Urobilinogen Test: Purpose, Procedure, Normal Range & Results

• Explains what urobilinogen is and why it appears in urine.
• Details why doctors recommend a urobilinogen test and how it’s done.
• Covers normal ranges, high and low urobilinogen levels, and what they mean.
• Lists common symptoms and conditions linked with abnormal urobilinogen.
• Provides India-specific tips on diet and lifestyle for better liver and gut health.
• Includes FAQs and reference sources for deeper understanding.

What Is Urobilinogen?

Urobilinogen is a colourless substance formed in your intestines when gut bacteria break down bilirubin, a yellow pigment produced from the normal breakdown of red blood cells. A small amount of this urobilinogen is reabsorbed into the blood and then excreted by the kidneys into the urine.

Because of this, the presence and amount of urobilinogen in urine can give important clues about how well your liver, gallbladder, and red blood cell systems are working.

What Is a Urobilinogen Test?

A urobilinogen test is a simple urine test that measures the amount of urobilinogen present. It is usually part of a routine urine analysis (urinalysis) or may be specifically requested when your doctor suspects liver or blood-related problems.

Types of Urobilinogen Testing

• Dipstick urine test: A chemically treated strip is dipped into a fresh urine sample; the strip changes colour depending on the level of urobilinogen.
• Laboratory urinalysis: Urine is analysed in a lab where urobilinogen is measured more precisely, often along with bilirubin, proteins, sugar, and other parameters.

Why Is the Urobilinogen Test Done?

Doctors may recommend a urobilinogen test for several reasons, especially when they suspect issues with the liver, bile ducts, or red blood cells.

Common Reasons to Order This Test

• Routine health check-up and screening.
• Evaluation of jaundice (yellowing of eyes and skin).
• Suspected liver diseases like hepatitis, cirrhosis, or fatty liver.
• Monitoring known liver disorders over time.
• Investigating hemolytic anaemia (when red blood cells break down faster than normal).
• Evaluating suspected bile duct obstruction (blockage in the tubes that carry bile from liver to intestine).

Symptoms That May Prompt a Urobilinogen Test

Your doctor may suggest this test if you have symptoms such as:

• Yellowing of skin or eyes (jaundice)
• Dark yellow or brown-coloured urine
• Pale or clay-coloured stools
• Abdominal pain, especially in the upper right side
• Loss of appetite and unexplained weight loss
• Extreme tiredness or weakness
• Nausea, vomiting, or general discomfort

How Is the Urobilinogen Test Done?

Before the Test

• Usually no special fasting is required.
• Inform your doctor about any medications or supplements you are taking, including Ayurvedic or herbal formulations, as some can affect urine test results.
• Drink water as usual unless your doctor advises otherwise.

Sample Collection

1. You will be given a sterile container for collecting your urine.
2. Clean the genital area with water or antiseptic wipes (if provided).
3. Start urinating into the toilet, then place the container midstream to collect urine, and then finish in the toilet. This is called a midstream clean-catch sample.
4. Close the lid tightly and hand it over to the lab staff as soon as possible.

During the Test

• The lab may first use a dipstick to get a quick reading.
• If needed, more detailed analysis is done using laboratory instruments.

After the Test

You can return to your normal activities immediately. Your doctor will discuss the report once it is available, usually within a few hours to a day, depending on the lab.

Normal Range of Urobilinogen in Urine

Most laboratories consider the following as a general reference range:

• Normal urobilinogen: 0.1 to 1.0 Ehrlich unit/dL (or reported as “normal”/“within range”)
• Trace amounts: Usually not a cause for concern; may be reported as “trace” or “slightly elevated”

The exact range can vary slightly from one lab to another, so it is essential to interpret results in context with the lab’s reference values and your overall clinical picture.

What Do Abnormal Urobilinogen Levels Mean?

High Urobilinogen in Urine

Increased urobilinogen levels may suggest:

• Hemolytic anaemia: Excessive breakdown of red blood cells, causing more bilirubin and therefore more urobilinogen.
• Liver disease: Such as viral hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), or cirrhosis.
• Congestive heart failure with liver congestion: Reduced blood flow to the liver can affect processing of bilirubin.

In many of these conditions, your doctor may order additional tests like liver function tests (LFTs), complete blood count (CBC), ultrasound of the abdomen, and others to confirm the diagnosis.

Low or Absent Urobilinogen in Urine

Very low or absent urobilinogen levels may indicate:

• Obstructive jaundice: A blockage in bile ducts (e.g., due to gallstones, tumours) prevents bile and bilirubin from reaching the intestine, leading to low urobilinogen.
• Severe liver dysfunction: When the liver is unable to process bilirubin properly.

In these situations, urine may be dark, and stools may be pale or clay-coloured due to lack of bile pigments.

Factors That Can Affect Urobilinogen Test Results

• Medications: Certain antibiotics, anti-malarial drugs, and medications like sulfonamides may interfere with test readings.
• Prolonged storage of urine: Urobilinogen is unstable and can break down if urine is kept for long before testing.
• Exposure to light and air: Can reduce the detectable amount of urobilinogen in the sample.
• Very dilute or very concentrated urine: May affect how levels appear in the report.

Health Conditions Linked With Abnormal Urobilinogen

Liver Diseases

• Viral hepatitis (A, B, C and others)
• Alcoholic liver disease
• Non-alcoholic fatty liver disease (NAFLD), common with obesity, diabetes, and high cholesterol
• Cirrhosis – advanced scarring of the liver

Blood-Related Conditions

• Hemolytic anaemia due to autoimmune causes, infections, or inherited conditions like thalassemia or sickle cell disease
• Reactions following blood transfusion mismatch

Bile Duct and Gallbladder Problems

• Gallstones blocking bile flow
• Inflammation of bile ducts (cholangitis)
• Pancreatic or bile duct tumours

How Is an Abnormal Urobilinogen Level Managed?

The treatment depends entirely on the underlying cause. A urobilinogen test only acts as an indicator; it is not a final diagnosis.

Typical Next Steps

• Detailed history and physical examination.
• Additional blood tests (LFTs, CBC, viral markers, etc.).
• Imaging tests like ultrasound or CT scan of the abdomen.
• In some cases, special tests such as liver biopsy or endoscopy.

Lifestyle and Dietary Support (India-Focused)

Along with medical treatment, your doctor may advise lifestyle changes to support liver and overall health:

• Balanced diet: Include dal, rajma, chole, sprouts, paneer, curd, buttermilk, soya chunks, eggs, fish, and chicken as protein sources.
• Fibre-rich foods: Whole wheat roti, multigrain atta, brown rice, millets (ragi, jowar, bajra), fruits (guava, papaya, apple), and vegetables (lauki, tori, bhindi, palak).
• Healthy fats: Use mustard oil, groundnut oil, or rice bran oil in moderation; avoid repeated deep-frying.
• Avoid excess alcohol: Even “social drinking” can harm the liver in the long term.
• Limit junk foods: Reduce intake of fried snacks, packaged chips, sugar-loaded sweets, and sugary cold drinks.
• Hydration: Drink 2–3 litres of safe drinking water daily unless restricted by your doctor.
• Exercise: Aim for at least 30 minutes of brisk walking, yoga, or other physical activity most days of the week.

Always discuss any major dietary change or supplements (including herbal and Ayurvedic preparations) with your doctor, particularly if you already have liver or kidney disease.

When Should You See a Doctor?

Consult a doctor promptly if you notice:

• Yellow eyes or skin
• Dark coloured urine for several days without obvious cause (like dehydration)
• Pale stools
• Persistent fatigue, loss of appetite, or weight loss
• Severe abdominal pain, especially in the upper right side

These symptoms, along with abnormal urobilinogen reports, may need urgent evaluation to rule out serious conditions like acute hepatitis, advanced liver disease, or bile duct obstruction.

Links to Relevant Tests and Packages at Seralis Lab

For a complete evaluation of liver function and related conditions, your doctor may suggest the following tests and packages from Seralis Lab. These can help interpret urobilinogen results and provide a broader picture of your health.

–>

FAQs

Question: Is urobilinogen always present in urine?

In small amounts, yes. Urobilinogen is normally formed in the intestine and a portion is excreted in urine. Completely absent or very high levels may indicate an underlying problem and should be interpreted by a doctor.

Question: Can I interpret my urobilinogen result by myself?

No. Urobilinogen values must be interpreted along with your symptoms, physical examination, and other test results (like LFTs, CBC, and imaging). Always discuss your report with a qualified doctor.

Question: Does drinking more water reduce urobilinogen in urine?

Drinking water can dilute urine but does not treat the root cause of abnormal urobilinogen levels. If your levels are abnormal, the underlying liver, bile duct, or blood disorder needs proper medical treatment.

Question: Can diet alone normalise abnormal urobilinogen levels?

Diet and lifestyle changes support liver health but cannot replace medical treatment. If there is a specific disease like hepatitis, cirrhosis, or hemolytic anaemia, you will need targeted therapy prescribed by your doctor.

Question: Is a urobilinogen test safe during pregnancy?

Yes. It is a simple urine test and is considered safe during pregnancy. In fact, urine tests are commonly done in pregnancy to monitor kidney function, infections, and other conditions.

Question: How often should I get my urobilinogen tested?

There is no fixed schedule for everyone. Your doctor may repeat the test based on your symptoms, underlying diseases, and treatment response. For routine health check-ups, it is typically included in a standard urinalysis.

References

• “Clinical Methods: The History, Physical, and Laboratory Examinations – Chapter: Examination of the Urine” by Walker HK, Hall WD, Hurst JW (1990). Source
• “Urobilinogen in Urine” by MedlinePlus, U.S. National Library of Medicine (Updated 2023). Source
• “Urinalysis: A Comprehensive Review” by Simerville JA, Maxted WC, Pahira JJ (American Family Physician, 2005). Source
• “Liver Function Tests” by Pratt DS, Kaplan MM (Gastroenterology, 2000). Source
• “Approach to the Patient with Jaundice or Abnormal Liver Test Results” by Carey WD (Cleveland Clinic, Updated 2022). Source