The results of the bilirubin test help determine if the liver is working properly, explains the American Association for Clinical Chemistry. Low bilirubin levels are not usually a cause for concern, but an elevated bilirubin level can indicate a problem with the liver.
The bilirubin blood test is ordered when a person has symptoms such as jaundice, abdominal pain, fatigue, amber-colored urine or abdominal swelling, states the American Association for Clinical Chemistry. The test is also ordered when a person has been exposed to hepatitis or has a history of excessive alcohol consumption. In adults and children, an increased total bilirubin level is associated with cirrhosis, pernicious anemia and transfusion reactions. Alcoholic liver disease, viral hepatitis and drug reactions cause the amount of direct bilirubin to exceed the amount of indirect bilirubin in the blood. Direct bilirubin may also be elevated due to tumors or gallstones.
In newborns, elevated bilirubin levels are sometimes due to the breakdown of red blood cells, notes the American Association for Clinical Chemistry. This breakdown occurs when the baby's blood type is not compatible with the mother's blood type. Newborns can also have elevated bilirubin levels due to genetic disorders and infections that are present at birth. In some newborns, an elevated bilirubin level returns to normal on its own. Other babies require surgery to correct the cause of an elevated bilirubin level.