Bilirubin. What is it, the norm for women by age, table. Diet, treatment for abnormal indicators

The role of bilirubin in the body

The analyzes take into account not only the overall indicator of the pigment, but also its fractions - direct and indirect. Exceeding the total concentration may indicate intoxication in the body, cirrhosis, viral hepatitis, malignant neoplasms in the liver or genetic disorders.

An increase in concentration is due to dysfunction of the gallbladder and biliary tract, or indicates a malfunction of the pancreas.

An increase in the level of indirect pigment can be explained by the presence of Gilbert's syndrome, past infections, hemolytic anemia, and spleen dysfunction. The value of this chemical element is indicative for recognizing anemia and jaundice in newly born children.

Detailed description of the study

The liver is an organ in which complex metabolic processes occur. The functional activity of the liver is provided by hepatocyte cells, they are responsible for:

1. Bilirubin exchange and bile formation;
2. Regulation of carbohydrate metabolism;
3. Regulation of fat metabolism;
4. Formation of many proteins, including enzymes;
5. Neutralization of toxic substances (medicines, alcohol, etc.).

Bilirubin is an orange-yellow pigment formed during the breakdown of heme (a component of hemoglobin). Every day, the human body synthesizes about 350 mg of indirect (free) bilirubin. Most of it is formed during the breakdown of red blood cells, a smaller part (about 20%) is formed from other heme proteins in the liver and bone marrow.

Free bilirubin is insoluble in water; it is transported in human blood plasma in combination with a protein - albumin. Next, the liver captures free bilirubin, and after a series of transformations it is converted into direct (associated with glucoronic acid) bilirubin, which is soluble in water.

Bound bilirubin in bile is sent to the gallbladder and released into the small intestine during food digestion. In the small intestine it is metabolized by bacteria to urobilinogen. Most of the urobilinogen is transformed into stercobilin, which turns the stool brown. A small amount of urobilinogen is reabsorbed by the liver and returns to the bile. A small part is excreted in the urine.

Normally, the level of indirect bilirubin in the blood is very low. If the concentration of bilirubin and its fractions increases, a person may develop yellowness of the skin and whites of the eyes. This condition is called jaundice.

Depending on the cause of bilirubin metabolism disorders, there are three types of jaundice:

1. Hemolytic;
2. Parenchymatous;
3. Mechanical.

1) Hemolytic, or suprahepatic, jaundice is associated with increased release of bilirubin into the blood due to increased breakdown of red blood cells. The pigment formed during destruction is not captured by hepatocytes, but remains in the blood (having a toxic effect). A similar pathology can be observed in newborns when their Rh factor is incompatible with that of the mother (Rh conflict).

In rare cases, a congenital disorder of bilirubin metabolism known as Gilbert's syndrome occurs. This disorder is associated with reduced activity of the enzyme glucuronyl transferase, which converts indirect bilirubin into direct bilirubin. As a rule, it is determined by chance and has a favorable clinical course.

Hereditary diseases associated with defects in the functioning of enzymes responsible for bilirubin metabolism also include Dubin-Johnson syndrome and Rotor syndrome.

Increased release of indirect bilirubin into the blood accompanies hemolytic anemia. This condition is also associated with the premature breakdown of red blood cells and the inability to fully metabolize this pigment in liver cells due to its excess.

May be caused by internal defects in the red blood cells themselves (hereditary pathology) or:

1. Taking certain medications (methyldopa, penicillin, quinine, etc.);
2. Immunological disorders;
3. Infections;
4. Mechanical damage to blood vessels;
5. Toxic effects (copper, lead).

2) Hepatic, or parenchymal, jaundice occurs due to lesions of the liver tissue. Such conditions are diagnosed with viral hepatitis, poisoning, sepsis, etc.

3) Mechanical, or subhepatic, (obstructive) jaundice occurs due to the presence of mechanical obstacles (stones, tumors) in the bile ducts, which impairs the outflow (excretion) of bile.

A bilirubin test may be used as part of an annual physical to evaluate liver health. It is also used to determine the causes of jaundice and helps the specialist determine the tactics of further therapy.

The study is also carried out in newborns with jaundice to determine its causes.

What test should be taken for bilirubin?

Most often, a biochemical blood test is performed to determine the concentration of bilirubin. Analysis will help determine the overall meaning of the dye and its associated species. And the indirect view is simply calculated from these two values.

Bilirubin is measured in micromoles per liter with very high accuracy, making it possible to detect problems in the body even before painful symptoms appear. Most often, the result of the study is ready the next day, but it is possible to conduct an urgent analysis, in which all indicators will be known within a few hours.

Causes of low bilirubin levels

Low bilirubin levels may occur due to the following factors:

• Abuse of drinks containing a lot of caffeine, such as energy drinks, black coffee, tea.
• Diseases of the heart and blood vessels, especially in chronic form, for example, cardiosclerosis, heart failure of various types, coronary heart disease.
• The presence of bad habits, alcoholism or smoking, and their abuse.
• Excessive use of certain medications.

Doctors recommend that women undergo a routine medical examination at least once a year and be sure to take all tests, including determining the level of bilirubin, because this indicator is a very important criterion for assessing their health status.

Indications for testing

Due to improper functioning of the liver and biliary tract, bilirubin is not completely eliminated from the body, toxicity occurs, and the tissues of the internal organs acquire a characteristic icteric color. This does not necessarily mean that the person has hepatitis.

A study is prescribed to determine the level of pigment if:

• hepatitis or cirrhosis is suspected;
• jaundice;

• liver cancer is suspected;
• the patient abuses alcohol;
• there are stones in the gallbladder;
• malfunction of the spleen;
• hemolytic anemia must be confirmed.

Direct bilirubin

Other names: Direct bilirubin, conjugated bilirubin, conjugated bilirubin, newborn bilirubin, Direct bilirubin, Conjugated bilirubin.

Service code for ordering 1049 (direct bilirubin) in the Sinevo medical laboratory.

general information

Bilirubin is a pigment found in bile. It is formed during the breakdown of waste hemoglobin, the main component of red blood cells. This is due to the constant renewal of red blood cells. The body reuses iron, which is part of hemoglobin, and the protein part of the molecule is converted into bilirubin.

Initially, when hemoglobin is broken down, indirect (unbound, unconjugated) bilirubin is formed. This bilirubin is toxic and to neutralize it, it is transported in the blood to the liver using a special protein - albumin. There it binds to a special component - glucuronic acid - and turns into direct (bound, conjugated) bilirubin, which, in turn, is non-toxic and is excreted with bile into the intestines and kidneys for excretion from the body. Total bilirubin determined in the blood is the sum of indirect and direct bilirubin.

Normally, direct bilirubin is practically not found in the blood. Its amount increases in cases where the liver is able to form direct bilirubin from indirect bilirubin, but cannot remove it in a timely manner. Most often this happens due to blockage of the bile ducts, as well as due to damage to liver tissue due to hepatitis or cirrhosis.

When the outflow of bile is obstructed (impaired outflow), bilirubin does not enter the intestines and, accordingly, does not turn into a brown pigment, so the stool becomes lightened. Excess amounts of direct bilirubin, penetrating into the urine, begin to give it a dark color.

In the Sinevo laboratory, total and direct bilirubin . The difference between them is the amount of indirect bilirubin.

Bilirubin is a marker of liver biliary tract dysfunction.

Indications for use:

• routine medical examination;
• preparation for surgical operations;
• alcohol abuse;
• jaundice of unspecified etiology;
• when symptoms appear (symptoms appear): weakness, loss of appetite, nausea, vomiting, abdominal pain (especially in the right hypochondrium), darkening of urine and lightening of stool, itching;
• assessment of the degree of bilirubinemia;
• differential diagnosis of various types of jaundice (jaundice) (study of bilirubin fractions);
• diseases of the liver and biliary tract;
• hemolytic anemia.

Method: colorimetric diazo method

Analyzer: Cobas 6000

Units: µmol/l

Material for research: venous blood serum

Preparation:

• Take on an empty stomach (after sleep and 8–12 hours of fasting). It is permissible to drink only clean non-carbonated water (up to 200 ml) (with the exception of glucose testing);
• do not consume spicy, fatty, fried foods and alcohol 1–2 days before the test;
• exclude physical and emotional stress 1 day before the analysis;
• do not smoke for at least 1 hour before the test;
• It is not recommended to take (take the test) after radiography, physiotherapeutic procedures and instrumental examinations.

Interpretation of results: (analysis results)

The result of laboratory tests is not a sufficient basis for making a diagnosis. Interpretation of the results and diagnosis is carried out only by the attending physician.

Reference values:

less than 5.0

Level up:

• hepatitis of various etiologies (acute viral hepatitis, hepatitis caused by cytomegalovirus, infectious mononucleosis, amoebiasis, opisthorchiasis, actinomycosis, secondary and tertiary syphilis, acute toxic hepatitis);
• taking hepatotoxic medications;
• pathology of the biliary tract (cholangitis, cholecystitis);
• oncopathology (primary hepatocarcinoma, metastatic liver lesions);
• hereditary hyperbilirubinemia (Dabin-Johnson syndrome, Rotor syndrome);
• hypothyroidism in newborns;
• obstructive jaundice (gastrointestinal tract disease, tumors of the head of the pancreas, helminthic infestation);
• biliary cirrhosis (primary or secondary);
• jaundice of pregnant women.

Downgrade:

• anemia of a non-hemolytic nature (CRF, tuberculosis, acute leukemia, post-hemorrhagic anemia);
• in premature babies (prematurity in children);
• smoking;
• the effect of sunlight or ultraviolet rays on a blood sample.

Factors influencing the result:

Promotion:

Substances that increase bilirubin levels: acebutolol, acyclovir, allopurinol, amitriptyline, antifungal drugs, antimalarial drugs, antipyretics, barbiturates, captopril, carbamazepine, cephalosporins, clindamycin, cyclosporine, diclofenac, doxorubicin, doxycycline, enalapril, furosemide, methotrexate, methyldopa, papaverine, penicillin, rifampicin, streptomycin, thiazides, hepatitis B vaccine, BCG vaccine, etc.

Demotion:

Substances that affect the decrease in bilirubin levels:

• alcohol,
• barbiturates,
• caffeine,
• prednisolone,
• penicillin,
• amikacin,
• anticonvulsants,
• theophylline, etc.

Where to get tested for direct bilirubin

take a blood test for direct bilirubin at any Synevo point in Minsk, Baranovichi, Bobruisk, Borisov, Brest, Vitebsk, Gantsevichi, Gomel, Grodno, Zhlobin, Lida, Mogilev, Mozyr, Molodechno, Novogrudok, Novopolotsk, Orsha, Pinsk, Polotsk, Rechitsa, Svetlogorsk, Slutsk, Smorgon, Soligorsk.

Preparing for the test

Bilirubin - the norm for women by age (table below) - indicates the proper functioning of organs such as the spleen, liver and bile ducts. But sometimes research results can be distorted. This occurs due to violation of certain conditions before taking the test.

Reasons that may affect the results of the study:

• abuse of coffee, alcohol, fatty foods before analysis;
• long exposure to the sun;
• taking hormonal medications and contraceptives;
• taking diuretics;
• taking medications containing codeine, caffeine, alcohol;
• taking sedatives containing barbiturates;
• heavy physical activity or a strict diet before taking the test;
• taking the test after completing a course of chemotherapy or after the last dose of antibiotics (at least 14 days must pass).

Blood is donated from a vein in the morning before breakfast . If it is not possible to refuse food for any reason, it is given 4–5 hours after the morning meal.

The rules for passing urine for bilirubin are no different from the usual ones applied to passing a general analysis. Before the examination, you must take a bath or shower. The initial portion of urine is passed, and the next one is collected in a sterile container.

Types of bilirubin

Red blood cells, whose “lifespan” (approximately 90 days) ends, begin to decompose. The main task of bilirubin is to remove the waste protein component of hemoglobin from the body. Initially, an indirect type of bilirubin is formed, which cannot leave the body on its own and is toxic to it.

The indirect species then travels through the bloodstream to the liver, where, after its further breakdown is complete, it combines with readily soluble glucuronic acid. There is a transformation of the indirect form into a direct form, which is easily excreted along with urine and feces.

General information

The renewal of red blood cells circulating in the blood is a physiological process. When they are destroyed, hemoglobin turns into indirect bilirubin. It is transported to the liver. Here the pigment combines with a sugar-containing substance. This compound is able to dissolve in liquid and is called direct bilirubin. It enters the intestines. Here the compound breaks down and a pigment is formed, which is excreted in the feces.

The direct fraction of the pigment is normally present in the blood only in small quantities. If bilirubin is not removed from the body in a timely manner, its concentration in the blood increases. The cause of this may be liver damage or blockage of the bile ducts. In the second case, bilirubin cannot enter the intestines and turn into brown pigment. Instead, it goes into the urine. Therefore, with this pathology, urine becomes dark, and feces, on the contrary, become lighter.

How is the amount of bilirubin determined?

There are several ways to determine the level of this chemical element in the blood:

The colorimetric method consists of identifying the amount of pigment, taking into account the color intensity of the resulting solution of pigment and diazotized sulfate acid.

This method is also called the Van Den Bergh method. The direct type reacts quite quickly, and the indirect type only after the introduction of an auxiliary substance - acetic acid, sodium benzoate, caffeine, methanol, urea or other reagents.

Medical diagnostic devices - bilirubinometers - are also used to calculate the concentration of bilirubin.

The work of some of them is based on the photometric research method.

The advantage of such devices is the speed of analysis and the minimal error of the results, since in this case the human factor can be completely eliminated.

To carry out an analysis with a bilirubinometer, it is enough to donate a small amount of blood from a finger (capillary). To operate such a device, special small disposable vessels containing anticoagulants are required. The biological material for research contained in this vessel is placed in a centrifuge, where the red blood cells are deposited.

After which the device calculates the amount of bilirubin in the patient’s blood. Modern devices can provide results in 7–15 seconds.

The normal level of bilirubin in the blood of women

Bilirubin, normal for women by age, table:

The ratio of direct and indirect bilirubin in newborns is normally approximately 90% to 10%, and by the 1st month of a child’s life it is already 75% to 25%. In adult women, these values ​​change diametrically opposite - the amount of insoluble pigment is 75%, the direct type is 25%.

When the pigment concentration increases to 33–35 µmol/l, the whites of the eyes acquire a characteristic yellow tint. When the value exceeds 50 µmol/l, the mucous membranes and skin also begin to turn yellow. Increased bilirubin accumulates in organ tissues, poisoning them and affecting the central nervous system.

Bilirubin and pregnancy

The amount of pigment should be carefully monitored during pregnancy. When a woman is pregnant, the body may experience an exacerbation of chronic diseases acquired before pregnancy (cholecystitis, anemia). Normally, the concentration of bilirubin should not increase.

In the table you can see the rate of bilirubin in women during pregnancy (but without depending on age)

Some past infections can also increase bilirubin levels. Toxicosis in the 1st trimester signals that the norm of pigment in the body of a pregnant woman is exceeded. If the amount of pigment in the mother’s body reaches a critical value, early delivery is performed.

A growing embryo is able to put pressure on the liver and gallbladder, thereby disrupting the circulation of bile and causing a rise in pigment levels.

Increased and decreased indicators

Deviation of bilirubin levels in women from the norm is due to the following pathological processes:

• pernicious anemia;
• cholecystitis;
• cholangitis;
• lack of vitamin B12;
• cholelithiasis;
• Rotor and Gilbert syndromes;
• metabolic dysfunction, etc.

A distortion of the value upward occurs due to excessive destruction of red blood cells, or a violation of the excretion of the enzyme from the body.

An increased level of the enzyme in the blood poses a great danger to women. Against the background of deviations, toxic damage to muscle tissue and the brain develops. An increase in the concentration of bilirubin in the blood can be recognized by the following symptoms:

• darkening of urine color;
• increased body temperature;
• skin itching;
• belching with bitterness;
• fast fatiguability;
• cardiopalmus;
• headache and dizziness.

If several signs appear, it becomes necessary to visit a doctor.

In contrast to elevated values, reduced enzyme levels are less common. Typically, deviations from the norm are caused by the following pathologies:

• exhaustion;
• renal failure;
• aplastic anemia;
• intoxication (tuberculosis type);
• dehydration;
• types of leukemia, etc.

There is an opinion that a reduced level of bilirubin poses less danger than an increased one. However, doctors have mixed opinions on this matter.

A low enzyme level is a risk factor for coronary heart disease. Sometimes the value drops due to seasonal depression. The level in the test results is 0-10 µmol/l.

It happens that alarming values ​​in test results are a technical error. It is not difficult to identify it; you need to pay attention not only to the general indicator, but also other biochemistry figures, bilirubin fractions.

Reasons for deviation from the norm

Basically, pathological conditions leading to the growth of pigment in the body are acquired (hepatitis, oncology, cirrhosis, cholecystitis), but there are also disorders transmitted genetically - Gilbert's syndrome and Crigler-Najjar syndrome.

In addition to diseases that lead to dysfunction of the gallbladder and liver, there are factors that do not in any way affect the functioning of these organs, however, they contribute to the growth of bilirubin in the body.

These include:

• anemia of various etiologies;

• diseases associated with accelerated destruction of red blood cells - malaria, blood poisoning;
• taking certain medications (penicillin antibiotics, diazepam, furosemide);
• receiving serious soft tissue injuries, accompanied by hematomas and bone fractures.

As can be seen from the table, the level of bilirubin in newborns can increase on days 3–4 and reach its maximum – 256 µmol/l. In children born prematurely, this value should not exceed 170 µmol/l.

Bilirubin levels during pregnancy

The norm is considered to be in the range of 3.4-222 µmol/l. During pregnancy, bilirubin levels may change, especially in the third trimester. The process is associated with increased load on the liver. This does not affect the general condition of the expectant mother and fetus.

If before pregnancy a woman led a healthy lifestyle, ate the right foods, and did not drink alcohol, the bilirubin level may remain within the normal range until delivery.

Despite the reasonable deviation of the amount of enzyme from the standard values, the pregnant woman is asked to undergo a more thorough examination. This is necessary to eliminate risk factors and identify serious pathologies in the body. Ignoring the problem is fraught with the development of jaundice and other dangerous diseases for which termination of pregnancy is recommended.

A stressful situation or prolonged depression can provoke an increase in bilirubin levels in a pregnant woman.

If distorted tests are not related to natural processes, suspicion falls on cholelithiasis, viral infections, impaired bile outflow, hepatitis, and sluggish pathologies in the liver. Medications (especially hormonal ones) and household chemicals also affect the value of the enzyme in the blood.

During pregnancy, bilirubin deviates from standard values ​​in the following cases:

• toxicosis in the early stages;
• preeclampsia and eclampsia;
• stagnation of bile (under pressure from the fetus on the liver);
• liver dystrophy (acute form).

Symptoms of abnormal bilirubin levels and when to see a doctor

Some factors may indicate an increase in the concentration of pigment in the blood even before the test results are obtained.

What to pay attention to:

• pain in the left hypochondrium after physical activity or sports training;
• feces become light-colored and urine darkens;
• the appearance of vomiting and nausea;
• yellowing of the whites of the eyes, skin and mucous membranes;
• dizziness and weakness;
• nausea, vomiting and lack of appetite;
• chronic fatigue and anxiety.

What drugs are prescribed

Bilirubin, the norm for women by age (the table above) should not exceed the limit value; in case of deviation from the norm, it gives a direct reason for prescribing therapy. If the cause of increased bilirubin is liver dysfunction, hepatoprotectors are used.

These remedies are not able to completely solve the problem in such serious diseases as hepatitis, cirrhosis, disorders caused by excessive use of alcohol or drugs, obesity, however, they can alleviate the patient’s condition.

Hepatoprotectors are pathogenetic agents for treating the liver. They restore cells, reduce inflammation, prevent fibrosis, and help cleanse the body of toxins.

Almost all drugs related to hepatoprotectors do not have proven medical effectiveness.

The exception is products containing ademetionine - Heptral, Heptor.

The detoxifying effect of ademetionine has been studied and proven scientifically. The herbal drug Karsil is also well known.

If the pigment concentration rises due to poisoning, therapy is prescribed with adsorbent agents that successfully absorb and remove toxins from the body. These include activated carbon, Smecta, Enterosgel.

If the cause of an increase in the amount of bilirubin is gallbladder dysfunction, choleretic drugs are prescribed. Diagnostics will allow you to determine the cause of the disease - a disorder in the liver, gallstones or pathological changes in the biliary tract.

The action of such drugs is aimed at enhancing the secretion of bile and facilitating its entry into the intestines, which helps speed up the digestion process and reduces the risk of gallstones.

Choleretic drugs differ in their effects - cholekinetics activate the work of the gallbladder, promoting its more frequent contraction, and cholespasmolytics, which affect the biliary tract, relaxing them; choleretics make bile less viscous. Choleretic drugs can also be of mixed type.

The composition of choleretic drugs can include not only synthetic, but also natural components. Chemicals have an analgesic effect, kill pathogenic bacteria and eliminate inflammatory processes, lower cholesterol levels. The effect of such drugs also affects the functioning of the intestines - digestion improves, and the decomposition process is suppressed.

The use of natural choleretic drugs, which may include not only medications, but also herbal decoctions and infusions, is based on the action of essential oils, resins, phytoncides, vitamins and some other substances included in their composition.

Herbal medicines have a beneficial effect on the functioning of the liver, dilute bile, stimulate the functioning of the stomach and pancreas, accelerate metabolism, and have an antibacterial and anti-inflammatory effect. The most famous natural choleretic drugs include Allohol, Holosas, Hofitol.

In case of serious disorders, choleretic drugs are prescribed in combination with antibiotics. In addition to medications, some types of mineral waters also have a choleretic effect.

To reduce the load on the liver and gallbladder, the doctor may prescribe medications containing enzymes that help improve the functioning of the pancreas and speed up metabolic processes. Examples of such drugs are Mezim, Pancreatin, Festal.

The consequence of some infectious diseases may be an increase in the concentration of bilirubin. To stop the inflammatory process, the doctor may prescribe treatment with antiviral drugs.

Pigment growth may be associated with vitamin B12 deficiency. It will be enough to compensate for the lack of this vitamin to reduce bilirubin.

With anemia, there is a decrease in the concentration of bilirubin, since the body does not produce a sufficient number of red blood cells, and, accordingly, the level of hemoglobin also drops. The tissues of the internal organs do not receive the oxygen necessary for normal functioning.

This also entails a decrease in bilirubin levels. Then iron-containing drugs are prescribed, such as Maltofer, Ferlatum, Aktiferrin.

In some cases, a similar effect of lack of hemoglobin can be caused by a strict low-calorie diet.

Bilirubin (the norm for women by age - the table is given above), namely its indicators, may deviate from the norm if parasites are present in the human body.

They feed on useful substances that come with food, process them and remove toxic products of their vital activity into the human body, which tend to accumulate in the tissues of internal organs, thereby poisoning them and causing an increase in the concentration of pigment.

A stool analysis will help determine what type of worms the patient has, after which the doctor will prescribe treatment. The most well-known means for combating helminths are Pirantel, Vormil, Helmintox, Nemozol.

Indications for the study

A blood test for direct bilirubin is carried out during the diagnosis of liver pathologies. Its results are required to confirm diseases of the bile ducts, hepatitis, and hereditary liver diseases. The test is mandatory if there are characteristic symptoms of liver problems (jaundice, pain in the right hypochondrium, etc.). Its results are interpreted in conjunction with data from other studies. In most cases, a comprehensive examination is required for accurate diagnosis and selection of an effective treatment method.

Diet

People suffering from diabetes mellitus are at risk of exceeding the norm of pigment in the body . In this case, the doctor most often prescribes a special diet.

The essence of such a diet is to completely eliminate overeating. You need to eat in fractional portions, 4-5 times a day. At least 2–2.5 hours should pass between the last meal and sleep. The amount of water, juices, and liquid soups consumed should be at least 2 liters per day. Fried foods are completely excluded from the diet. Salt should be limited and not consumed more than 10 g per day.

Products that cause an increase in pigment concentration:

• sausages and smoked products;
• legumes;
• sorrel, radish, onion, garlic;
• hard cheeses;
• buns, chocolate, ice cream, cakes and pastries;
• lamb and pork, poultry – duck;
• types of fish with high fat content;
• berries or fruits that have a sour taste;
• alcoholic and carbonated drinks;
• hot seasonings and sauces;
• pickles;
• mushrooms;
• canned food

There is another group of products that help reduce bilirubin in the blood.

These include:

• low-fat fermented milk products;
• light dietary soups with vegetables;
• boiled eggs (the yolk must be omitted);
• sweet fruits and berries;
• cereal porridge;
• veal, rabbit, as well as turkey and chicken meat;
• honey;
• teas, homemade compotes and jelly;
• some vegetable crops such as beet and carrots;
• a small amount of butter or vegetable oil;
• stale bread or homemade crackers.

These products will relieve the liver and gallbladder, relieve pain and increase the effectiveness of taking medications.

In medicine, this diet is called table No. 5.

For breakfast, you can prepare porridge with milk or water - semolina, buckwheat, rice or oatmeal. Products with cottage cheese are also added to the diet - cheesecakes, casseroles, dumplings. It is recommended to drink tea or weak coffee with milk.

The next meal should be in 2-3 hours. It is recommended to eat a baked apple, sweet fruit or a handful of berries.

For lunch you should eat a bowl of vegetable soup. Meat and fish, cutlets, vegetables should be either stewed or steamed. The second course can be puree or vegetable stew. They drink fruit juice, compote or jelly.

After 2-3 hours, you can eat a small amount of marshmallows or cookies, drink a glass of heated milk or freshly squeezed juice.

Dinner must be eaten no later than 7 pm. For dinner you can eat a casserole, pasta, mashed potatoes, stewed cabbage or porridge of your choice.

The diet can be supplemented with a small piece of chicken fillet or steamed fish and a salad of fresh vegetables. You can also prepare a vinaigrette by omitting the pickled cucumbers and beans. Half an hour before bedtime, you can drink a cup of low-fat yogurt or kefir. The principle of the diet for pregnant women remains the same.

Phototherapy

After birth, the child’s body no longer needs such a large number of blood cells, which leads to their increased destruction and an increase in bilirubin in the newborn’s blood. This manifests itself in the form of jaundice 3–5 days after birth.

Phototherapy is used to treat jaundice and hemolytic disease in newborns. It is carried out using special ultraviolet lamps, which contribute to the transformation of indirect toxic bilirubin into its direct form, which is not dangerous for the child’s body. Such light therapy is safe for the child, which cannot be said about drug treatment.

To carry out phototherapy, the child is placed in a box where lamps are installed. The genitals are covered with a bandage, and the eyes are protected with glasses. Usually the course of treatment is 4 days. You can take short breaks of 2–3 hours if the jaundice is not pronounced. Irradiation is carried out from all sides, periodically shifting the child, changing his position.

Breastfeeding should not be canceled, as it helps remove pigment from the child’s body. If it is not possible to attach to the breast, use a bottle. During phototherapy, a biochemical test of the child’s blood is performed every day to determine the effectiveness of the procedure.

Undesirable reactions include dryness and flaking of the skin, diathesis, diarrhea, and rashes. Phototherapy is mainly used in the treatment of newborns, but sometimes it is also used to treat adults.

Increased bilirubin

Reasons for the high rate

Bilirubin levels may increase due to:

• The presence of severe gallstone disease, especially in chronic or acute form.
• The presence of serious diseases of the gallbladder or liver, for example, cirrhosis or hepatitis.
• The presence of bad habits, such as smoking or alcoholism, especially with frequent abuse.
• The appearance of various forms of acute respiratory infections and acute respiratory viral infections, as well as influenza and other infectious diseases.
• Abuse of many drugs, especially analgesics, aspirin, various groups of antibiotics, hormonal drugs.
• Hereditary factor.
• The presence of prolonged and very frequent bleeding.
• The presence of malignant neoplasms in the body.
• Diseases of the pancreas that are inflammatory in nature.

Increased bilirubin in the blood for a long time poses many dangers to the female body, for example, this condition threatens serious toxic damage to the muscles, which can spread to the brain. This will require urgent qualified medical care.

Treatment

In order to quickly and effectively reduce bilirubin, it is important to determine the exact cause that caused this disorder. And since the causes of the disorder are very diverse, only an experienced doctor can prescribe adequate therapy in each specific case, based on the available indications.

The main method of treating elevated bilirubin is infusion therapy, which involves intravenous infusions of glucose and detoxification drugs, as well as special solutions that accelerate the removal from the body of not only this substance, but also all its breakdown products.

But doctors resort to the above method of infusion therapy only in particularly severe cases.

An easier way to treat high levels of bilirubin in the blood is phototherapy , in which the patient is irradiated with special lamps that do not harm him. With this effect, indirect bilirubin, which is toxic, is destroyed. In this case, the indirect pigment is transformed into its direct form, after which it is easily processed by the body and removed from it.

The phototherapy method is completely safe, so it is often used even in cases where the amount of bilirubin urgently needs to be reduced in infants up to one year old.

Folk remedies

It is possible to normalize bilirubin levels, in accordance with the table, in a woman’s body at any age through the use of traditional medicine recipes.

An infusion prepared from corn silk stabilizes the functions of the liver, biliary tract and kidneys. Take 1 d.l. stigmas, pour 200 ml of boiling water, then keep in a steam bath for 15–17 minutes.

Then the infusion is allowed to cool for 45–50 minutes, after which it is filtered and water is added so that the volume is 200 ml. Before use, the infusion is heated and shaken. Drink it every 2–4 hours, 1–3 tbsp. for adults, and 1–2 d.l. for children for a month.

Tea made from chamomile flowers effectively reduces bilirubin. For this, 1 tbsp. the herbs are placed in a teapot and 200 ml of boiling water is poured in, left for half an hour and filtered. The liquid is then divided into three equal parts, which should be taken after each main meal.

Adding 1 tsp. mint leaves in tea help normalize digestion, improve the functioning of the liver and gall bladder. This tea can be drunk for 1.5–2 months.

A decoction of birch leaves effectively reduces the level of bilirubin in the blood. 3 tsp you need to pour 1 tbsp. boiling water and leave for 25–30 minutes. The resulting broth is divided into 8 equal parts. Drink 1 part 4 times a day. Store in the refrigerator.

For the infusion of St. John's wort, you need to take 2 tbsp. herbs and pour 200 ml of boiling water over them. Leave for 30 minutes and then filter. You need to drink the infusion in the morning and evening after meals, 100 ml. The course of treatment is usually 1 month.

Surgical intervention

Before any surgical interventions, the level of pigment in the blood is also examined. If it reaches 55 µmol/l, but other liver test parameters do not exceed normal values ​​and there are no signs of disturbances in the functioning of the liver and gallbladder, then the operation is not cancelled.

In some cases, if the cause of increased bilirubin is gallbladder dysfunction, surgery may be performed. Gallstones or the gallbladder itself are removed. Stones are formed due to the fact that the consistency of bile becomes more viscous, which complicates its outflow from the body.

Prerequisites for the development of gallstone disease are:

• lack of physical activity and obesity;
• pregnancy;
• inflammatory processes in the biliary tract;
• female;
• elderly age;
• excessive consumption of alcoholic beverages;
• operations performed on the stomach and intestines.

Surgical intervention is performed in several ways. The laparoscopic method is based on the use of special medical equipment - a laparoscope.

This method is the least traumatic and the safest for the patient, since the incisions on the abdomen are very small and other internal organs are not affected during the operation. The duration of such an operation is on average 40–50 minutes.

Under certain conditions, only the stones are removed, and the gallbladder itself is preserved. This operation is performed if there are no disturbances or inflammatory processes in the functioning of this organ, and the diameter of the largest stones does not exceed 3 cm.

An experienced doctor will be able to quickly establish the reason for the excess bilirubin value in a woman’s body at any age, based on the data in the table and finding out which type of pigment indicators exceeded the norm. It is important to recognize the symptoms of the disease in time and conduct the necessary research, which will determine an effective course of treatment.

Article design: Mila Friedan

Bilirubin in pregnant women

During the period of gestation, it is very important to constantly monitor the level of bilirubin, which should be in the range from 8.4 to 20.5 µmol/l. It is very important not to exceed the maximum value, since in this case the woman may experience jaundice, since the level of this substance is always related to the functioning of the liver and bile.

In most cases, during pregnancy, the level of bilirubin in women is normal, but sometimes there may be fluctuations in one direction, both minor and very noticeable. If, when deciphering the analysis, it is clear that the amount of pigment does not meet the established standards, the woman must undergo a full examination.

It is important to remember that high bilirubin levels can have a very negative impact on the health of a developing baby, which may indicate a possible illness.

Some diseases, such as hemolytic anemia, can have very serious consequences, including leading to premature birth and sometimes stillbirth. Therefore, it is important to detect and treat any diseases on time.