Bilirubin Urine Test

Written by Erica Roth | Published on July 25, 2012
Medically Reviewed by George Krucik, MD


Bilirubin is a brownish-yellow pigment that is produced when red blood cells break down. The substance is found in the liver and is normally passed out of the body during digestion. The natural process of red blood cells dying while new cells are produced means that everyone has bilirubin in their bodies.

Bilirubin only becomes dangerous when it accumulates in the bloodstream. High levels of bilirubin can cause jaundice, a medical condition in which your skin looks yellow. This can be a sign of liver disease in children and adults.

Bilirubin that measures higher than 25 mg can lead to brain damage, deafness, and motor conditions such as cerebral palsy. A urine test is one way of measuring how much bilirubin you have in your body.

Preparing for Bilirubin Testing

Some prescription drugs can cause a false positive, or a higher-than-normal reading of bilirubin in your body. False positives indicate high bilirubin levels that are not a marker of liver disease. Discuss your medication usage with your doctor.

If you routinely take the following drugs, you may be asked to stop taking them for a couple of days prior to your bilirubin testing:

  • diuretics
  • birth control pills
  • steroids
  • barbiturates
  • sulfonamides

Visit your local medical testing lab to get the special container needed to collect your urine. This is usually a large plastic jug fitted with a screw-on cover.

Bilirubin Testing Procedure

Testing bilirubin levels through urinalysis is painless, but requires a time commitment and attention to detail. A thorough and accurate test requires you to collect your urine over the course of 24 hours.

On the day you begin the bilirubin urine test, urinate in the toilet when you first wake up in the morning. You do not need to collect this first specimen. Each time you urinate throughout the day, collect the urine in the container.

You may use a small cup to collect the urine and pour it into the container to make the process easier. Cover the container tightly after each use and store it in the refrigerator during the 24-hour collection period.

Collect your urine again on the morning of the second day. This is your last collection, and should be your first urination of the morning. Label the container with your name and the date, and return the full container to the lab facility.

Bilirubin Testing in Infants

Newborn babies often have jaundice. This is because infants make more red blood cells than adults, and their livers are not as efficient at removing bilirubin from the body. Increased bilirubin and the resulting jaundice can be dangerous to infants if the underlying condition is not treated.

Testing bilirubin through urine may be challenging for parents of infants being tested. The lab will supply you with urine collection bags to fit into your child’s diaper. Place the bag over your baby’s penis or labia and put on their diaper as usual.

Use a fresh bag at each diaper change. Put the contents of each collection bag into the collection container.

Results of Bilirubin Testing

The results of a bilirubin 24-hour urine test should be available within a few days after you’ve completed the test. Your medical care provider will notify you with the results.

In healthy people, bilirubin is not present in urine. If your test shows bilirubin present, you may need to undergo blood tests to measure your bilirubin levels and liver function.

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