called blood poisoning or septicemia)
  • Gallstones 
  • Hepatitis 
  • Sickle cell disease ( type of anemia that affects people)
  • Certain malignancies or tumor
  • Scarring of the bile duct

Should you have any questions regarding your test results it is always recommended that you consult with your healthcare provider. 

Related tests:  indirect bilirubin, liver function tests, bilirubin total blood test, ALT, AST, albumin 

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