Reviewed By: Pramod Kerkar, MD, FFARCSI

Bilirubin is a yellowish brown pigment formed by the breakdown of hemoglobulin of red blood cells in the human body. It is metabolized in the liver and converted into a conjugated form to get excreted through the stool. Only a trace amount of bilirubin is circulated in the blood. When bilirubin level exceeds more than the normal range in the blood, the condition is called hyperbilirubinemia. High levels of bilirubin in adults can signal towards many types of diseases related to liver, gallbladder, pancreas and red blood cells. The elevation in bilirubin levels can be caused by viral infection of liver, alcohol, taking medicines, gallstones, and infections of the gallbladder, liver diseases, hemolytic anemia etc.

What Does High Bilirubin in Adults Mean?

Bilirubin is a natural byproduct formed when hemoglobin of old worn out red blood cells are broken down. The liver plays the vital role in the excretion of bilirubin. Most bilirubin is excreted through the stool from the body when the liver converts bilirubin into excretable soluble form and supplies it through bile. Bile is stored in the gallbladder. Bilirubin is responsible for the yellow color of the stool. Only a small proportion of bilirubin is circulated in the blood.

The normal value of bilirubin in the blood for adults is 1.2 mg/dL. This range when exceeds over 3 mg/dL, then the condition is termed as hyperbilirubinemia. The levels of bilirubin determine the health of the liver.

In Adults, High Bilirubin May Represent Following Symptoms Of Jaundice-

  • Yellowish discoloration of the sclera of eyes, nails, and skin
  • Darkish urine
  • Pale stool
  • The feeling of nausea and vomiting
  • Loose motions (diarrhea)
  • Fever
  • Abdominal and muscular pain according to the underlying causes.

In Adults, High Levels Of Bilirubin Indicate Following Ailments-

Blood Disorders- when the breakdown of red blood cells is more than normal in conditions like a blood transfusion, hemolytic anemia, sickle cell anemia, etc., then high levels of bilirubin is produced. Autoimmune diseases like lupus, some leukemia, lymphomas, and infection with Epstein-Barr virus can also induce hemolytic anemia that can cause high bilirubin levels. Thus, elevated levels of bilirubin point towards any blood disorder.

Liver Scarring – a modern lifestyle and high consumption of alcohol can cause damage to the liver. New scars or fibrosed tissue develops in the liver preventing it to function properly. This can result in high bilirubin.

Liver Inflammation- any liver disease like hepatitis or injuries can cause inflammatory changes in the liver resulting in high bilirubin levels.

Infections – high bilirubin level is also observed in infections of the liver. These infections interfere with the conversion of bilirubin in the conjugated form. Thus, bilirubin gets collected in the blood.

Dysfunctions of Bile Duct- the anomaly of the bile duct, obstruction in the duct by stones or stricture in the bile duct can lead to an increase in the levels of bilirubin. Bile get obstructed in the duct

Gallstones- high levels of bilirubin may indicate towards the presence of gallstones. Bilirubin is naturally stored in gallbladder before secretion as bile. Obstruction created by gallstones in the gallbladder may interfere with normal excretion of bilirubin resulting in high levels of bilirubin in the blood.

Cancer of the Pancreas or Gallbladder- the Cancerous growth of pancreas or gallbladder can obstruct the bile duct. It also interrupts the normal functioning of the gallbladder, thus leading to an elevation in the levels of bilirubin in the blood.

Conclusion

Bilirubin is a byproduct of the normal breakdown of red blood cells. The levels of bilirubin are regulated by the liver. Any affections of the liver, gallbladder or any disease of red blood cells induce the elevation of bilirubin in adults. This results in jaundice which is marked by yellowish discoloration of the skin, the sclera of eyes and nails. High levels of bilirubin are treated by the treatment of the underlying cause.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 27, 2018

This article does not provide medical advice. See disclaimer

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