What does it mean to be positive for bilirubin during a physical examination

A positive bilirubin test usually indicates abnormal levels of bilirubin in the blood or urine, which may be caused by liver disease, biliary obstruction, or hemolytic disease. Bilirubin positivity is mainly caused by physiological factors, hepatitis, gallstones, hemolytic anemia, drug effects, and other reasons.

1. Physiological factors

Intense exercise, prolonged fasting time, or excessive fatigue may lead to transient elevation of bilirubin, manifested as weak positive urine bilirubin. This situation does not require special treatment. It is recommended to adjust the daily routine and avoid fasting physical examinations. After re examination, most cases can be restored to normal.

2. Hepatitis

Viral or alcoholic hepatitis can damage the ability of liver cells to process bilirubin, leading to an increase in both direct and indirect bilirubin. Patients may experience symptoms such as fatigue and jaundice, and need to be diagnosed through liver function tests and hepatitis virus screening. Commonly used liver protective drugs in clinical practice include compound glycyrrhizin tablets, silibinin capsules, and bicyclic acid tablets.

3. Gallstones

When common bile duct stones block bile excretion, direct bilirubin reflux into the blood can lead to positive results. Typical symptoms include upper right abdominal colic and clay colored stool, which can be diagnosed by ultrasound examination. Mild stones can be treated with ursodeoxycholic acid capsules to promote bile excretion, while severe obstruction requires endoscopic stone removal surgery.

4. Hemolytic anemia [SEP]: Excessive destruction of red blood cells can produce excess indirect bilirubin, which becomes positive when it exceeds the liver's metabolic capacity. The patient often has pale complexion and soy sauce colored urine, and the blood routine shows a decrease in hemoglobin. Autoimmune diseases or hereditary spherocytosis need to be investigated, and if necessary, prednisone tablets should be used to control hemolysis.

5. Drug Effects

Anti tuberculosis drugs such as rifampicin capsules and isoniazid tablets may interfere with bilirubin metabolism, and certain antibiotics such as sulfamethoxazole tablets may also cause false positives. Re examination after discontinuation of medication can be used for identification, and liver function should be regularly monitored during medication.

If bilirubin is found to be positive, liver function and abdominal ultrasound examinations should be performed to clarify the cause. In daily life, it is necessary to avoid drinking alcohol and high-fat diet, supplement high-quality protein such as egg white, fish, etc. in moderation, and pay attention to observing changes in urine color. If there is persistent positivity or yellow staining of the skin and sclera, it is necessary to seek medical attention promptly at the gastroenterology or liver disease department.