What process occurs to bilirubin in the intestines after it is conjugated?

After bilirubin is conjugated in the liver, it is secreted into the intestines primarily as bilirubin diglucuronide. In the intestinal environment, particularly with the presence of gut bacteria, this conjugated bilirubin undergoes further transformation into urobilinogen.

Urobilinogen can be reabsorbed back into the bloodstream, and a portion is eventually excreted in urine, contributing to its yellow coloration, while some is converted to stercobilin, giving feces their characteristic brown color. The transformation into urobilinogen is essential in the metabolism of bilirubin and reflects normal physiological processes involving the breakdown and elimination of heme products in the body.

Understanding this metabolic pathway is crucial in neonatal care, particularly in assessing bilirubin levels and managing conditions like jaundice, as abnormal levels can indicate underlying issues with liver function or hemolysis.