Bilirubin in my blood: what it means, causes, diet
Bilirubin are called pigment, which is formed during the breakdown of haemoglobin. His metabolism is quite a complex process. The article States, causing increased amount of the specified pigment, and how it manifests itself.
General characteristics of bilirubin
This substance is mainly formed in the process of disintegration of erythrocytes (85%) or hemodynamic compounds (for example, cytochromes or myoglobin). A day destroyed about 1% of red blood cells. In this case, the hemoglobin contained in them, can form up to 300 mg of bilirubin.
In the body there are two forms of bilirubin – direct and indirect (associated). Total bilirubin as a separate composition, this ratio only indicates the total amount of the above forms. Free bilirubin is a very toxic compound. It is not soluble in water, so cannot be excreted from the body. However, with the blood it reaches the liver and there begins to communicate with glucuronic acid. He goes into the related form. This means that the bilirubin can be dissolved in water and bile or urine excreted from the body.
To assess the degree of violation of exchange of bilirubin, you should know the concentration in norm. The amount of indirect bilirubin should be no more than $ 16.2 µmol/l, and the concentration of direct shape – from 0 to 4.3. Accordingly, the total bilirubin should be no more than 20,5 mkmol/l.
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The etiology of hyperbilirubinemia
When you register an elevated bilirubin? In the mechanism of hyperbilirubinemia lies excessive breakdown of red blood cells, impaired bilirubin metabolism (in the liver), as well as its impaired elimination through a bad flow of bile. The main causes of excessive concentration of bilirubin:
- Diseases of the blood, especially forms of anemia in which red blood cells reveal an abnormal, haemolytic disease (when it is observed immune aggression against normal cells of the blood), and the effect on erythrocytes of different chemical compounds and toxins.
- Hyperbilirubinemia recorded in the pathology of the liver, which are accompanied by the defeat or destruction of the hepatocytes (for example, hepatitis, bacterial, autoimmune, viral, cirrhosis, exposure to certain drugs and toxic compounds). When the biochemical analysis also recorded increased ALT and AST (aminotransferase).
- Cholelithiasis, pancreatitis, dyskinesia of the gallbladder, presence of tumors or enlarged lymph nodes that are located in close proximity to the bile ducts and impede the normal flow of bile.
- Alcohol poisoning.
- Lack of cyanocobalamin.
- Gilbert syndrome, which is characterized by an inherited deficiency of hepatic enzymes.
Reasons for the increase in bilirubin also include helminthiasis and jaundice of pregnant women, infectious disease (e.g., typhoid, malaria or sepsis), and inherited forms of jaundice (e.g., Rotor’s syndrome), a blood transfusion that is incompatible with the group or RH factor is massive bleeding in the form of large hematomas, and congenital anomalies.
We should call hyperbilirubinemia in newborns. There is jaundice of varying intensity. Why is this happening? Cause is the destruction of red blood cells, which occurs in the process of replacement of fetal hemoglobin in its «adult» form. In most cases, jaundice recorded on day 5 of life. Over time, it resolves on its own without harming the baby.
When the infant is significantly increased unbound form of bilirubin, jaundice develops nuclear. What can be the consequences? When the jaundice observed damage of brain structures. This can lead to a fatal end, so the baby needs immediate intensive care.
The symptoms of hyperbilirubinemia
Often, increasing the concentration of bilirubin has no clinical symptoms. When excess formation of bilirubin (hyperbilirubinemia suprarenal) can observe the following:
- lemon-yellow color of the skin, mucous membranes and whites of the eyes (with an increase of bilirubin in 2 times or more);
- lethargy and weakness, apathy and bad mood;
- cal becomes intense brown color;
- darkening of urine;
- neurological disorders (may present with loss of consciousness, slurred speech, excessive drowsiness and decreased vision).
If high bilirubin is associated with damage to liver tissue, then register:
- so-called «red jaundice», which appears yellow-red colouration of skin and mucous membranes; over time, in this form of jaundice, the skin acquires a greenish tint (when bilirubin twice normal);
- bitter taste in the mouth;
- weak itching of the body;
- vomiting (usually single);
- nausea and heartburn, pain in upper quadrant right;
- urine of dark color.
Impaired bile flow also have an increased bilirubin (obstructive hyperbilirubinemia). In this case, record the following violations:
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- yellowing of mucous membranes, skin, sclera;
- very intense itching of the body;
- pain in the right hypochondrium;
- bitter taste in the mouth;
- discoloration of feces (sometimes to white color);
- weight loss;
- signs of vitamin deficiency.
What is dangerous high levels of bilirubin?
When changes in the metabolism of bilirubin is impaired digestion, resulting in in patients record deficiencies. Also interferes with the normal liver function, especially its detoxification function and formation of proteins. In addition, hyperbilirubinemia can cause cholecystitis or the formation of stones.
Hyperbilirubinemia – what does it mean for the body? When excess amounts of bilirubin affects not only the liver but also the brain and kidneys, which are also subject to the toxic effects of bile pigments. Therefore, when detected in the blood of such violations should conduct appropriate therapy.
Treatment of high bilirubin
The best method of treatment determined by the doctor after finding out the etiology of metabolic disorders of bilirubin. What to do? In the first place eliminate the etiological factor that causes hyperbilirubinemia.
The main method to reduce the high bilirubin is infusion therapy. To her resorted to in severe cases when you need to quickly excrete the excess bilirubin as well as products of its metabolism. As a rule, carried out the infusion of glucose and special detoxification solutions. An effective method is phototherapy. It involves the exposure of patients special lamps. Under their influence, indirect bilirubin passes into a straight shape and can be excreted from the body. This technique is most widely used in Pediatrics.
How to treat patients after the elimination of acute manifestations of hyperbilirubinemia is determined by the physician. Is pharmacological treatment of the underlying disease, which was triggered by the rise of bilirubin. Also appointed agents for the protection of hepatocytes and better outflow of bile.
In the scheme of treatment must include diet. It provides for the restriction of salt and coffee, refusing from fried, smoked foods, alcohol and black bread. In the diet useful to include buckwheat and oat porridge, increase the amount of fluid (up to 2.5 liters per day in the form of herbal teas, non-carbonated mineral water, fruit compotes). Diet with increased bilirubin also provides for the rejection of sour types of fruit, mushrooms, spinach, a variety of sweets and preservation. With proper treatment the patient’s condition quickly improved and his bilirubin level is reduced to normal values.