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, a trauma surgeon at Geisinger Medical Center in PA, 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.”

akram alashari

Dr. Alashari was formerly with Grand Strand Regional Medical Center in SC as an abdominal and critical care surgeon. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/Guschenkova