What Does It Mean If You Have Urobilinogen in Your Urine?

Causes of excess urobilinogen in urine may include viral hepatitis, cirrhosis, or liver damage.

Urobilinogen forms as the liver processes bilirubin from red blood cells and releases it into the intestine.

Urobilinogen is a substance that is produced when bilirubin, a waste product produced by the breakdown of red blood cells, is processed in the liver and released into the intestine. Some of the urobilinogen produced in the intestine is reabsorbed and returned to the liver; the rest is excreted in the feces.

A small amount of urobilinogen is excreted in the urine in the form of urobilin. Urobilinogen is colorless, while urobilin gives urine its yellow color.

Excess urobilinogen in urine may indicate liver diseases, such as viral hepatitis, cirrhosis, or liver damage. Other causes of high urobilinogen in urine include:

• Drugs
• Toxic substances
• Conditions associated with increased red blood cell destruction (hemolytic anemia)

In a person with low urobilinogen in urine and/or signs of liver dysfunction, it can be indicative of hepatic or biliary obstruction.

Normal urobilinogen levels in urine are typically less than 17 umol/L or 1 mg/dL. It is common to have values within the 0 to 8 mg/dL range. An increase or decrease in urobilinogen in urine is considered abnormal and is investigated in a clinical setting.

Urobilinogen urine tests could be ordered at your regular checkup, as part of ongoing liver condition monitoring, or if you have symptoms of liver disease, such as:

• Jaundice (causes your skin and eyes to turn yellow)
• Nausea and/or vomiting
• Dark-colored urine
• Pain and swelling in the abdomen
• Itchy skin

Urobilinogen levels in urine that are higher than normal may indicate:

• Hepatitis
• Cirrhosis
• Liver damage due to drugs

Having raised urobilinogen in urine does not necessarily mean that you have a serious health problem. However, if you have elevated levels of urobilinogen in your urine, talk to your doctor and discuss any potential underlying causes. Your doctor may recommend further testing or treatment, depending on the underlying cause of the urobilinogen in your urine.

A low or negative result for urobilinogen on a urine test may indicate:

• A problem with the liver or the bile ducts, which can affect the body's ability to produce and/or excrete bilirubin, and consequently, urobilinogen
• A problem with the production or breakdown of red blood cells

Urobilinogen level in urine could be low or absent due to:

• Blockage in the structures that carry bile from your liver
• Blockage in the blood flow of the liver
• Problem with liver function

A low or negative result for urobilinogen on a urine test is not always a cause for concern. It can be due to diet, medications, and other medical conditions. Discuss the results of your UBG urinalysis test with a doctor to determine the cause and any necessary treatment.

A small amount of urobilinogen is naturally found in the urine. A level below 1 mg/dL is not considered clinically significant. However, when combined with other abnormalities in urine and bloodwork, higher levels of urobilinogen may indicate a health problem.

• Liver disease
  • Liver cirrhosis, hepatitis, or liver cancer can increase bilirubin and urobilinogen levels in the urine. Symptoms of liver disease may not be noticeable until urobilinogen levels become apparent.
  • When urobilinogen levels are high in the urine, the doctor may order complete blood counts and liver enzyme tests.
• Blood cell abnormalities
  • Several conditions cause the body to produce antibodies that destroy red blood cells. The result will be an increase in bilirubin levels in the blood, which can be detected through a blood test or a high level of urobilinogen in the urine.
• Biliary disease
  • Cholestasis (obstruction of the bile ducts) or cholangitis (inflammation of the bile ducts) may cause urobilinogen levels to increase in the urine, as well as an increase in bilirubin and liver enzyme levels.
• Congestive heart failure
  • The heart does not pump as much blood as is needed to ensure adequate perfusion. As a result, sufficient oxygen and nutrients do not reach the organs and tissues. In response to the heart's decreased ability to pump blood, the kidneys attempt to compensate by retaining fluid in the body. As a result, the arms, legs, ankles, and other organs will swell and appear congested. Inadequate blood supply to the liver causes an increase in bilirubin and urobilinogen.
• Lead poisoning
  • The most common cause is the ingestion of lead-based paint or dust contaminated with lead in older buildings. Other sources of lead poisoning are contaminated air, water, and soil. When lead builds up in the body over time, it causes health problems and severe liver damage leading to high urobilinogen in urine.
• Certain medications
  • Antibiotics can destroy beneficial bacteria in the gut that convert bilirubin into urobilinogen. Vitamin C and ammonium chloride may increase the acidity of the urine when taken in large amounts. Acid urine will have a lower concentration of urobilinogen.

Excess urobilinogen in urine or urobilinuria can be caused by several factors, including liver disease, certain medications, and gastrointestinal problems.

The treatment for urobilinuria will depend on the underlying cause but may include:

• If urobilinuria is caused by liver disease, treatment will focus on addressing the liver problem. This may involve medications, such as antiviral medications for hepatitis or medications to reduce inflammation in the liver. In severe cases, a liver transplant could be necessary.
• If urobilinuria is caused by certain medications, switching to a different medication or adjusting the dosage could be necessary.
• If urobilinuria is caused by gastrointestinal problems, such as inflammatory bowel disease or a blockage in the intestines, treatment will focus on addressing these issues. This may involve medications, dietary changes, or surgery.

Doctors may identify and treat the underlying cause of urobilinuria to effectively manage the condition.

Is 0.2 urobilinogen normal?

Normal levels range from 0.1 to 1.8 mg/dL, so 0.2 urobilinogen in urine is normal.

How is urobilinogen removed?

About 80% of urobilinogen is converted to stercobilin in the intestines, and excreted in stools. The remaining 20% is reabsorbed into the bloodstream, and goes to the liver, from where approximately 10% is secreted back in the bile fluid to the intestines. The remaining 10% goes to the kidney where it is converted into urobilin and excreted in urine.

What is the difference between urobilinogen and bilirubin?

Bilirubin is an insoluble (unconjugated) yellow compound that results from the routine breakdown of old and defective red blood cells. It is a by-product of heme, the red compound in hemoglobin found in red cells. The liver converts bilirubin into a soluble form (conjugated bilirubin) and secretes it in the bile fluid that is used by the intestines to digest fats.

The intestines further break down conjugated bilirubin, the process that results in urobilinogen. Urobilinogen is a colorless compound that gets its yellow color when it is oxidized into urobilin, and it is excreted in stool and urine. Urobilinogen and stercobilinogen are produced when beneficial bacteria in the intestines secrete bilirubin reductase, an enzyme that breaks down bilirubin and makes it easy to eliminate from the body.

Can dehydration cause urobilinogen in urine?

Dehydration makes the urine more concentrated and increases the urobilinogen percentage in urine.

How to reduce urobilinogen in urine?

The underlying cause has to be treated to reduce urobilinogen in urine. Many conditions can cause liver damage or excessive breakdown of red blood cells (hemolysis), so it is necessary to diagnose the condition to get appropriate treatment. If medications are causing an increase in urobilinogen, discontinuation or changing the dosage or medication can help reduce the levels.

In addition, following a diet that contains a lot of fruits, vegetables, and fiber, and avoiding alcohol and fatty foods will keep your liver and digestive system healthy, and the levels of urobilinogen within the normal range. Exercise regularly and drink adequate water.