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Urobilinogen is a yellow by-product of bilirubin reduction. It is formed in the intestines by the bacterial enzyme bilirubin reductase. [ 1 ] About half of the urobilinogen formed is reabsorbed and taken up via the portal vein to the liver, enters circulation and is excreted by the kidney.
Unconjugated bilirubin is not water-soluble and so is not excreted in the urine. Testing urine for both bilirubin and urobilinogen can help differentiate obstructive liver disease from other causes of jaundice. [61] As with billirubin, under normal circumstances, only a very small amount of urobilinogen is excreted in the urine. If the liver's ...
Unconjugated bilirubin is hydrophobic, so cannot be excreted in urine. Thus, the finding of increased urobilinogen in the urine without the presence of bilirubin in the urine (due to its unconjugated state) suggests hemolytic jaundice as the underlying disease process. [39]
Choluria (or bilirubinuria) is a symptom defining an abnormal darkness of the urine, mainly due to a high level of conjugated bilirubin. [1] [2] Choluria is a common symptom of liver diseases, such as hepatitis and cirrhosis. It can be described as dark or brown urine, often referred to as the color of Coca-Cola.
Urine urobilinogen is increased in liver disease and hemolytic jaundice (jaundice due to increased destruction of red blood cells); in the latter case, urine bilirubin is typically negative. In bile duct obstruction, urine bilirubin increases but urobilinogen is normal or decreased, as bilirubin cannot reach the intestines to be converted to ...
Conjugated bilirubin is then secreted along with bile into the intestine and is either excreted in faeces as urobilinogen or reabsorbed into blood and transported back to the liver. The varied causes of hyperbilirubinemia are best understood from bilirubin metabolism.
Results from the urine test should be confirmed by a complete blood count (CBC) and serum testing for total serum bilirubin and fractionated bilirubin. [32] Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis . [ 28 ]
Although 20% of the secreted bilirubinoid bile is reabsorbed by the small intestine, [2] conjugated bilirubin is not reabsorbed in small intestine. All conjugated bilirubin in the large intestine is metabolised by colonic bacteria to urobilinogen, which is then further oxidized to urobilin and stercobilin. Urobilin, stercobilin and their ...
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