Bilirubin is directly elevated - what does this mean? Bilirubin straight: norm
Not every person knows the anatomy thoroughlyits body and substance, the elements that it contains. For this reason, after receiving the results of the tests, we sometimes experience increased anxiety. After all, we can not explain or understand certain meanings, and therefore, it is not in our competence to properly assess our state. One of these little-known values is elevated bilirubin in the blood. Causes and methods of treatment, as well as the symptoms of such a condition, we consider below.
Bilirubin - a substance in the human body
This organic substance, formed duringnatural decomposition of hemoglobin due to the destruction of red blood cells - erythrocytes. This process occurs continuously as the end of the life of red blood cells. Bilirubin can be seen in blood plasma or bile. Deviations from the norm of the presence of bilirubin in these liquids most often indicate the presence of pathological conditions of the blood (increased destruction of erythrocytes), liver or bile ducts.
The difference between direct bilirubin and other species
In medical science, there are two types of bilirubin- direct and indirect. The second one, called still unbound, is formed in the liver cells (about 80%), and the remainder in the spleen and bone marrow cells.
Direct bilirubin, called bound,is formed in the liver by attaching to indirect bilirubin glucuronic acid. This is required in order to convert the toxic and insoluble substance into a soluble form and successfully remove it from the body with bile.
However, a non-toxic and easily soluble straightBilirubin can also have harmful effects on the body. With an increased concentration of this substance in the bile, it is prone to precipitation and crystallization, which can eventually lead to the formation of solid deposits in the structural elements of the gallbladder and its ducts.
In the results of laboratory tests,the common bilirubin is mentioned, but this name is clinical, there is no such substance in the body. By this concept is meant the total amount of direct and indirect bilirubin.
What is the purpose of the blood test for direct bilirubin?
This study is very important because it allowsanswer the question of whether the increase in bilirubin is associated with impaired liver function or not. The increase in total bilirubin due to high indices only indirect is possible with an increase in the decomposition of hemoglobin. And an increase in only an easily soluble substance is most often encountered with difficulty in the outflow of already formed bile, for example, with mechanical blockage of the bile ducts.
The causes of increased bilirubin in the blood are different. A serious diffuse pathology of the liver is hepatitis. The disease is characterized by the fact that the cells of this organ are unable to remove the pigment into the gallbladder and its ducts in the right amount. Timely analysis of blood for direct bilirubin will identify this disease and prevent its further progression.
What is the norm of bilirubin?
In order to clearly define the pathologicalcondition, experts have established the concept of the norm of bilirubin in the blood. It can vary individually within a wide range, but exceeding these values can indicate serious health problems.
Norms for adults
Children under 1 month
Range from 8.5 to 20.5 μmol / l
First day after birth: 51-60 μmol / l
up to 15.4 μmol / l
not less than 90% of total bilirubin
up to 5.1 μmol / l
not more than 10% of the total
In the table below, we see that differentof age categories the norm of bilirubin in blood differs. Elevated bilirubin, the symptoms, whose treatment is determined only by a specialist, can occur already in the first day after birth. Therefore it is important to monitor its level in the blood so as not to miss a serious pathology of the internal organs.
At what pathologies is there an increase in direct bilirubin?
Increased concentration of pigment is possible when it is formed too much, or there are obstacles to its removal from the body.
Most often excessive formation of bilirubinis observed with various hereditary diseases, not only the liver, but also the organs of hematopoiesis. This can lead to various anemia, primarily associated with increased fragility of red blood cells, as well as the pathology of the spleen, which excessively destroys red blood cells, including healthy ones.
Difficulties in transformation and deducingBilirubin is more often associated with liver disease that occurs due to toxins or inflammation. Often this picture is given by cholelithiasis and oncological changes.
Causes that entailed a rise in the level ofbilirubin in the analyzes, are divided into two large groups: liver and extrahepatic. The first are more often caused by diffuse processes in the liver tissues, and the latter - with cicatricial or other mechanical disturbances of the process of bile outflow.
- Acute viral hepatitis A, B, C.
- Chronic and bacterial hepatitis (with brucellosis, leptospirosis).
- Toxic hepatitis caused by the action of drugs, including.
- Intrahepatic cholestasis.
- Oncological diseases of the liver.
- Pressure of bile ducts.
- Diseases of these moves.
Thus, an elevated level of directbilirubin can indicate various abnormalities in the body and can not be the basis for an accurate diagnosis. But knowing this indicator, you can conduct further targeted examination of the patient.
Increased unbound bilirubin in the blood
If the test results indicatean increased level of indirect pigment, then you should pay attention to the general blood test, namely the number of red blood cells and hemoglobin. Since indirect bilirubin is altered by increased hemoglobin breakdown, a person will have obvious signs of anemia. Due to the accumulation of excess unbound pigment in the blood, signs of hemolytic anemia (through jaundice) appear and intensify.
Causes of decreased bilirubin
One of the leading reasons for the lowering of directbilirubin is ischemic heart disease. This phenomenon also occurs after taking alcohol, caffeine (including energy drinks) and a number of medications (penicillin, prednisolone and others).
How externally manifested elevated bilirubin in the blood?
If the bilirubin is directly elevated, what does it mean? With a large concentration of direct bilirubin in the blood, yellowing of the sclera is observed in patients, and in more severe conditions and skin conditions. Urine acquires a rich yellow color, and feces, on the contrary, discolour due to impaired pigment removal through the intestine. Upon examination, the doctor may detect a dense or enlarged liver, there may be pain in the area of the gallbladder projection.
If bilirubin is directly elevated, what does this mean forpatient, who suffered acute viral hepatitis? In this case, a person can complain of a decrease in appetite, nausea, heaviness and pain in the right hypochondrium.
With a difficult outflow of bile there is a changecolor of the skin. This is due to the fact that bilirubin is not evacuated through the intestine, but returns to the bloodstream and is filtered out in the kidneys. In addition to the symptoms of "mechanical jaundice", signs of the disease that caused the outflow of bile may manifest itself clearly. These are the symptoms of acute, chronic pancreatitis, cholelithiasis, etc. The most effective methods of diagnosing diseases in such cases are ultrasound or tomography. They help to identify the inflammatory edema of the walls of the bile ducts, as well as their overlapping with various neoplasms.
Bilirubin in children of the first days of life
Metabolism in newborns is somewhatdiffers from that in adults. At birth in the blood there is a high content of fetal hemoglobin, which is subject to rapid disintegration and excretion from the body. Therefore, in the first day of life, physiological, natural jaundice is very often observed. But as the enzyme system of the liver transforms indirect bilirubin into a direct one, these signs quickly disappear.
However, there is a possibility of the emergence and pathological jaundice of the newborn. It can be caused by such processes as:
- incompatibility by blood group or Rh factor of mother and child;
- hereditary erythrocyte fragility, which causes increased formation of indirect bilirubin;
- infectious hepatitis;
- violations of the outflow of bile from the liver of a mechanical nature and others.
Treatment for increased bilirubin in the blood
What to do if bilirubin is elevated, definitelyimpossible to say. Actions depend on several factors. First you need to identify the nature of the disease, why it arose. The reasons for the increase in bilirubin in the blood are varied, when diagnosing and prescribing the treatment, the doctor can not rely on only one or two studies. Additional tests may be prescribed: ultrasound diagnosis, computed tomography, which allows to identify the presence of solid deposits or other obstacles to the outflow of bile, because of which there is an increased bilirubin in the blood. The causes, treatment of this pathological process can be determined in some cases by a hematologist (specialist in blood diseases), in others - by an infectious disease specialist. If there is a difficulty in the outflow of bile, therapy is prescribed to relieve spasms of the bile duct and gall bladder.
However, like many substances in the body,Bilirubin should not be taken as a completely useless slag. As recent studies have shown, bilirubin is a very good antioxidant, superior in its effectiveness to vitamin E. It is able to inactivate peroxide compounds, preventing the development of many pathological conditions and diseases. Thus, in people with a high content of bilirubin in the blood, the risk of atherosclerotic vascular lesions and associated heart diseases is significantly reduced. Bilirubin is able to fight aggressive free radicals, significantly reducing the risk of oncological diseases.
Features of bilirubin in pregnant women
Sometimes it happens that in pregnant womenbilirubin direct elevated. What does this mean for them? The state of pregnancy can not in any way provoke a decrease or increase of this substance. Most often, future mothers note that in the results of the analysis the reference indicator of the substance corresponds to the "Bilirubin direct norm" graph. Raised, lowered it may be not due to pregnancy, but with exacerbation of chronic diseases or the emergence of new pathologies. Elevated levels of pigment in the blood can be caused by diseases such as cholestasis, hemolytic anemia, viral hepatitis, cholecystitis. Such conditions require an immediate and complete examination of a woman, after which the doctor prescribes adequate and effective treatment.
Ways to lower bilirubin
If you find symptoms of increaseddirect bilirubin, it is necessary to get rid of them, since such a state can affect the condition of internal organs. First of all, you need to study your diet to lower the level of this pigment. A good result can be achieved by changing the supply. To do this you need:
- stop eating fried and spicy foods;
- completely eliminate from the diet alcoholic beverages;
- Do not use beverages with gases;
- Newborn babies need to drink more fluid to quickly remove toxins from the body.
It is necessary to give maximum attention to the liver. Applying these simple rules of nutrition, you allow this body to be cleansed and restored. A healthy liver actively gets rid of a large amount of bilirubin in bile and blood. In addition, it is necessary to follow the healthy work of the intestine. Boiled and baked food contributes to the good work of the intestines. You can not exhaust yourself with endless diets or hunger, this leads to a malfunction in the digestive organs.
Thus, only a symptom isa condition in which bilirubin is directly elevated. What does it mean? This suggests that it is important not just to lower the amount of pigment in the blood, but also to treat the cause.
Pathological processes in the liver will bemanifest through nausea, pain in the area of this organ, a feeling of heaviness, a rise in temperature, a bitter taste in the mouth. If increased bilirubin is caused by anemia, it will manifest through the yellow shade of the mucous membranes, chronic fatigue, frequent cardiac contractions, pain in the left part of the chest. Elevated bilirubin, due to diseases of the biliary tract, will manifest through dark urine, anorexia, severe itching and nausea.
At such conditions it is necessary to hand over the analysis of a blood on a bilirubin a straight line. What do the results and recommendations for reducing it mean? The doctor will say.