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The Urine for Bile Salt & Bile Pigment test detects the presence of bile salts and bile pigments — primarily Bilirubin and Urob...
Also known as: Urine Bilirubin & Urobilinogen Test · Urine Bile Test · Bilirubin in Urine · Urinary Bile Pigment Test
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*Inclusive of home collection charges
The Urine for Bile Salt & Bile Pigment test detects the presence of bile salts and bile pigments — primarily Bilirubin and Urobilinogen — in urine. These substances are normally absent from or present only in trace amounts in urine. Their detection signals liver dysfunction, biliary obstruction, or increased haemolysis — making this a simple, non-invasive, first-line test for investigating jaundice, dark urine, and suspected liver or biliary disease. No fasting required.
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What Does the Urine for Bile Salt & Bile Pigment Test Measure?
| Level / Result | Possible Interpretation |
|---|---|
| Bilirubin: Negative | Urobilinogen: Trace (Normal) | Normal liver and biliary function |
| Bilirubin: Positive | Urobilinogen: Absent/Low | Obstructive (cholestatic) jaundice — bile duct blockage; conjugated bilirubin backs up into blood and spills into urine; reduced gut bilirubin means less urobilinogen |
| Bilirubin: Positive | Urobilinogen: Elevated | Hepatocellular jaundice — liver cell damage (hepatitis, cirrhosis); liver both leaks conjugated bilirubin into blood and has reduced ability to clear reabsorbed urobilinogen |
| Bilirubin: Negative | Urobilinogen: Elevated | Pre-hepatic (haemolytic) jaundice — increased RBC breakdown produces excess bilirubin; liver conjugates it and excretes it into gut; excess urobilinogen is reabsorbed and spills into urine; unconjugated bilirubin doesn't appear in urine |
| Bile Salts: Positive | Significant biliary obstruction or liver disease — bile salts normally absent from urine |
Important Note: Urine bile findings are a screening tool — they guide but do not replace further investigations. Jaundice requires confirmation with serum bilirubin (total, direct, indirect), liver function tests (LFT), blood count, and imaging (ultrasound abdomen). Urine bilirubin degrades rapidly on exposure to light and must be tested within 1–2 hours of collection. All results must be reviewed by a physician.
The Three Patterns of Jaundice — At a Glance: (1) Pre-hepatic / Haemolytic: Urine bilirubin negative, urobilinogen elevated — excess unconjugated bilirubin in blood, but it is not water-soluble and does not reach urine. Stools are dark. (2) Hepatocellular: Both urine bilirubin and urobilinogen elevated — liver is damaged, leaking conjugated bilirubin into blood AND unable to process reabsorbed urobilinogen. (3) Obstructive / Cholestatic: Urine bilirubin strongly positive, urobilinogen absent — bile cannot reach the intestine, so no urobilinogen is produced; conjugated bilirubin backs up into the bloodstream and is filtered into urine. Stools are pale/clay-coloured.
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