As a result of disintegration, bilirubin is formed in the spleen, bone marrow and liver of hemosomal proteins. It is a yellow-brown bile pigment. Previously, doctors believed that it is necessary only for the processing of hemoglobin, but recent studies have shown that it is also a natural antioxidant.
When conducting a blood test, establish the amount of this pigment in the blood. So, we are talking about the fact that an elevated total bilirubin is detected in the blood in the event that its concentration exceeds 20.5 μmol / l. Separately, determine the amount of its conjugated (straight) and unconjugated (indirect) form. This is done using 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 to the liver. This form is considered poisonous, it adversely affects the central nervous system.
Direct bilirubin is formed after the neutralization of this pigment by the liver cells. It becomes water-soluble and leaves the body with bile, initially falling into the intestine. It is this pigment that gives feces a dark color.
Reasons for raising
As a result of the development of a number of diseases, elevated bilirubin in the blood can be detected in a person. What does this mean, we must 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 a source of problems. Elevated bilirubin in the blood may be due to:
- an increase in the intensity of erythrocyte decay;
- liver damage and impaired processing of indirect bilirubin;
- problems with the flow of bile;
- heredity (loss of one of the links required for processing indirect forms of bilirubin).
Proper diagnosis allows us to understand why bilirubin in the blood is elevated. Causes identified in a timely manner, allow to eliminate the main problem. Due to adequate and timely prescribed therapy, it is possible to get rid of the onset of jaundice.
Symptoms of the disease
It is easy to detect an increase in the concentration of bilirubin in the blood. Signs of these problems are always pronounced. So, the main symptom of the fact that a person has increased bilirubin in the blood is the yellowness of the sclera, mucous membranes and skin membranes. This is due to the fact that the pigment produced easily penetrates into the tissues of the body and changes their color. It also affects the nerve endings, causing itching.
In addition, the following symptoms are observed:
- bitter eructations, nausea, loss of appetite;
- weakness, headaches, heart palpitations;
- heaviness in the right and left hypochondrium;
- dark urine (it may become the color of tea);
- noticeable discoloration of feces.
Of course, only after a comprehensive examination, it is safe to say that the patient has elevated bilirubin in the blood. But, as a rule, such a diagnosis does not come as a surprise. Indeed, according to the presence of clinical signs, the doctor even before the tests, suggests that the level of this pigment in the venous blood may be elevated.
Red cell destruction
One of the causes of jaundice is hemolytic anemia. As a result, increased destruction of red blood cells begins. If there are certain defects in the structure of these blood cells, they speak of congenital hemolytic anemia. This condition can occur in diseases such as sickle cell anemia, thalassemia, microspherocytosis in hereditary form.
As a result of autoimmune processes, in the fight against immunity with its own erythrocytes, acquired hemolytic anemia occurs. This condition may also begin to develop with poisoning, malaria, as a result of taking certain medications.
There are also other factors that explain why bilirubin is elevated in the blood. The reasons for the increase in the indirect form of this pigment may also be as follows:
- hepatitis toxic, viral or alcoholic origin;
- cancer of the liver;
With these diseases there is a feeling of heaviness in the right hypochondrium, bitter belching, discomfort after each intake of heavy or fatty foods, weakness and a noticeable decrease in efficiency. When hepatitis viral etiology often increases in temperature. All these diseases are accompanied by darkening of the urine.
Violation of the outflow of bile
Understand what it means increased bilirubin in the blood, you can, if you see the results of tests. The level of pigment to be increased due to the increasing concentration of its direct or indirect form. Conjugated bilirubin often increases due to gallstone disease, which is accompanied by a violation of the outflow of bile, with cancer of the gallbladder and pancreas.
These problems may include the following symptoms:
- pain in the liver (right hypochondrium region);
- nausea, vomiting, abdominal distension, loss of appetite, constipation, or diarrhea;
- dark urine.
If the outflow of bile is completely disturbed, then the feces become like white clay.
Elevated direct bilirubin in the blood always causes jaundice. First of all, the sclera of the eyes are stained, then the mucous membranes and skin.
Problems in kids
Newly minted parents often face the fact that their babies are diagnosed with elevated bilirubin in the blood. What this means can be determined through special studies. The reason for this condition can be the usual physiological processes that occur in the body of the baby after birth, or hemolytic anemia.
Physiological jaundice occurs due to the fact that in the blood system of the fetus in the erythrocytes there is a special fetal hemoglobin. These blood cells begin to massively collapse, the liver of a newborn can not always cope with their disposal, and the baby’s mucous membranes and skin become jaundiced. If on the 3-4th day after birth the concentration of pigment in the blood exceeds 256 µmol / l, then the child is prescribed phototherapy. In some cases, also make droppers with glucose. For premature babies, the rate is 171 µmol / l.
For pathological problems, such as hemolytic disease of the newborn, bilirubin increases excessively.
Fortunately, only a few future mothers are faced with a situation in which they are informed that bilirubin is elevated in blood counts. This condition occurs, as a rule, in the third trimester. An increase in the concentration of the direct form of this pigment suggests that a hepatic cholestasis could begin to develop in a pregnant woman. This is a condition in which the outflow of bile is violated 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 retake tests for hepatitis. It also checks if hemolytic anemia or cholecystitis could have started in a pregnant woman.
It is important to understand in time why bilirubin in the blood is elevated. Adequate treatment should be prescribed immediately. Indeed, in some cases, hemolytic disease of the fetus can begin. It is characterized by general swelling of the baby. In this case, childbirth begins prematurely, and the child may 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 the cells of the liver. At the same time it is connected and transformed 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 gets into the feces and excreted with him.
But indirect bilirubin is considered toxic. It can affect the intestines and other parts of the digestive tract, lungs, heart and nervous system. Elevated bilirubin in the blood significantly affects the overall condition of the person. Jaundice symptoms appear that prevent the body from functioning properly.
Selection of treatment regimen
You can decide on the therapy if you make an accurate diagnosis and determine why bilirubin in the blood is elevated. In cholelithiasis, it is important to ensure the normal flow of bile. In most cases, it is recommended to surgically remove the gallbladder. But also the patient may be asked to crush the stones with the radio wave method. You can dissolve the remaining formations and stimulate the outflow of bile with the help of the preparations “Henofalk”, “Ursofalk” and a number of similar ones.
For problems with the liver, therapy should be aimed at restoring its functioning. It is important to be examined, to pass tests for all kinds of hepatitis, to make liver tests, to undergo an ultrasound. It 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 established diagnosis. It is also important in all cases to drink hepatoprotectors. These are such medicines as “Hepatosan”, “Prohepar”, “Heptral”, “Carsil”, “Hepabene”.
Hemolytic anemia makes blood transfusions. In some situations, even removal of the spleen is indicated. With prolonged jaundice that lasts for several years, it often becomes the only method. Thanks to splenectomy can significantly improve the composition of the blood.
Measures to reduce bilirubin
In addition to the basic 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 an unconjugated form into a conjugated one. To reduce the toxic effect is often prescribed droppers with glucose.
Acute life-threatening conditions can be stopped with the help of the drug "Phenobarbital." But it is necessary to use it only as prescribed by a doctor in the hospital. He is even prescribed to newborns in whom elevated bilirubin in the blood can have a detrimental effect on the central nervous system.
Also, doctors may recommend drinking a decoction of corn stigmas, chamomile, immortelle. These methods are considered popular, but they also help speed recovery.