Urobilinogen in wee: normal levels, causes and treatment

Urobilinogen is what you get when bilirubin breaks down in your intestines. It gets absorbed into your bloodstream and then comes out in your wee. If there’s more bilirubin being made, there’ll be more urobilinogen in your gut and your wee too.

Usually, there’s less than 1.0 mg/dL of urobilinogen in your wee. If you’ve got more than that, it could be a sign of liver problems, haemolytic anaemia, or issues with your bile ducts. If you find high levels of urobilinogen in your wee, it’s best to see your doctor for a proper check-up.

Common causes

A little bit of urobilinogen in your wee is normal. If it’s under 1 ml/dL, you don’t need to worry. But higher levels, along with other unusual results in your wee and blood tests, might mean something’s up. Here are some possible causes:

Liver disease

Things like cirrhosis, hepatitis, or liver cancer can raise the amount of bilirubin in your body, which means more urobilinogen in your wee. You might have liver problems even if you don’t have any other symptoms. That’s why it’s a good idea for your doctor to do more blood tests, like a full blood count and liver enzyme tests, if they find high urobilinogen levels.

Blood cell problems

Sometimes, your body makes antibodies that attack your red blood cells, breaking them down. This raises the bilirubin levels in your blood, which you can spot in a blood test or by seeing high levels of urobilinogen in your wee.

Haemolytic anaemia can also lead to higher bilirubin levels, as well as an enlarged spleen (splenomegaly). The spleen’s job is to filter your blood and get rid of old red blood cells, as well as make and store white blood cells. If it’s not working properly, that can mean more bilirubin in your body.

Biliary disease

Conditions like cholestasis (blocked bile ducts) or cholangitis (inflamed bile ducts) can also cause higher urobilinogen levels in your wee. These problems can raise the levels of bilirubin and liver enzymes in your blood too.

How to treat it

If you’ve got more than 1 mg/dL of urobilinogen in your wee, you need to see your doctor to figure out what’s causing it. Once they know what’s wrong, they can start treating you.

Maybe haemolytic anaemia is causing high urobilinogen levels, and your doctor might give you medicines that help control your immune system, like corticosteroids or immunosuppressants. If your liver’s the problem, you might need to rest and change your diet.

If you’ve got liver cancer, you might need surgery to remove the affected bits of your liver, and then have chemotherapy and/or radiotherapy afterwards.