Bilirubin Total (Direct and Indirect) Test

This test is advised to patients with jaundice (yellowish pigmentation of the eyes and the skin), abdominal pain and tenderness, nausea, and vomiting. 
The causes of high unconjugated bilirubin are pre-hepatic destruction of RBC for e.g., haemolytic anaemia, large hematoma, megaloblastic anaemia
The causes high conjugated bilirubin include hepatitis due to alcohol, infection, drug reaction, autoimmune disorders and post hepatic causes can be gall stones, pancreatic or gall bladder cancer

This test measures the total, direct and indirect bilirubin levels 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 total bilirubin levels indicate either that the RBCs are being broken down at an abnormal rate or that the liver is not breaking down the bilirubin properly. This may occur due to jaundice, anaemia's or liver conditions like cirrhosis, ascites, hepatitis, or certain drug toxicities.

 High bilirubin direct levels indicate problems in liver affecting the bilirubin disposal. This may occur due to jaundice, or liver conditions. High direct bilirubin levels may also occur due to certain blockages like gall stones or certain pancreatic issues.

High bilirubin may also occur due to sickle cell or other types of anaemia.  Gilbert's syndrome is a condition leading to faulty enzyme that processes the bilirubin leading to high bilirubin levels. All these require further clinical correlation. 

Low bilirubin levels are usually not harmful.