Elevated Bilirubin (Jaundice): Causes, Symptoms, and Treatment

Our body naturally produces bilirubin. However, this pigment fulfills important functions if it is too concentrated in the blood, it can cause jaundice and other symptoms.

In this article, we will analyze what are the causes and symptoms of high bilirubin and what treatments are recommended for this disorder.

What is Bilirubin

Bilirubin is a yellow pigment that occurs as a result of the degeneration of hemoglobin., A protein found in red blood cells that carries oxygen between the lungs and other tissues.

Bilirubin acts primarily as a cellular antioxidant; this reduction in oxidation processes results in less wear of the cells. However, the excessive presence of antioxidants can damage cells.

This pigment is at the origin of the color of the hematomas and that of the stool, during its elimination by the bile. It also explains the peculiar complexion of people with jaundice.

Several beneficial properties are attributed to moderately elevated bilirubin levels in addition to cellular protection, among which stands out the decrease in the risk of atherosclerosis and other cardiovascular diseases.

Types of bilirubin

We can distinguish two types of bilirubin: direct or conjugated and indirect or unconjugated. The sum of the values ​​of the two types is called “total bilirubin”.

Indirect bilirubin is one that has not yet reached the liver, where it will become soluble in water, allowing it to be excreted.

In turn, direct bilirubin is produced in the liver indirectly. It accumulates in the gallbladder and binds to the bile, through which it will be eliminated later.

Normal and high levels

In healthy adults, normal values ​​of total bilirubin are less than 1.2 mg / dl (Milligrams per deciliter of blood), approx.

Indirect bilirubin is concentrated in the blood in an approximate ratio of 0.1 to 0.5 mg / dl, while healthy levels of direct bilirubin are between 0 and 0.3 mg / dl.

Different diseases can cause an increase in direct or indirect bilirubin levels in our body., Causing various symptoms.

Symptoms of hyperbilirubinemia

Levels of bilirubin greater than 2 or 2.5 mg / dl in blood can cause jaundice, a term for yellowish pigmentation of the mucous membrane, eyes and skin.

For jaundice to be visible on the skin, it is usually necessary for total bilirubin levels to exceed 3 mg / dl., While the white part of the eyes may turn yellow from 2 mg / dl. Other common symptoms are darkening of the tone of urine and, conversely, the acquisition of a pale coloration by the feces.

Conjugated or direct hyperbilirubinemia and unconjugated or indirect hyperbilirubinemia are distinguished depending on whether the disease causing it increases one or the other type of bilirubin.

Causes of high bilirubin

Hyperbilirubinemia is usually caused by diseases of different typesBut there are also other causes that may be enough for its development, such as chemotherapy and the use of antipsychotics, among others.

Direct hyperbilirubinemia

The most common causes of increased conjugated bilirubin levels are related to liver problems.

  • Hepatitis: Damage to liver cells caused by inflammation can increase direct bilirubin levels.
  • cirrhosis of the liver: Diseases such as alcoholism or certain viruses can cause liver cells to replace scar tissue; severe cirrhosis causes jaundice.
  • Gallstones and tumors in the pancreas, they can clog the gallbladder, making it difficult to remove bilirubin.
  • Dubin Johnson and rotor syndromes: Benign hereditary diseases of which jaundice is the main symptom.

Indirect hyperbilirubinemia

Some of the most common causes of unconjugated hyperbilirubinemia are:

  • Hemolytic anemia: Disorder that causes premature breakdown of red blood cells, increasing bilirubin and “bad cholesterol” levels.
  • Gilbert’s Syndrome: Benign hereditary disease that can cause mild jaundice in times of stress or in poor general health.
  • Crigler-Najjar syndrome: A form of inherited jaundice that can cause brain damage to babies born with it.

Treatment of jaundice

Treatment for jaundice depends on the disease causing the increase in bilirubin. Jaundice is usually cured by strengthening the liver, as many of its causes are determined by liver problems.

If the gallbladder is obstructed, surgery is usually necessary. Treatment for other illnesses that cause hyperbilirubinemia is usually done with medication.

Beyond these assumptions, mild jaundice usually does not require treatment in adults. If it is itchy, it can be reduced by using cholestyramine, a medicine that helps break down bilirubin.

In infants, in whom elevated bilirubin levels are common and may be slightly more worrying, jaundice is treated with blood transfusion and light therapy.

Likewise, drink plenty of water, eat fruits and vegetables, and limit the intake of saturated fat and refined sugars are natural ways to reduce the symptoms of high bilirubin.

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