As a result of disintegration in the spleen, bone marrow and liver of hemo-containing proteins, bilirubin is formed. It is a pigment of bile yellow-brown color. Previously, physicians believed that it is only needed for the processing of hemoglobin, but recent studies have shown that it is also a natural antioxidant.
Forms of bilirubin
When performing a blood test, the amount of this pigment in the blood is set. So, we are talking about the fact that an increased total bilirubin in the blood is detected if its concentration exceeds 20.5 μmol / l. The amount of its conjugated (direct) and non-conjugated (indirect) form is separately determined. This is done with the help of special laboratory tests.
Indirect bilirubin is toxic. It is formed as a result of the breakdown of red blood cells and the release of hemoglobin, and then binds in the liver. This form is considered poisonous, it negatively affects the central nervous system.
Direct bilirubin is formed after neutralization of this pigment by liver cells. It becomes water-soluble and leaves the body with bile, falling first in the intestine. It is this pigment that gives the feces a dark color.
The reasons for the increase
As a result of the development of a number of diseases, an elevated bilirubin in the blood can be detected in a person. What this means, it is necessary to understand. First of all, the causes that led to an increase in the concentration of this pigment in the venous blood should be established.
Experts identify several factors that are the source of problems. Elevated bilirubin in the blood may be due to:
- increased intensity of erythrocyte decay;
- liver lesions and irregularities in the processing of indirect bilirubin;
- problems with outflow of bile;
- heredity (loss of one of the links necessary for the treatment of the indirect form of bilirubin).
Correct diagnosis allows you to understand why bilirubin in the blood is elevated. The reasons, revealed in a timely manner, allow to eliminate the main problem. Thanks to adequate and timely treatment, you can get rid of the jaundice that has begun.
Symptoms of diseases
It is not difficult to detect an increase in the concentration of bilirubin in the blood. The signs of these problems are always pronounced. So, the main symptom of the fact that a person has elevated bilirubin in the blood, is icteric sclera, mucous membranes and skin membranes. This is due to the fact that the produced pigment easily penetrates into the tissues of the body and changes their color. It also acts on the nerve endings, causing itching.
In addition, there are such symptoms:
- bitter belching, nausea, loss of appetite;
- weakness, headaches, heart palpitations;
- heaviness in the right and left hypochondrium;
- darkening of urine (it can become the color of tea);
- marked discoloration of stool.
Of course, only after a comprehensive examination it can be stated with certainty that the patient has elevated bilirubin in the blood. But, as a rule, such a diagnosis does not come as a surprise. After all, due to the presence of clinical signs, the doctor even before taking the tests indicates that, probably, the level of this pigment in the venous blood will be increased.
Destruction of red blood cells
One of the causes of jaundice is hemolytic anemia. As a result, increased destruction of erythrocytes begins. If there are certain defects in the structure of these blood cells, they speak of congenital hemolytic anemia. This condition can occur with such diseases as sickle cell anemia, thalassemia, microspherocytosis in hereditary form.
As a result of the course of autoimmune processes, when fighting immunity with their own erythrocytes, acquired hemolytic anemia occurs. This condition can begin to develop also with poisoning, malaria, as a result of taking certain medicines.
Problems with the liver
There are also other factors that explain why bilirubin is elevated in the blood. The reasons for the increase in the indirect shape of this pigment may also be as follows:
- hepatitises of toxic, viral or alcoholic origin;
- cancerous liver damage;
With these diseases, there is a feeling of heaviness in the right hypochondrium, bitter belching, discomfort after every intake of heavy or fatty foods, weakness and a marked decrease in efficiency. With hepatitis of the viral etiology, a temperature increase is often observed. All these diseases are accompanied by darkening of urine.
Disturbance of outflow of bile
Understand what it means increased bilirubin common in the blood, you can if you see the results of tests. The pigment level should be increased due to the increase in the concentration of its direct or indirect form. Conjugated bilirubin is often increased due to cholelithiasis, which is accompanied by a violation of the outflow of bile, with oncological diseases of the gallbladder and pancreas.
These problems can be accompanied by such symptoms:
- pain in the region of the liver (region of the right hypochondrium);
- nausea, vomiting, bloating, decreased appetite, constipation, or diarrhea;
- darkening of urine.
If the outflow of bile is completely disturbed, the stool becomes like white clay.
Elevated direct bilirubin in the blood always causes jaundice. First of all, eye sclera, then mucous membranes and skin integuments are painted.
Problems in Toddlers
Newly-minted parents often face the fact that their babies are diagnosed with elevated bilirubin in their blood. What this means can be determined with the help of special studies. The cause of this condition can serve as the usual physiological processes that occur in the body of a baby after birth, or hemolytic anemia.
The physiological jaundice arises from the fact that in the circulatory system of the fetus in erythrocytes there is a special fetal hemoglobin. These blood cells begin to mass destruction, the liver of the newborn can not always cope with their utilization, and the mucous and skin integuments of the baby become icteric. If on day 3-4 after birth, the pigment concentration exceeds 256 μmol / l, then the child is prescribed phototherapy. In some cases, also make droppers with glucose. For premature babies, the norm is 171 μmol / l.
In pathological problems, such as hemolytic disease of the newborn, bilirubin increases excessively.
Complication of pregnancy
Fortunately, only a few future mothers are confronted with a situation in which they are informed that bilirubin is elevated in blood analysis. This condition occurs, as a rule, in the third trimester. An increase in the concentration of the direct form of this pigment indicates that the hepatic cholestasis could begin to develop in a pregnant woman. This is a condition in which the outflow of bile is disturbed directly from the liver. The disease occurs even in healthy expectant mothers.
But sometimes an increase in bilirubin can indicate a number of diseases. Doctors recommend retaking the tests for hepatitis. Also it is checked, whether the hemolytic anemia or a cholecystitis could begin at the pregnant woman.
It is important to understand in due time, why bilirubin in the blood is elevated. Adequate treatment should be given promptly. After all, in a number of cases, hemolytic disease of the fetus may begin. It is characterized by a common swelling of the baby. In this case, birth begins prematurely, and a child can die in utero or almost immediately after birth.
What is dangerous bilirubin
As a result of the destruction of hemoglobin, a yellow-brown toxic pigment is released. With the normal functioning of all systems, it is processed by liver cells. At the same time, it binds and transforms into a direct form. Such bilirubin becomes water-soluble, it can no longer enter into various reactions, producing a toxic effect. If his level is normal, then he falls into the feces and is taken out with it.
But indirect bilirubin is considered toxic. It can affect the intestines and other parts of the digestive tract, lungs, heart and nervous system. Increased bilirubin in the blood significantly worsens the general condition of a person. There are symptoms of jaundice that interfere with the body to function normally.
Selection of treatment regimens
Determine the therapy can be, if you establish an accurate diagnosis and determine why increased bilirubin in the blood. With cholelithiasis it is important to ensure a normal outflow of bile. In most cases, it is recommended to remove the gallbladder surgically. But also the patient can be offered to shatter the stones with the radio wave method. Dissolve the remaining formations and stimulate the outflow of bile with the help of drugs "Henofalk", "Ursofalk" and a number of similar ones.
In case of problems with the liver, therapy should be aimed at restoring its functioning. It is important to be examined, to pass tests on all kinds of hepatitis, to make liver tests, to undergo ultrasound. This is necessary to understand why bilirubin is elevated in the blood. Treatment consists in the selection of antiviral, anti-inflammatory, antibacterial, immunostimulating agents. They are selected depending on the diagnosis. It is also important in all cases to drink hepatoprotectors. These are such medicines as "Hepatosan", "Progepar", "Geptral", "Karsil", "Gepabene".
In hemolytic anemia, blood transfusion is done. In some situations, even removal of the spleen is indicated. With prolonged jaundice, which lasts for several years, it often becomes the only method. Thanks to splenectomy, the blood composition can be significantly improved.
Measures to reduce bilirubin
In addition to the main therapy aimed at eliminating the disease, it is also important to stimulate the withdrawal of bilirubin from the body. With the help of phototherapy - irradiation with special lamps - it is possible to stimulate the processing of this pigment from unconjugated form to conjugated. To reduce the toxic effect, often prescribed droppers with glucose.
Acute conditions threatening life can be managed with the help of the drug "Phenobarbital". But it is necessary to use it only for the doctor's prescription in the hospital. It is even prescribed to newborns whose elevated bilirubin in blood can have a disastrous effect on the central nervous system.
Also, doctors can recommend drinking a decoction of corn stigmas, chamomile, immortelle. These methods are considered folk, but they also help to speed up recovery.