What Does Urobilinogen in Urine Indicate?

Urobilinogen is a colorless by-product of the transformation process of bilirubin (a yellow product).

Bilirubin is produced during hemolysis (breakdown of old red blood cells). This bilirubin is used by the liver to produce bile, a fluid that helps digest food in the intestines.

Some part of the bile flows through the ducts from the liver directly into the intestines whenever food is consumed, and the rest is stored in the gallbladder for further needs.

The good bacteria in the intestines break down the bilirubin in the bile to produce urobilinogen.

A portion of urobilinogen is excreted from the body through stools. Some urobilinogen reenters the bloodstream and is reabsorbed by the liver, where it is recycled into bile. A small amount of urobilinogen is excreted from the body via urine.

Urobilinogen in urine tests can be a part of a routine urinalysis, which is often used to check the general health status of an individual.

It can help diagnose diseases affecting the liver, gallbladder, or bile ducts and hemolytic anemia.

People with liver disease may experience symptoms, such as:

• Nausea
• Vomiting
• Lack of appetite
• Fatigue
• Weakness
• Jaundice
• Swelling and/or pain in the abdomen
• Swelling in the ankles and legs
• Dark-colored urine
• Light-colored stools
• Frequent itching

Hemolytic anemia may present with:

• Fatigue
• Dizziness
• Heart palpitations
• Headache
• Confusion
• Jaundice
• Hepatomegaly
• Splenomegaly

The normal urobilinogen levels in urine range between 0.1 to 1.8 mg/dL (1.7 to 30 µmol/L). A concentration of more than 2.0 mg/dL (34 µmol/L) is pathological.

Low urine urobilinogen may result from the following:

• Obstructive jaundice
• Congenital enzymatic jaundice (hyperbilirubinemia syndromes)
• Treatment with broad-spectrum antibiotics (due to destruction of the intestinal bacterial flora)

Urobilinogen in urine (above the normal expected value) can be an early sign of liver damage, even before the initiation of symptoms. Urobilinogen is normally found in the urine in trace amounts (0.2 to 1.0 mg/dL).

A urinalysis detects the levels of urobilinogen and is often recommended for people who have a high risk for liver damage or disease because of a family history of liver disease.

The treatment primarily depends on the cause of abnormal levels of urobilinogen, but may include:

• Hemolysis: Iron supplementation to help replace lost red blood cells.
• Medications: The medication is stopped, or an alternative is prescribed.
• Liver diseases: Appropriate and extensive treatment is used depending on the extent of liver damage. In rare and severe cases, a liver transplant could be required
• Lifestyle modifications: Engage in regular exercise and consume a healthy and well-balanced diet.