Increased bilirubin in the blood - causes and treatment

• Bilirubin direct, indirect and general
• Elevated bilirubin in the blood: causes and symptoms
• Bilirubin norm in children and adults
• Physiological jaundice of newborns
• How to lower bilirubin

Bilirubin is a pigment of a saturatedyellow-brown color, which is produced in many organs and tissues and is the product of the final disintegration of hemoglobin and other hemo-containing proteins in the cells of the liver, bone marrow and spleenki.

The physiological role of bilirubin is not fully understood, however, according to the latest research, it is needed not only for the utilization of hemoglobin, as previously thought, but also is a powerful natural antioxidant, which gives great prospects for the discovery of new methods of treatment of oncological, cardiological and many other diseases.

Bilirubin direct, indirect and general ^

In the human body, bilirubin is present in two forms:

• direct( bound),
• and indirect( free).

Total bilirubin in its pure form does not exist, but is defined as the total amount of direct and indirect, and, as a rule, direct bilirubin should be 75% of the total. Every day in the body, about 250-350 mg of bilirubin is produced, with about 80% being produced by the decay of erythrocytes( from 1 gram of hemoglobin - about 36 grams of bilirubin).

As is known, human blood is a rapidly renewing connective tissue consisting of plasma and element cells: erythrocytes( provide tissues with oxygen), leukocytes( responsible for immunity and fighting infections) and platelets( responsible for blood clotting).

Erythrocytes, or red blood cells - are the most numerous of the blood cells. They live on average about 120 days, after which they disintegrate, releasing the hemoglobin contained in them.

Hemoglobin, after complex chemical reactions, initially is converted into free, or indirect bilirubin, insoluble in water and extremely poisonous. It is concentrated in the liver by grasping it with hepatic cells from the blood.

In the liver, free bilirubin is, as it were, "neutralized" - under the influence of special enzymes it combines with glucuronic acid and becomes bound. Thanks to the action of glucuronic acid, direct bilirubin, unlike the indirect one, becomes soluble and less toxic - it is easily dissolved in the bile, it enters with it into the intestines and then is removed from the body naturally along with the feces, giving it a brown color.

Elevated bilirubin in the blood: causes and symptoms ^

In normal bilirubin exchange, a very small amount of direct bilirubin enters the blood. However, with pathological failures, its concentration can significantly increase both in blood( hyperbilirubinemia) and in urine( bilirubinuria), penetrating into surrounding tissues and causing yellowing of the skin, sclera of the eyes and mucous membranes.

In addition, frequent signs of the disease:

• nausea,
• weakness,
• vomiting,
• bitter eructation,
• severity in the right hypochondrium,
• discolored, almost white feces,
• urine color beer,
• itching.

The main causes of bilirubin metabolism disorders:

• Blood diseases in which there is a sharp increase in the number of non-viable red blood cells( anemia), immune aggression towards normal red blood cells( hemolytic disease of the newborns, Rh-conflict of the child with the mother), and the effects of toxic and chemical substances onblood cells.

• Diseases of the liver( viral, bacterial, autoimmune, toxic and medicinal hepatitis, jaundice), affecting or destroying liver cells. With severe jaundice, not only the skin and sclera of the eyes turn yellow, but also saliva, sweat, tears, breast milk and all internal organs.

• Disturbance of free passage of bile through the bile ducts - cholelithiasis, dyskinesia of the gallbladder, pancreatitis, the presence of tumors, scars or enlarged lymph nodes in the vicinity of the bile ducts.

• Alcohol, chemical and drug poisoning.

• The lack of vitamin B12.

• The hereditary deficiency of the liver enzyme is Gilbert's syndrome.

• Physiological jaundice of newborns.

The norm of bilirubin in children and adults ^

Determining the level of bilirubin in the blood is an important tool for diagnosing many diseases, primarily the liver, biliary tract and hematopoiesis system, and is one of the main indicators of biochemicalblood test.

The total, indirect and direct bilirubin normal values ​​for adults and children are given in the table:

Newborn physiological jaundice ^

Elevated bilirubin in newborns is not a disease and, in most cases, passes on its own and does not require treatment. This phenomenon is called physiological jaundice( jaundice) of newborns and is associated with the adaptation of the child's organism to the changed environmental conditions.

The fact is that, the blood of children of the first days of life contains the so-called fetal hemoglobin( formed in the womb), which differs in composition from the hemoglobin of an adult and is subject to active replacement during the first month of life.

Due to the fact that when a hemoglobin is replaced, a significant amount of the products of erythrocyte destruction is released, and the liver and the bile excretory system of the baby does not yet function fully, for about 3-4 days, its skin and mucous membranes can turn yellow. It is not necessary to be frightened of this condition - as soon as the enzyme system of the child fully works, the skin color will change to gently pink, usually this happens on the 7th-8th day of life. Somewhat longer and more pronounced may occur jaundice in case of Rhesus conflict( negative Rhesus in the mother and positive in the infant) or in the presence of the fetus in the first blood group, and in the child the second( less often the third).At the same time, children become unnecessarily drowsy and need to be awakened for feeding.

To reduce the toxicity of exposure to high levels of bilirubin and accelerate its excretion with feces and urine, in modern medicine, the phototherapy method is widely used. The baby is placed under a special lamp, covered with an eye patch and covered, if possible, on both sides. As a rule, after 4 days of phototherapy, the symptoms of jaundice completely disappear.

A positive effect on the treatment of jelly is breastfeeding and previously applying the baby to the breast - this helps to quickly remove meconium and reduces the likelihood of complications. In more severe cases, with severe forms of jaundice, donor blood transfusion may be required to save the nervous system and the child's life from toxic effects.

How to lower bilirubin ^

To lower bilirubin in the blood, first of all, it is necessary to establish the root cause of its increase. Otherwise, it will continue to increase, because hyperbilirubinemia is not an isolated disease, but one of the symptoms of the disease.

• In particular, if stagnation of bile is to blame, it is sufficient to remove the obstruction, for example, to remove a stone in the gallbladder or to conduct a course of treatment with drugs that improve bile secretion.
• When viral hepatitis requires antiviral treatment, with hemolytic anemia - means to prevent increased disintegration of erythrocytes.
• If the cause is related to the intoxication of the body, the intake of adsorbents binding toxic substances and hetaprotectors serving to protect the liver will help.

In addition, to reduce the enzyme in the blood, you need to maximally relieve the liver and gallbladder, changing your diet to a healthy diet:

• From the menu, you should exclude sharp, smoked and fried foods, carbonated drinks, alcohol, strong tea, sweets.
• Give preference to fresh, boiled and baked products, especially vegetables - this will help to eliminate the causes of constipation, restore the beneficial microflora and ensure rapid removal of toxins from the intestine.
• In order not to disturb the digestive tract, eat often, but little by little, do not overeat and do not allow long breaks between meals.
• In addition, during the acute period, hunger diets for weight loss are banned, observance of the therapeutic diet for cholelithiasis is indicated.

To make the right diagnosis, you need to know how to properly prepare for the delivery of tests. Blood is taken from the veins in the morning on an empty stomach, it is not recommended to take food and drink coffee( caffeine lowers the level of bilirubin) within 8 hours before the procedure, otherwise the results of the study may be unreliable.

In the days before blood donation refuse fatty foods( so as not to overload the liver) and from excessive physical exertion provoking pain in the right hypochondrium. To obtain accurate indicators, sometimes a preliminary cancellation( up to 2 weeks) of certain drugs, in particular vitamin C and antiepileptic drugs, is required.

If the test is carried out correctly and showed the enzyme level is well below normal, this should also alert. The causes of low bilirubin are not well understood, because, more often than not, people suffer from an elevated enzyme content, and not from a lowered one.

However, according to some medical studies, there is a direct relationship between its reduced level and the disease of coronary heart disease, that is, the risk of heart attacks and strokes is much lower with high bilirubin than at low bilirubin.

In conclusion, I want to note that a high level of bilirubin requires careful attention and strict control, as it is extremely toxic to the central nervous system and causes a lot of ailments - persistent headaches, loss of strength, slowing of the pulse( bradycardia).

Therefore, the best way to avoid intoxication of the brain and the entire body - at the first symptoms to seek help from a doctor.