Bilirubin is a brownish-yellow pigment that’s 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, which is a medical condition that causes your skin to look yellow. This can be a sign of liver disease in children and adults.

Bilirubin levels are affected by age and overall health. For babies, bilirubin that measures higher than 20-25 milligrams per deciliter can lead to neurological damage. This is why it’s important to check their bilirubin levels. A urine test is one way of measuring how much bilirubin you have in your body.

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 aren’t necessarily associated with 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 before your bilirubin testing:

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-top cover.

Testing bilirubin levels through urinalysis is painless, but it 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, don’t collect urine the first time you urinate. This is because your first specimen of urine is usually more concentrated. After the first time you urinate, start collecting your urine. This means each time you urinate throughout the day, collect the urine in the container rather than flushing it down the toilet.

You may use a clean, 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 it should be your first urination of the morning. Label the container with your name and the date, and then return the full container to the lab facility.

Newborn babies often have jaundice. This is because infants’ livers aren’t as efficient at removing bilirubin from the body. Increased bilirubin and the resulting jaundice can be dangerous to infants if the underlying condition isn’t 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.

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

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


How are abnormal bilirubin levels treated in children or adults?

Anonymous patient


High levels of bilirubin can be damaging for children, which is why timely treatment is important. A high level of bilirubin in a baby is treated with phototherapy, in which the baby is placed under a light lamp to help make their bilirubin water-soluble and able to be easily removed from the body. Exchange transfusions can also help with high levels of bilirubin in the blood.

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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