Bilirubin in Urine

A bilirubin in urine test measures the levels of bilirubin in your urine. Normally, bilirubin isn't found in urine. If there is bilirubin in your urine (called bilirubinuria), it may be an early sign of a liver condition.

Bilirubin is a yellow substance your body makes during the normal process of breaking down red blood cells. Your liver uses bilirubin to make bile, a fluid that helps you digest food in your intestines. Some bile flows through bile ducts (small tubes) from your liver directly into your intestines.

The rest is stored in your gallbladder for when you need it. A healthy liver removes most of the bilirubin from your body. But if there is a problem with your liver or bile ducts, bilirubin can build up in your blood and get into your urine.

Why this test is done

Your health care provider may have ordered a bilirubin in urine test as part of your routine checkup. The test may also be ordered if you have symptoms of a liver condition, gallbladder disease, or a problem with your bile ducts. These symptoms may include:

• Nausea and vomiting
• Lack of appetite
• Fatigue
• Weakness
• Jaundice, a condition that causes your skin and eyes to turn yellow
• Swelling and/or pain in your abdomen (belly)
• Swelling in your ankles and legs
• Dark-colored urine (pee) and/or light-colored stool (poop)
• Frequent itching

Bilirubin in urine can be an early sign of liver damage. It may even show up before you have symptoms. So, your provider may order a bilirubin in urine test if you have a high risk for liver damage or disease.

Reasons for an increased risk may include the following:

• A family history of liver disease
• Alcohol use disorder (AUD)
• Obesity
• Diabetes
• Taking certain medicines that can cause liver damage
• Hepatitis or exposure to hepatitis

How to prepare

You don't need any special preparations for a bilirubin in urine test. If your provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test.

Certain medicines and supplements may affect your results, so let your provider know what you are taking. But don't stop taking any medicines unless your provider tells you to. Your provider will let you know if there are any special instructions to follow.

Sample type

Urine

Other names for this test

urine test, urine analysis, UA, chemical urinalysis, direct bilirubin