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Jaundice

Jaundice

Alternative Names

Yellow skin and eyes, Icterus, Eyes – yellow, icterus

What is Jaundice

Jaundice is a yellow color in the skin, the mucous membranes, or the eyes. The yellow pigment is from bilirubin. Bilirubin is a byproduct of old red blood cells. Blirubin is the yellow color you see when a bruise is healing.

It occurs when the amount of old red blood cells in the blood increases. If there are too many red blood cells retiring for the liver to handle, yellow pigment builds up in the body. When there is enough to be visible, jaundice results.

It is also called icterus and yellow skin.

Signs and symptoms

Symptoms of jaundice commonly include the following:

Yellow skin and the white part of the eyes (sclera) when jaundice is more severe, these areas may look brown
Yellow color inside the mouth
Dark or brown-colored urine
Pale or clay-colored stools

It is important to note if the whites of your eyes are not yellow, you may not have jaundice. Your skin can turn a yellow-to-orange color if you eat too much beta carotene, the orange pigment in carrots.

Possible complications

If you leave Jaundice untreated, it can worsen and affect other parts of the body. In newborns, untreated jaundice can cause kernicterus.

What causes

Jaundice can be classified into three categories on the bases of its cause

Pre-Hepatic: Too much bilirubin being produced for the liver to remove from the blood
Hepatic: A defect in the liver that prevents bilirubin from being removed from the blood.
Post-Hepatic: Blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines.

Pre-hepatic (before bile is made in the liver)

Jaundice in these cases is caused by rapid increase in the breakdown and destruction of the red blood cells (hemolysis), overwhelming the liver's ability to adequately remove the increased levels of bilirubin from the blood. Examples of conditions with increased breakdown of red blood cells include:

Malaria,
Sickle cell crisis,
Spherocytosis,
Thalassemia,
Glucose-6-phosphate dehydrogenase deficiency (G6PD),
Drugs or other toxins,
Autoimmune disorders.

Hepatic (the problem arises within the liver)

Jaundice in these cases is caused by the liver's inability to properly metabolize and excrete bilirubin. Examples include:

Hepatitis (commonly viral or alcohol related),
Cirrhosis,
Drugs or other toxins,
Crigler-Najjar syndrome,
Gilbert's syndrome,
Cancer.

Post-hepatic (after bile has been made in the liver)

Jaundice in these cases, also termed obstructive jaundice, is caused by conditions, which interrupt the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.

Causes of obstructive jaundice include :

Gallstones in the bile ducts,
Cancer (pancreatic and gallbladder/bile duct carcinoma),
Strictures of the bile ducts,
Cholangitis,
Congenital malformations,
Pancreatitis,
Parasites,
Pregnancy,

Prevention

The jaundice can in some cases be prevented. Some preventive measures include the following:

Avoid heavy alcohol use (alcoholic hepatitis, cirrhosis, and pancreatitis).
Vaccines for hepatitis (hepatitis A, hepatitis B).
Take medications which prevent malaria before travelling to high-risk regions.
Avoid high-risk behaviors such as intravenous drug use or unprotected intercourse (hepatitis B).
Avoid potentially contaminated food/water and maintain good hygiene (hepatitis A).
Avoid medications that can cause hemolysis in susceptible individuals (such as those with G6PD deficiency, a condition that leads to red blood cell breakdown after consumption of certain substances).
Avoid medications and toxins which can cause hemolysis or directly damage the liver.

Treatment

Treatment can be vary based on the medical condition responsible for causing jaundice, and the associated symptoms and complications. Treatments may include the following: