Jaundice is a condition in which the skin, eyes, and mucous membranes turn yellow due to bilirubin buildup, a waste product of red blood cell breakdown. It affects people of all ages, but it is more common and usually harmless in newborns. Occasionally, jaundice may indicate an underlying problem with the liver, gallbladder, or blood cells. It is essential to know about the causes, symptoms, diagnosis, treatment, and prevention of jaundice in order to prevent it.
Jaundice can be caused by a problem in any of the three phases of bilirubin production and elimination:
Pre-hepatic: When red blood cells breakdown abnormally quickly, bilirubin production increases. A person can develop hemolytic anemia (a condition in which red blood cells are destroyed prematurely), malaria (a parasitic infection that affects red blood cells), or sickle cell disease (a genetic disorder that causes abnormal shapes in red blood cells).
Hepatic: This occurs when there is a problem with the liver's ability to process bilirubin. A variety of factors can contribute to this condition, including viral infections (including hepatitis A, B, and C), alcohol abuse, autoimmune disorders (such as primary biliary cirrhosis), genetic defects (like Gilbert's syndrome and Crigler-Najjar syndrome), or medications.
Post-hepatic: This occurs when there is an obstruction of the bile ducts that carry bilirubin from the liver to the intestine. This can happen due to gallstones (hard deposits of cholesterol or bile salts that form in the gallbladder), inflammation of the gallbladder (cholecystitis), tumors of the pancreas or bile ducts, or scarring of the bile ducts (primary sclerosing cholangitis).
The most obvious symptom of jaundice is the yellowing of the skin, eyes, and mucous membranes. However, depending on the cause and severity of jaundice, other symptoms may include:
Itchy skin
Fatigue
Loss of appetite
Nausea and vomiting
Dark urine
Pale stools
Abdominal pain
Fever and chills
Weight loss
Confusion and mental changes
As a first step in diagnosing jaundice, a physician will examine the patient physically and ask about his or her medical history and symptoms. The doctor may order some tests to measure the level of bilirubin and liver enzymes in the blood. These tests can help determine the type and cause of jaundice.
In a complete blood count (CBC), red blood cells, white blood cells, and platelets are measured. A low red blood cell count or a high reticulocyte count (immature red blood cells) may indicate hemolysis. Infection or inflammation can cause a high white blood cell count.
During liver function tests (LFTs), enzymes and proteins that are produced or processed by the liver are measured. An elevated level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), or bilirubin may indicate liver dysfunction or damage.
A positive Coombs test indicates autoimmune hemolytic anemia or drug-induced hemolysis.
The blood smear test examines a sample of blood under a microscope for abnormal shapes or sizes of red blood cells, which may help diagnose conditions like sickle cell disease and malaria.
An abdominal ultrasound is a diagnostic tool for detecting liver, gallbladder, pancreatic, or bile duct diseases, such as gallstones, tumors, and inflammation.
Through the mouth, a flexible tube with a camera and light source (endoscope) is inserted into the duodenum (the first part of the small intestine), for endoscopic retrograde cholangiopancreatography (ERCP). A dye is injected through the endoscope into the bile ducts and pancreas to make them visible on an X-ray. This helps identify blockages or abnormalities in these organs.
The treatment of jaundice depends on the underlying cause and severity of the condition. Some of the possible treatments are:
Medications: These may include antibiotics (to treat infections), steroids (to reduce inflammation), antihistamines (to relieve itching), or ursodeoxycholic acid (to dissolve gallstones).
Surgery: This may be needed to remove gallstones, tumors, or scarred bile ducts that are causing obstruction or damage to the liver or bile ducts.
Blood transfusion: This may be needed to replace the lost or damaged red blood cells in cases of severe hemolysis or bleeding.
Phototherapy: This is a treatment that uses blue light to help break down bilirubin in the skin. It is mainly used for newborns with jaundice, but it may also be used for adults with severe jaundice that does not respond to other treatments.
Liver transplant: This is a surgery that replaces a diseased liver with a healthy one from a donor. It is usually reserved for cases of end-stage liver failure that cannot be treated by other means.
Some of the ways to prevent jaundice or reduce its risk are:
Avoiding or limiting alcohol consumption
Getting vaccinated against hepatitis A and B
Practicing safe sex and avoiding sharing needles
Eating a balanced diet and maintaining a healthy weight
Drinking plenty of fluids and staying hydrated
Avoiding medications that can harm the liver or cause hemolysis
Seeking medical attention if you have symptoms of jaundice or liver disease
You should be aware of the signs and symptoms of jaundice and seek medical help if you experience them. It is important to take care of your liver and your health in order to prevent jaundice. A good diagnosis and proper treatment can resolve or manage most cases of jaundice. Some cases of jaundice, however, indicate a life-threatening condition that requires immediate attention. Therefore, you should take care of your liver and your health in order to prevent jaundice as much as possible.
