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Enterohepatic circulation of drugs. Enterohepatic circulation is the circulation of biliary acids, bilirubin, drugs or other substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver.
In medicine, bilirubinuria is an abnormality in which conjugated bilirubin is detected in the urine. [1] The term "biliuria" is very similar, but more general. It refers to the presence of any bile pigment in the urine. Conjugated bilirubin is detected in urine at bilirubinemia of approximately 30-34 mmol/L or 2 mg/dL.
Choluria (or bilirubinuria) is a symptom defining an abnormal darkness of the urine, mainly due to a high level of conjugated bilirubin. [1] [2] Choluria is a common symptom of liver diseases, such as hepatitis and cirrhosis. It can be described as dark or brown urine, often referred to as the color of Coca-Cola.
Hyperbilirubinemia can cause a yellowing of the skin called jaundice depending on the level of bilirubin in the blood. [3] Additional symptoms of hyperbilirubinemia include darker urine (bilirubinuria) due to increased unconjugated bilirubin removed from the body in urine.
The jaundice produced by the accelerated destruction of red blood cells does not produce bilirubinuria, as the high serum bilirubin is found in the unconjugated form and the kidneys are unable to excrete it. The test strips use a diazotization reaction in order to detect bilirubin.
Hemolytic jaundice, also known as prehepatic jaundice, is a type of jaundice arising from hemolysis or excessive destruction of red blood cells, when the byproduct bilirubin is not excreted by the hepatic cells quickly enough. [1]
Bilirubin glucuronide is a water-soluble reaction intermediate over the process of conjugation of indirect bilirubin. [1] Bilirubin glucuronide itself belongs to the category of conjugated bilirubin along with bilirubin di-glucuronide. [2]
Bile acid synthesis occurs in liver cells, which synthesize primary bile acids (cholic acid and chenodeoxycholic acid in humans) via cytochrome P450-mediated oxidation of cholesterol in a multi-step process.