The human body is a complex biochemical laboratory. Everything is in dynamic balance, constantly moving, changing. Despite the instability of various indicators, they are all within the dynamic norm. That is, we are not talking about a single indicator of a particular substance, but about some reference (normal) values (about an interval). A slight fluctuation is enough for the body to fail. One of the most important indicators of health is a pigment called bilirubin. Indirect bilirubin (NB) can be elevated due to pathological or natural physiological reasons (which is much less common). What is indirect bilirubin, why does it rise. Need to figure it out.
Bilirubin is a special pigment. Its production is carried out by the tissues of the spleen and bone marrow. This substance is part of the bile and is formed mainly during the destruction of erythrocyte cells. In laboratory practice, two types of pigment are distinguished: direct and indirect bilirubin (not counting the general indicator).
There are several main differences:
- Indirect bilirubin is a free (non-conjugated) substance. It is an intermediate product of the processing of "obsolete" erythrocyte cells. Unlike the direct form, the substance is characterized by toxicity and does not dissolve in water. Because of this, it is difficult for the body to remove this harmful substance from the bloodstream.
- Direct bilirubin (also called conjugated bilirubin), in contrast, is the end product. The substance acquires a similar form after processing by the liver as a result of a conjugation reaction. This is a safe bilirubin, which dissolves perfectly in water and is easily excreted from the body with feces (urine, feces).
Both types of bilirubin are constantly present in the human body, but if the indicators are within the normal range, the person does not feel problems. Troubles begin with an increase in the concentration of a substance, especially an indirect form.
Norm of bilirubin
As already mentioned, the presence of indirect bilirubin is not an indicator of the presence of diseases. Even healthy people have direct and indirect bilirubin. If the concentration of these substances is within the reference values indicated by the laboratory, we are talking about a variant of the physiological norm.
An increase in indirect bilirubin may be associated with age. The younger the patient, the higher the indirect bilirubin. In newborns, the concentration of the substance can increase and reach significant numbers due to the large number of decomposing blood cells, red blood cells. This is also considered normal.
To indicate the norm, you need to know which method is used for blood tests. There is a standardized formula for calculating the concentration of indirect bilirubin:
ABOUT (total beat.) - PB (direct beat.) \u003d NB (indirect beat.)
We can talk about the following indicators:
- adult men and women: up to 15.5-19.0 µmol per liter of blood;
- newborns under the age of 2 days: 56-199 micromoles per liter;
- newborns aged 2 to 6 days: 26-207 micromoles per liter;
- children older than 6 days: 6-22 micromoles per liter.
These are approximate figures. When visiting a treating specialist, it is imperative to know what the reference values are. So it will be easier for the specialist to navigate.
Causes of increased indirect bilirubin
There are a huge number of probable reasons for the increase in the concentration of indirect bilirubin. Almost always it is a question of one disease or another. Among the reasons:
The reasons, as already mentioned, are many. It is not possible to understand them on your own. Diagnosis of the root cause should only be done by a doctor.
Concomitant symptoms with increased indirect bilirubin
Although self-diagnosis is a dead end, knowledge of the symptoms associated with a particular disease is necessary. This makes it easier to figure out which specialist to contact.
The most common symptoms of elevated indirect bilirubin were and still are:
- loss of appetite;
- nausea;
- yellowing of the skin and sclera;
- eructation with a taste of acid;
- weakness, weakness;
- headache and dizziness;
- vomit;
- pain in the right side;
- flatulence;
- discoloration of the stool;
- skin itching.
Based on the characteristic symptoms, the patient may assume a particular problem and go to a specialized specialist for help.
Diagnostics
Sometimes it is enough to look at the patient to guess what he is ill with. In the case of bilirubin, the sclera of the eyes become yellow. Especially severe cases are accompanied by yellowing of the skin.
An increase in bilirubin can be detected through a biochemical blood test. However, this is not informative. It is much more important to establish the root cause of the problem. Depending on the cause, consultation of the following specialists is recommended:
- hematologist (for anemia);
- gastroenterologist (for pathologies of the liver and gallbladder);
- hepatologist (instead of a gastroenterologist for liver problems).
The first thing a patient needs to do is go to an appointment with a general practitioner. He will make an initial diagnosis and give directions to other doctors. Often, to establish an accurate diagnosis, they resort to instrumental studies:
- Abdominal ultrasound. Allows you to identify problems with the liver and gallbladder.
- Liver scintigraphy. Gives an opportunity to evaluate the functionality of the body.
To detect anemia, a complete blood count is needed, which will show a decrease in hemoglobin and a deficiency of red blood cells.
Treatment
It is aimed at eliminating the root cause of the increase in indirect bilirubin. In the case of therapy, they resort to prescribing medications:
- hepatoprotectors;
- anti-inflammatory;
- iron-based preparations.
To alleviate the condition, antispasmodics and analgesics are prescribed.
Prevention
It is almost always enough to follow some simple recommendations:
- It is necessary to fully, fractionally eat and not overeat. Anemia is a frequent companion of malnutrition, while liver problems are observed from improper diet and overeating.
- It is important to give up alcohol or minimize its consumption.
- At the first manifestations of diseases of the liver, gallbladder, or even suspicions, it is necessary to go to the doctor for examination.
An increase in indirect bilirubin is a complex problem. However, with timely diagnosis and treatment of the underlying disease, it is possible to cope with it. It is important to do this in tandem with your doctor and not self-medicate.
