Bariatric Surgery and Bilirubin Toxicity

According to a variety of sources, an estimated 100,000 people or more have opted to undergo bariatric surgery over the past year. These are individuals usually are at least 100 pound overweight or have a Body Mass Index (BMI) of 35 to 40 or higher, and are clearly looking for a last-ditch effort to help cure their obesity. There are many potential side effects to the surgery however, and one of the health risks involved is the possible appearance of bilirubin in urine after bariatric surgery.

What is bilirubin? It is a vital antioxidant. It is also a waste product created from dead red blood cells. Bilirubin is formed when the hemoglobin in these cells is broken down molecularly. It combines with a blood plasma protein and is then carried to the liver. There, it becomes part of bile and is either stored in the gallbladder or is absorbed into the gastrointestinal tract. However, it can also be further broken down, and thus goes into feces or urine, giving each their respective colors. However, if too much bilirubin is created, it can cause jaundice or bilirubin toxicity.

Bilirubin is also one of the factors that causes gallbladder disease and the formation of gallstones. Bilirubin combines with cholesterol to form bile, and bile is stored in the gallbladder. When stones form, they can cause severe abdominal pain as well as jaundice. Sometimes as a result, the gallbladder can become infected or inflamed, and this condition is known as cholecystitis. Sometimes, prescription medication can help alleviate the discomfort and help heal the condition. However, sometimes surgery is needed, especially in severe cases.

On a prominent obesity-related website, one patient who had bariatric surgery discusses her experiences in terms of doctors finding high bilirubin levels in her urine a little over two months after the procedure. She said that he has experienced three days of sharp, severe pain in the right portion of his lower abdomen, near the right ovary, as well as back pain. A urinalysis revealed high bilirubin levels, pointing towards a possible kidney or bladder infection or a ruptured appendix, which is another possible side effect of gastric bypass surgery. The patient was placed on Cipro, a medicine used to help cure bacterial infections including those of the urinary tract, and at last report was still waiting and hoping for the best. Additional surgery, however, was a real possibility.