If bilirubin has been found in your urine, is there ANY reassurance that this might have a benign cause?

“Bilirubin is not normally found in the urine,” says Akram Alashari, MD, an abdominal and critical care surgeon for Grand Strand Surgical Specialists, Grand Strand Regional Medical Center, Myrtle Beach, SC, and author of  THE POWER OF PEAK STATE.

“A positive test for urine bilirubin confirms that any raised plasma levels are from conjugated hyperbilirubinemia.

“Causes of bilirubin in the urine include hepatocellular [liver] dysfunction and any cause of bile duct obstruction [which, unfortunately, can include cancer of the bile ducts, gallbladder, liver, pancreas and metastases from distant primary cancers].”

What is meant by “benign”? To some people, this means anything but cancer. To others, it means not only that, but also non-serious.

With that said, some individuals, then, will consider the following as benign causes of a bile duct obstruction—which can lead to bilirubin in the urine:

Bile duct inflammation



Abnormal narrowing of the biliary ducts



But most causes of biliary obstruction are from the presence of gallstones.

Additional Benign Causes of Bilirubin in the Urine

“Urine bilirubin levels may be elevated by medications including barbiturates, birth control pills, steroids and diuretics, and reduced by medications including ascorbic acid and indomethacin,” says Dr. Alashari.

“Urobilinogen and etodolac [arthritis drug] may cause false-positive bilirubin results, while uric acid, nitrite and extended exposure to direct sunlight may cause false negative results.”