Laxatives: A Bilirubin-Reduction Strategy?

can laxatives reduce bilirubin

High bilirubin levels, or hyperbilirubinemia, can be caused by a variety of conditions, including gallstones, liver dysfunction, hepatitis, bile duct obstruction, and hemolytic anemia. In newborns, high bilirubin levels are common and usually temporary, occurring due to the breakdown of red blood cells and the underdeveloped nature of their livers. However, in adults, high bilirubin levels may indicate an underlying health condition such as jaundice, gallstones, or liver issues. While there is no direct evidence that laxatives can reduce bilirubin, maintaining a healthy diet and avoiding processed foods, added sugars, and saturated fats can help manage high bilirubin levels.


Can a Mediterranean diet reduce bilirubin?

Bilirubin is a brownish-yellow substance that forms when red blood cells break down at the end of their life cycle. It is processed by the liver and gallbladder and excreted in stool and urine. A build-up of bilirubin can cause jaundice, a condition that causes a yellowing of the skin and eyes.

The Mediterranean diet is a way of eating that is inspired by the traditional dietary patterns of the countries bordering the Mediterranean Sea. It is characterised by an emphasis on plant-based foods, such as fruits, vegetables, whole grains, legumes, nuts and seeds, as well as healthy fats like olive oil. The diet typically includes a moderate amount of fish and poultry, with a lower intake of red meat, and low to moderate consumption of dairy and eggs.

Adopting a Mediterranean diet may help to reduce bilirubin levels, particularly if you have liver disease. This is because the Mediterranean diet is typically low in processed foods, added sugars, saturated fats and carbohydrates, all of which can contribute to liver disease and increase bilirubin levels.

A balanced diet that includes a variety of fruits and vegetables, lean proteins, and plenty of water can support liver health and reduce jaundice. Liver-friendly foods include:

  • Fresh fruits and vegetables, especially brightly coloured ones such as berries, citrus fruits, carrots, beets, cruciferous vegetables, and leafy greens.
  • Whole grains such as oatmeal, which are a good source of dietary fibre and phenolic acids.
  • Lean proteins such as tofu, legumes, poultry, and fish.
  • Healthy fats like nuts and oily fish (e.g. salmon and mackerel), which are rich in polyunsaturated and monounsaturated fats.

In addition to diet, it is important to stay hydrated by drinking enough water, as this can also support liver function and help to flush out toxins.

Other Factors Affecting Bilirubin Levels

It is important to note that while diet can play a role in managing bilirubin levels, there are also other factors to consider. For example, certain medications, genetic conditions, and underlying health issues such as gallstones or liver problems can also impact bilirubin levels.

If you have high bilirubin levels or are concerned about jaundice, it is recommended to consult a doctor or registered dietitian, who can provide personalised recommendations based on your individual health needs.

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What is Gilbert's syndrome and how does it affect bilirubin levels?

Gilbert's syndrome is a common, harmless, and mild genetic liver condition that affects the organ's ability to process and remove bilirubin from the body. Bilirubin is a waste product and a by-product of the breakdown of red blood cells, giving bile its distinctive yellow colour. It is processed by the liver and excreted in stool and urine.

People with Gilbert's syndrome inherit a mutated gene, which means they do not produce enough liver enzymes to keep bilirubin at a normal level. This results in a build-up of excess bilirubin in the body, known as hyperbilirubinemia, which can cause jaundice—a condition that turns the skin and whites of the eyes yellow. However, this is usually mild and harmless, and Gilbert's syndrome does not require treatment.

The syndrome is present at birth but often goes unnoticed until puberty or later, as bilirubin production increases during puberty. It is also more common in males than females and affects people of all ages, races, and ethnicities. It is estimated that 3-7% of Americans have Gilbert's syndrome, and in the UK, it is thought that at least 1 in 20 people are affected.

People with Gilbert's syndrome may experience occasional and short-lived episodes of jaundice, which can be triggered by things like fasting, illness, or physical exertion. However, about 1 in 3 people with the syndrome do not experience any symptoms at all and may only discover they have it through blood tests for unrelated problems.

While Gilbert's syndrome does not require treatment, it is important to be aware of potential triggers and to seek medical advice if you experience chronic gastrointestinal problems, dark-coloured urine, clay-coloured stool, or jaundice.


What are the symptoms of high bilirubin?

High bilirubin levels, or hyperbilirubinemia, is a condition characterised by an excessive amount of bilirubin in the bloodstream. Bilirubin is a waste product formed when red blood cells break down, and it is normally processed by the liver and eliminated from the body through stool and urine. When bilirubin levels are high, it can lead to a condition called jaundice, which causes yellowing of the skin and eyes.

  • Yellowing of the skin and whites of the eyes (jaundice)
  • Fatigue and weakness
  • Abdominal pain and swelling
  • Unintentional weight loss
  • Dark or brown-coloured urine
  • Pale or clay-coloured stools
  • Itchy skin (pruritus)

In newborns, jaundice is the main sign of high bilirubin levels. It typically first appears on the face and then spreads to the chest, belly, arms, and legs as bilirubin levels increase. Newborns with jaundice may also exhibit the following symptoms:

  • Difficulty waking up or sleeping
  • Poor feeding or sucking
  • Reduced urine output and fewer stools

If you or anyone around you is experiencing any of these symptoms, it is important to seek medical attention promptly.

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What are the causes of high bilirubin?

High bilirubin levels, also known as hyperbilirubinemia, can be caused by a variety of factors, and can occur in both newborns and adults.

Causes of High Bilirubin Levels in Newborns

In newborns, high bilirubin levels are common and usually temporary, resolving within a few weeks. This occurs because newborns have more red blood cells, which they break down more quickly, but their livers are not yet developed enough to keep up with this process. This results in a buildup of bilirubin, leading to jaundice, a yellowing of the skin and eyes.

Causes of High Bilirubin Levels in Adults

In adults, high bilirubin levels are often indicative of an underlying health condition and should be assessed by a doctor. Some of the most common causes include:

  • Liver dysfunction: Conditions such as cirrhosis, liver cancer, alcoholic liver disease, or autoimmune hepatitis can impair the liver's ability to process and remove bilirubin from the bloodstream.
  • Hemolytic anemia: This condition causes red blood cells to break down too quickly, leading to increased bilirubin levels. It can be inherited or caused by autoimmune conditions, an enlarged spleen, or an infection.
  • Gallstones: These are hard masses that form in the gallbladder and can block the tubes that drain bile, resulting in a buildup of bilirubin.
  • Gilbert's syndrome: A genetic disorder that affects the liver's ability to process bilirubin, causing it to build up in the bloodstream.
  • Hepatitis: Inflammation of the liver, often due to a viral infection, can hinder the liver's ability to process bilirubin effectively.
  • Bile duct obstruction: Blockages in the bile ducts, which connect the liver to the gallbladder and small intestine, can impede the movement of bile and lead to increased bilirubin levels.
  • Pancreatitis: Inflammation of the pancreas can also cause elevated bilirubin levels.
  • Cancer: Liver cancer, pancreatic cancer, and colon cancer have been linked to high bilirubin levels.
  • Dehydration: Dehydration can be a factor contributing to increased bilirubin levels.
  • Medications: Certain medications, such as antibiotics, anticonvulsives, and antifungals, can impair liver function and lead to high bilirubin levels.
  • Strenuous exercise: Vigorous physical activity, such as marathon running, can temporarily raise bilirubin levels.
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How is bilirubin tested?

A bilirubin test is used to measure the levels of bilirubin in the blood. Bilirubin is a yellow pigment that occurs when red blood cells break down. It is processed by the liver and excreted in bile, which is a fluid that helps us digest food. A healthy liver will remove most of the bilirubin from the body.

A bilirubin test is used to check the health of the liver and diagnose newborn jaundice. It is also used to help diagnose other health conditions like jaundice, anemia, and liver disease.

Bilirubin levels can be measured in urine and blood. Urine tests that are positive for bilirubin will be followed by a blood test to measure the levels of bilirubin present. Bilirubin tests are usually done by drawing blood through a small needle inserted into a vein in the arm. The blood is then sent to a lab for analysis.

Before the test, it is recommended to avoid eating or drinking for four hours. It is also important to inform the doctor about any medications being taken, as certain drugs can alter the results. After the test, patients can resume their normal activities.

The bilirubin test measures total bilirubin levels and can also give levels of two types of bilirubin: unconjugated and conjugated. Unconjugated bilirubin is created from red blood cell breakdown and travels to the liver. Conjugated bilirubin is the result of a chemical change in the liver, after which it moves to the intestines to be removed through stool.

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