Bile pigment Test

Your doctor may order a bile pigment test if you have the following symptoms:

• Nausea accompanied by vomiting
• Abdominal discomfort and pain
• Weakness and fatigue
• Persistent tiredness 
• Yellowing of eyes and skin (jaundice)
• Pruritus (intense itching of skin due to the increased concentration of bile pigments in the body)

Most of these symptoms are associated with one or other liver disease. 

A bile pigment test is also ordered to people who have:

• Hereditary cholestatic syndrome (a group of rare liver disorders)
• Intrahepatic cholestasis during pregnancy (a liver disorder occurring in pregnant women where the bile builds up in the liver and interferes with the functioning of the liver)
• Biliary cirrhosis (a chronic liver disease in which the bile ducts get damaged gradually)
• Sclerosing cholangitis (a chronic disease characterised by damage of the bile ducts)

You do not need any specific preparations before this test. However, if you have any allergies or underlying health conditions or if you are taking medications, then you must inform the doctor. 

This test is conducted on a 24-hour urine sample as it gives average values of bile pigment excreted through the day. An average value is a better indicator of body function than a single reading from a random urine sample.

You will be provided with a container to collect the sample. The collection of the sample should begin in the morning. Do not collect the first urine of the day. After this, samples should be collected from every urine throughout the day for the next 24 hours.

In between use, keep the urine container in a cool environment. You can also keep it in a refrigerator. This would keep the sample intact before analysis. 

Make sure to label the container with your name along with the date and time of collection of the sample. 

After the sample is collected (in a period of 24 hours), it must be taken to the laboratory for analysis. 

If the test is being performed on an infant, you'll be provided with a urine collection bag along with a container. Before you collect the sample, make sure to clean the area around the urethral opening of the baby. Then, place the urine collection bag appropriately so as to avoid any spillage.

Empty the sample into the container and deliver it to the laboratory for testing. 

Normal results:

If the test indicates the absence of bile pigments in the urine, the results are considered to be negative or normal. 

Abnormal results:

While a small amount of urobilinogen tends to be present in the urine - the normal range for urobilinogen across all age groups is taken to be 0.2-1 mg/dl - a high concentration of this bile pigment indicates liver damage. If there is no or too little urobilinogen in your urine, it may indicate:

• A blockage in the structures carrying bile from your liver
• Liver malfunctioning 

An abnormally high level of urobilinogen in your urine can mean:

• Liver disease 
• Hepatitis 
• Cirrhosis 

A high level of bilirubin (another bile pigment) and urobilinogen may be an indication of:

• Liver diseases (such as hepatitis)
• Malfunctioning of the liver
• Biliary obstruction
• Jaundice

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.