Bilirubin Direct Serum Test

This test is advised to patients with jaundice (yellowish pigmentation of the eyes and the skin), dark coloured urine, clay coloured stools, abdominal pain and tenderness, nausea, and vomiting. 
The causes include hepatitis due to alcohol, infection, drug reaction, autoimmune disorders and post hepatic causes can be gall stones, pancreatic or gall bladder cancer

The Bilirubin direct serum test is done in the following cases:

• To assess the status of jaundice in patients.
• To identify the prognosis of hepatitis due to alcohol.
• To determine if the patient has any condition concerning auto-immune diseases.
• To assess the impact of post-hepatic causes, such as pancreatic cancer, gall stones, or gall bladder cancer.
• To observe in patients obstruction of the bile duct that might prevent the excretion of bile.
• To examine the presence of cholestasis due to the consumption of some drugs.
• To understand if the patient has any congenital defect leading to increased bile in the blood.

People with the Following Symptoms Should Take the Bilirubin Direct Serum Test:

• Yellowish pigmentation of the eyes
• Yellow pigmentation in the skin
• Suspected hepatitis
• Jaundice in newborns
• Clay-coloured stools
• Dark-coloured urine
• Abdominal tenderness and pain
• Vomiting and nausea
• Drug reaction

The test measures the level of direct (conjugated ) bilirubin in the blood.

The blood sample is taken from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a  little sting when the needle goes in or out. This usually takes less than five minutes.

High bilirubin direct levels indicate problems in liver affecting the bilirubin disposal. 
Hepatic causes include: hepatitis due to alcohol, infection, drug reaction, autoimmune disorders
Post-hepatic causes include gall stones, pancreatic or gall bladder cancer

If you are experiencing any of the following symptoms, you should get the levels of direct bilirubin tested:

• Chills
• Abdominal Swelling
• Fever
• Fatigue
• Nausea
• Chest Pain
• Weakness
• Dizziness

If you have any of the symptoms mentioned above, you should get your Bilirubin Direct Serum levels tested. In the case of newborns, the levels of direct bilirubin need to be included in the routine medical checks. Infants should be tested between their third and seventh days. This is the period of the peak for the levels of direct bilirubin.

Your healthcare provider may ask you not to consume food or water leading four hours before the test to prepare. Certain medications cannot be consumed before taking the Bilirubin Direct Serum test. Ask your healthcare provider to understand which ones would impact the bilirubin levels.

The high levels of bilirubin indicate that your body may not be clearing the element from the body properly. However, the high result is not indicative of any ailment. The test is part of other allied tests such as Alkaline phosphatase, Alanine transaminase, or Aspartate transaminase. The high bilirubin levels only indicate damage to the liver or any other disease.

In normal adults, the direct bilirubin level is generally 0.3 mg/dL. It will be different for women or children. Certain medications, food, or exercise also impact the levels.

Jaundice typically occurs when the liver fails to process red blood cells (RBCs) as they break down. Jaundice is characterised by the yellowing of the whites of the eyes and skin which happens due to the build-up of bilirubin.

Liver failure or loss of liver function either happens gradually (chronic) or suddenly (acute). It can be caused due to high doses of paracetamol or acetaminophen, alcohol abuse, reaction to a medication, hepatitis infection, or an advanced fatty liver. Jaundice, swellings and stomach aches are the common symptoms of liver failure.

Yes, high bilirubin levels for prolonged periods indicate severe liver disease. It also increases the risk of cirrhosis.

Conjugated bilirubin