00:00
Now, let's take a
look at bilirubin.
00:03
I got to tell you that was
one of my favorite words
I learned in medical
terminology when we said
hyperbilirubinemia.
It just sounded fun to say
but really what we're looking
at is bilirubin in your urine.
00:15
So I want to talk about
what a normal level is.
00:18
You can have a small amount.
00:20
Remember this is on
that list of things
that it's okay to have
some of but not too much.
00:25
So a small amount is 0.5 to
1 milligram per deciliter.
00:29
Now I have a picture up
there for you of an organ
you'll recognize as the liver.
00:34
The reason I put
the liver there is
because I want to talk
about the difference between
unconjugated or
unchanged bilirubin
because unconjugated bilirubin
is not water soluble.
00:47
We're addressing bilirubin
in your urine in order for
it to make it to your urine.
00:53
It's got to be water soluble.
00:55
So if it's unconjugated
it's not going to
make it to the urine
because it won't be able to
pass through the glomerulus.
01:02
The bilirubin has to be
conjugated or changed
in order for it to
be water soluble.
01:08
So when its present
in the urine,
it represents a state
of bilirubinuria,
in order my favorite word
was emia that meant blood
but we're talking
about bilirubinuria.
01:20
We're talking about
bilirubin in your urine.
01:24
So if I get a positive result
for bilirubin in the urine
let's talk about
what that means.
01:29
It's not supposed to be found
in large amounts in the urine.
01:34
So if I do see increased bilirubinuria higher than one,
now this could be a sign
of biliary tract disease.
01:40
So bilirubin should be
connected to the liver for you.
01:44
The biliary tract is all
the plumbing for the liver
and the pancreas down
into the small intestine.
01:51
So keep in mind,
that plumbing member
connects your liver,
your gallbladder,
if you still have one,
your pancreas down to
the small intestine.
02:00
That's the biliary tract.
02:02
We've got some problems
there that maybe
while you have bilirubin
excessively in your urine.
02:08
Other liver problems cirrhosis,
that can be an issue.
02:12
Gallstones in the biliary tract,
hepatitis, liver disease,
tumors in the liver
or the gallbladder.
02:19
Okay.
02:21
You have reached my limit.
02:23
That is one two, three, four,
five six things to memorize.
02:27
Nobody can keep track of that,
so let's make it simpler.
02:30
Bilirubin has a picture
of what up there?
Right.
02:34
The liver.
02:35
Now keeping in mind what's
involved in the liver is also
the biliary tract, the plumbing,
that takes the
bile from the liver
either stored in the gallbladder
or can move it on
down past the pancreas
into the small intestine.
02:51
So every one of those
things is going to point to
a problem with the liver
or the organs that are
attached to the biliary tract.
03:01
So that's all you need
to remember bilirubin
and the liver,
the biliary tract disease,
or the liver are causes
for elevated bilirubin.