Bilirubin Question

Bile is a liquid released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine.

When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing levels of bilirubin in the blood.

Any obstruction of the bile duct between the liver and the duodenum, including stones in the common duct, cancer of the head of the pancreas.

Bilirubin cannot reach the intestine and so the water-soluble, conjugated bilirubin goes back into the blood plasma and reaches all tissues. The plasma bilirubin concentration can be greatly elevated and jaundice marked. Conjugated bilirubin is excreted into the urine which is dark brown, maybe almost black. Stools are pale. If you have a biliary obstruction, bile (along with the bilirubin present in it) will not make its way to the GI tract and color the stool.

The stool will be more clay-colored. The biliary obstruction will also result in a conjugated bilirubinemia-conjugated bilirubin, being water soluble, will filter in the kidney and make the urine dark (on the other hand, unconjugated bilirubin which is bound to albumin will not be filtered at the kidney-but this is not the case in a biliary obstructive scenario). The whole deal about urobilinogen is somewhat irrelevant to this discussion as the dark urine is a result of the conjugated bilirubin being filtered at the kidney.

Disorders of the biliary tract

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Thanks Esme!

The water soluble conjugated bilirubin re entering the plasma and traveling to the tissues to cause jaundice is exactly what I wish I could have thought of.

Thanks again.

I'll bet..... YOU're welcome.