Wednesday, February 9, 2011

Bile in urine

I spoke to Dr. Speece today, and he said that the color of Mom's urine probably indicates that there is bile in her urine. He didn't elaborate much more than that, so I have to do some research on that.


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http://en.wikipedia.org/wiki/Bilirubin

Bilirubin (formerly referred to as hematoidin) is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of red blood cells. Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases. It is responsible for the yellow color of bruises, urine[dubious ], and the yellow discoloration in jaundice.

Metabolism

[edit] Unconjugated (indirect)

Erythrocytes (red blood cells) generated in the bone marrow are disposed of in the spleen when they get old or damaged. This releases hemoglobin, which is broken down to heme as the globin parts are turned into amino acids. The heme is then turned into unconjugated bilirubin in the reticuloendothelial cells of the spleen. This unconjugated bilirubin is not soluble in water. It is then bound to albumin and sent to the liver.

[edit] Conjugated (direct)

In the liver it is conjugated with glucuronic acid by the enzyme glucuronyltransferase, making it soluble in water. Much of it goes into the bile and thus out into the small intestine. Some of the conjugated bilirubin remains in the large intestine and is metabolised by colonic bacteria to urobilinogen, which is further metabolized to stercobilinogen, and finally oxidised to stercobilin. This stercobilin gives feces its brown color. Some of the urobilinogen is reabsorbed and excreted in the urine along with an oxidized form, urobilin.

[edit] In urine

Normally, a tiny amount of bilirubin is excreted in the urine if any. If the liver’s function is impaired or when biliary drainage is blocked, some of the conjugated bilirubin leaks out of the hepatocytes and appears in the urine, turning it dark amber. However, in disorders involving hemolytic anemia, an increased number of red blood cells are broken down, causing an increase in the amount of unconjugated bilirubin in the blood. As stated above, the unconjugated bilirubin is not water soluble, and thus one will not see an increase in bilirubin in the urine. Because there is no problem with the liver or bile systems, this excess unconjugated bilirubin will go through all of the normal processing mechanisms that occur (e.g., conjugation, excretion in bile, metabolism to urobilinogen, reabsorption) and will show up as an increase in urine urobilinogen. This difference between increased urine bilirubin and increased urine urobilinogen helps to distinguish between various disorders in those systems.

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http://uk.answers.yahoo.com/question/index?qid=20070404103351AAy8z2S

bile is breakdown of bilirubin,which is product of iron
catabolism in blood.....normally there isn't a whole lots of bililrubin in blood...normally it gets passed off in stool.....if the liver becomes infected or sick,a backup of bilirubin in blood spills into urine.....causes can be from drugs,hepatitis,viruses,cancer,etc......… a gallbladder that has stones and the bile duct that normally empties the bile,becomes blocked by stone or obstruction,you might see bilirubin in urine,,,lastly,kidney stones cause blood in urine and this can breakdown into free bilirubin.....so a chem panel is also needed here to see what the liver is doing....steve borne,MT,CLS

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