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Jaundice : Symptoms, Causes, Diagnosis and Treatment

What is Jaundice?

Jaundice is a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment. Jaundice has many causes, including hepatitis, gallstones and tumors. In adults, jaundice usually doesn't need to be treated. Jaundice is a term used to describe a yellowish tinge to the skin and the whites of the eye. Body fluids may also be yellow.

The color of the skin and whites of the eyes will vary depending on levels of bilirubin. Bilirubin is a waste material found in the blood. Moderate levels lead to a yellow color, while very high levels will appear brown.

About 60 percent of all infants born in the United States have jaundice. However, jaundice can happen to people of all ages and is normally the result of an underlying condition. Jaundice normally indicates a problem with the liver or bile duct. ?Jaundice? is the medical term that describes yellowing of the skin and eyes. Jaundice itself is not a disease, but it is a symptom of several possible underlying illnesses. Jaundice forms when there is too much bilirubin in your system. Bilirubin is a yellow pigment that is created by the breakdown of dead red blood cells in the liver. Normally, the liver gets rid of bilirubin along with old red blood cells.

Jaundice belongs under the category of Skin Disease. Hepatocellular jaundice, Hemolytic jaundice, Obstructive jaundice are some common types of Jaundice. Generally Male, Female, Child are the victim of the Jaundice. Seriousness of this disease is Low.

Symptoms of Jaundice are :

  • Change in skin color.
  • Dark color urine
  • Feeling cold
  • abdominal pain
  • Abdominal pain has many potential causes. The most common causes ? such as gas pains, indigestion or a pulled muscle ? usually aren't serious. Other conditions may require more-urgent medical attention.

    While the location and pattern of abdominal pain can provide important clues, its time course is particularly useful when determining its cause.

    Acute abdominal pain develops, and often resolves, over a few hours to a few days. Chronic abdominal pain may be intermittent, or episodic, meaning it may come and go. This type of pain may be present for weeks to months, or even years. Some conditions cause progressive pain, which steadily gets worse over time.

  • Medium Fever
  • A fever is a higher-than-normal body temperature. It?s a sign of your body's natural fight against infection.

    • For adults, a fever is when your temperature is higher than 100.4°F.
    • For kids, a fever is when their temperature is higher than 100.4°F (measured rectally); 99.5°F (measured orally); or 99°F (measured under the arm).

    The average normal body temperature is 98.6° Fahrenheit (or 37° Celsius). When you or your child?s temperature rises a few degrees above normal, it?s a sign that the body is healthy and fighting infection. In most cases, that?s a good thing.

    But when a fever rises above 102°F it should be treated at home and, if necessary, by your healthcare provider if the fever doesn?t go down after a few days.

    Causes

    Jaundice can be caused due to:

    Jaundice can be caused by a problem in any of the three phases in bilirubin production.

    Before the production of bilirubin, you may have what's called unconjugated jaundice due to increased levels of bilirubin caused by:

    • Reabsorption of a large hematoma (a collection of clotted or partially clotted blood under the skin).
    • Hemolytic anemias (blood cells are destroyed and removed from the bloodstream before their normal lifespan is over).

    During production of bilirubin, jaundice can be caused by:

    • Viruses, including Hepatitis A, chronic Hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis).
    • Alcohol.
    • Autoimmune disorders.
    • Rare genetic metabolic defects.
    • Medicines, including acetaminophen toxicity, penicillins, oral contraceptives, chlorpromazine (ThorazineŽ) and estrogenic or anabolic steroids.

    After bilirubin is produced, jaundice may be caused by obstruction (blockage) of the bile ducts from:

    What kind of precaution should be taken in Jaundice?

    Certain conditions leading to jaundice can be prevented, whereas others may be less preventable. However, there are certain measures that can be taken in order to decrease the risk of developing jaundice.

    • Take medications as instructed in order to prevent potential liver damage or unintentional overdose. Individuals with certain medical conditions (for example, G6PD deficiency or cirrhosis) should avoid certain medications altogether. Discuss medications with your health care professional.
    • Avoid high-risk behaviors such as unprotected intercourse or intravenous drug use, and implement universal precautions when working with blood products and needles. This can decrease your risk of developing hepatitis B or hepatitis C.
    • Consider being vaccinated against hepatitis A and hepatitis B. There is currently no available vaccine against hepatitis C.
    • Avoid potentially contaminated food products or unsanitary water, as this may decrease your risk of developing hepatitis A.
    • When travelling to areas where malaria is endemic, take the recommended precautions and prophylactic medications in order to prevent the development of malaria.
    • Consume alcohol responsibly and only in moderation. This can prevent alcoholic hepatitis, alcoholic cirrhosis and pancreatitis, among other conditions. Certain individuals will need to avoid alcohol altogether.
    • Avoid smoking, as it is a risk factor for the development of pancreatic cancer, as well as many other malignancies.

    Treatment for the Jaundice

    Diagnosis:

    The presence of jaundice requires a comprehensive medical evaluation to determine the cause. Initially, your health-care professional will take a detailed history of your illness and perform a physical exam, which can sometimes determine the cause of the jaundice. Initial blood testing will also be undertaken, with special attention being given to your:

    • Liver blood tests
    • Complete blood count (CBC)
    • Electrolyte pane
    • Lipase levels

    Blood testing for exposure to hepatitis may also be ordered. Additional blood testing may be ordered based on the initial results. A urinalysis will likely also be ordered.

    Depending on the results of initial blood tests, further studies may be needed to help diagnose the underlying disease process. In certain cases, imaging studies will need to be obtained in order to evaluate for any abnormalities of the liver, gallbladder and pancreas. These imaging studies may include:

    • Abdominal ultrasound
    • Computerized tomography (CT) scan
    • Magnetic resonance imaging (MRI)
    • Cholescintigraphy (HIDA scan)

    Occasionally, people will need further invasive testing to determine the cause of the jaundice. Procedures that may be ordered include endoscopic retrograde cholangiopancreatography (ERCP) or a liver biopsy.

    Treatment:

    The treatment for jaundice depends entirely on the underlying cause. Once a diagnosis has been established, the appropriate course of treatment can then be initiated. Certain patients will require hospitalization, whereas others may be managed as outpatients at home.

    • In certain individuals with jaundice, the treatment will consist of supportive care and can be managed at home. For example, most cases of mild viral hepatitis can be managed at home with watchful waiting and close monitoring by your doctor (expectant management). Novel medications for hepatitis C now can offer a cure for this condition.
    • Alcohol cessation is necessary in patients with cirrhosis, alcoholic hepatitis, or acute pancreatitis secondary to alcohol use.
    • Jaundice caused by drugs/medications/toxins requires discontinuation of the offending agent. In cases of intentional or unintentional acetaminophen (Tylenol) overdose, the antidote N-acetylcysteine (Mucomyst) may be required.
    • Various medications may be used to treat the conditions leading to jaundice, such as steroids in the treatment of some autoimmune disorders. Certain patients with cirrhosis, for example, may require treatment with diuretics and lactulose.
    • Antibiotics may be required for infectious causes of jaundice, or for the complications associated with certain conditions leading to jaundice (for example, cholangitis).
    • Blood transfusions may be required in individuals with anemia from hemolysis or as a result of bleeding.
    • Individuals with cancer leading to jaundice will require consultation with an oncologist, and the treatment will vary depending on the type and extent (staging) of the cancer.
    • Surgery and various invasive procedures may be required for certain patients with jaundice. For example, certain patients with gallstones may require surgery. Other individuals with liver failure/cirrhosis may require a liver transplant.

    Possible complication with Jaundice

    The type of complication and the severity of complications vary with the underlying cause leading to jaundice. Certain individuals will not suffer any long-term after effects and will have a full recovery, while for others the appearance of jaundice will be the first indication of a life-threatening condition. A few of the potential complications include:

    References:

    1 https://my.clevelandclinic.org/health/diseases/15367-adult-jaundice 2 https://www.medicalnewstoday.com/articles/165749#complications 3 https://www.healthline.com/health/jaundice-yellow-skin#treatment 4 https://patient.info/digestive-health/abnormal-liver-function-tests-leaflet/jaundice#nav-6 5 https://www.medicinenet.com/jaundice_in_adults/article.htm#what_is_the_prognosis_for_an_adult_with_jaundice_can_it_be_cured_is_it_fatal 6 https://www.webmd.com/hepatitis/jaundice-why-happens-adults 7 https://www.mayoclinic.org/diseases-conditions/infant-jaundice/symptoms-causes/syc-20373865

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