Introduction
A medical condition which has a yellow skin appearance along with the whites of eyes and mucous membrane is known as Jaundice. This occurs due to an increase in the level of bilirubin. Bilirubin is a yellow-orange pigment present in the bloodstream as a waste material after iron is removed from blood. Abnormal level of bilirubin changes the colour appearance to brown.
Cause of Jaundice
Jaundice is caused due to an inflammation of liver or obstructed bile duct. Many other factors also constitute jaundice. In technical terms it is known as icterus. Jaundice occurs more often in newborn babies and is termed as neonatal jaundice. The neonatal jaundice is caused as the newborn liver is not fully developed and is less effective in processing bilirubin from the blood.
The main function of the liver is to filter the waste material from blood. Conjugated bilirubin is formed as it reaches the liver, and this formed because of chemicals attaching to bilirubin.
In normal conditions, the liver produces a digestive juice called bile. The conjugated bilirubin enters the bile and then exits from the body. The brown faecal matter is because of the bilirubin.
In Abnormal conditions, the bilirubin is leaked into the surrounding tissues which is known as Hyperbilirubinemia which causes the yellow colour in the skin and eyes.
Symptoms of Jaundice
Symptoms of jaundice are as follows:
Appearance of yellow colour on the skin, whites of eyes and mucous membrane.
Passage of dark urine and itchiness.
In the initial stages of jaundice, following symptoms occur
Fever
Abdominal pain
Vomitings
Weight loss
Drowsiness, agitation, and confusion
Symptoms of Jaundice in Infants
A common health issue faced by infants is jaundice. Around 60% of newborns experience jaundice which increases the percentage of premature deliveries before 37 weeks of pregnancy. The jaundice symptoms are usually shown within 72 hours of birth.
Due to the starting stages of body growth in infants, it is difficult to analyse the symptoms unlike adults. Physical examination on the body such as slightly pressing on the chin of the body should be done to check for jaundice.
Additional symptoms include:
Crying loudly
Change in skin tone
Poor feeding
Urine colour changes to yellow
Sleepiness and lethargic
The symptoms of jaundice usually resolve naturally without the intervention of treatment within 2 weeks. Abnormal levels in bilirubin in some cases are treated by either a blood transfusion or phototherapy. The risk of any treatment in infants is due to a condition called Kernicterus which is a rare type of permanent brain damage.
Types of Jaundice
Jaundice is mainly treated by the underlying cause of it. The treatment is given according to the symptoms rather than making it a common pattern for the disease.
The different kinds of jaundice observed according to the symptoms are:
Hepatocellular Jaundice: This occurs due to the damage or injury to the liver. Main cause of liver damage is due to the infections, excessive consumption of alcohol, and parasitic infections. Treatment is provided by liver surgery or transplantation which helps to control further damage.
Hemolytic Jaundice: In this kind of jaundice the symptoms appear as increase in the level of bilirubin which occurs due to accelerated rate of erythrocytes or red blood cells. Malaria, anaemia etc.
Obstructive Jaundice: Hindrance of bilirubin from exiting the liver is the main cause for this kind of jaundice. Blockage is cleared by surgery to clear the bile duct system.
Underlying Factors Causing Jaundice
The main cause of jaundice is either due to accumulation of bilirubin or hindering the function of the liver to filter bilirubin. This results in deposition of bilirubin in tissues.
The Underlying factors are:
Acute inflammation of Liver: This impairs the ability of liver to conjugate and secrete bilirubin, which results in accumulation of bilirubin level.
Inflammation of Bile Duct: The inflammation occurs due to the hindrance in secretion of bile and removal of bilirubin, resulting in jaundice.
Obstruction of Bile Duct: Disposal of bilirubin by liver occurs in this case, leading to jaundice.
Hemolytic Anemia: Uncontrolled production of Red blood cells leads to increase in the production of bilirubin which causes hemolytic anemia.
Gilbert’s Syndrome: An inherited condition which impairs the ability of enzymes to process the excretion of bile.
Cholestasis: The passage of bile from the liver is interrupted in this condition. The conjugated bilirubin present in the bile remains in the liver due to the obstruction of passage instead of being excreted.
Some of the rare conditions which cause jaundice are:
Crigler-Najjar Syndrome: This is an inherited condition which impairs the enzyme responsible for processing bilirubin.
Dubin-Johnson Syndrome: An inherited form of chronic jaundice which inhibits the secretion of conjugated bilirubin from the cells of liver.
Pseudojaundice: Harmless form of jaundice which occurs due to excess levels of beta-carotene. This is caused due to high intake of carrot, pumpkin, or melon.
Diagnosis for Jaundice
The most basic method of diagnosing jaundice is by checking the levels of bilirubin. The physical check is performed by examining the abdomen, feel for tumor, and checking for the firm condition of liver.
Various tests can be done to check the condition of the liver and the level of bilirubin to diagnose jaundice.
Bilirubin Tests: Difference in the level of unconjugated bilirubin when compared to conjugated bilirubin result in hemolytic anemia.
Full Blood Count: This provides a complete report of the count of RBC, WBC, and Platelets.
- Hepatitis A, B, and C tests: This accounts for various kinds of liver functions.
Treatment for Jaundice
Usually there is no requirement of jaundice in adults, it is a rather severe problem in infants. The causes and complications of jaundice can be easily treated. For example, a healthcare professional can prescribe medications to treat itching. Also, if the liver has been damaged, there may be a need to transplant it.
Prevention of Jaundice
Jaundice can be prevented by taking care of the liver and doing some lifestyle changes.
Always try to eat balanced meals.
Exercise regularly to maintain healthy weight.
Limit the consumption of alcohol and avoid smoking and taking intravenous drugs.
Avoid taking herbal supplements without consulting your doctor.
Conclusion
Jaundice is a medical condition which is characterized by the yellow appearance of skin and eyes. This is caused by liver inflammation or an obstructed bile duct. We also learnt about types, diagnosis, treatment and prevention of jaundice.
FAQs on Jaundice
1. What is jaundice and what causes the characteristic yellowing of the skin and eyes?
Jaundice is not a disease itself, but a visible sign of an underlying medical condition. It is characterized by the yellowing of the skin, the whites of the eyes (sclera), and mucous membranes. This yellow colour is caused by a high level of bilirubin, a yellow-orange bile pigment, in the blood. Normally, the liver processes and excretes bilirubin, but when this process is disrupted, bilirubin builds up in the body, leading to the yellow discoloration.
2. What are the main types of jaundice, as classified in biology?
Jaundice is typically classified into three main types based on what part of the bilirubin processing pathway is disrupted:
- Pre-hepatic Jaundice: This occurs before the liver is involved. It is caused by conditions that increase the rate of red blood cell breakdown (haemolysis), such as sickle cell anemia or malaria, overwhelming the liver's ability to process bilirubin.
- Hepatic Jaundice: This results from damage or disease within the liver itself, impairing its ability to conjugate and excrete bilirubin. Common causes include hepatitis (viral or alcoholic), cirrhosis, and liver cancer.
- Post-hepatic Jaundice (Obstructive Jaundice): This happens after the bilirubin has been processed by the liver but cannot be drained properly. It is caused by a blockage in the bile ducts, often due to gallstones, tumours, or inflammation.
3. What are the initial symptoms of jaundice that a student should be aware of?
The most prominent sign of jaundice is a yellow tint to the skin and the whites of the eyes. However, other early symptoms often appear alongside or even before the yellowing becomes obvious. These include:
- Dark-coloured urine: Urine may appear dark yellow, brown, or tea-coloured due to excess bilirubin being excreted by the kidneys.
- Pale stools: Stools may become light-coloured or clay-coloured because bilirubin is blocked from entering the intestines.
- Fatigue and generalized weakness.
- Itchy skin (pruritus).
- Abdominal pain, particularly on the upper right side.
4. How is the pigment bilirubin formed and what is its connection to jaundice?
Bilirubin is a waste product formed during the normal breakdown of hemoglobin from aged or damaged red blood cells. This process occurs in the spleen, liver, and bone marrow. The newly formed bilirubin (unconjugated) is toxic and not water-soluble. It travels through the bloodstream to the liver, which converts it into a water-soluble form (conjugated bilirubin). This conjugated form is then excreted into bile and eliminated from the body through stool. Jaundice occurs when this pathway is disrupted, causing bilirubin to accumulate in the blood.
5. How does the liver's role in digestion and detoxification directly relate to jaundice?
The liver is central to both digestion and detoxification, and its failure in these roles leads to jaundice. For digestion, the liver produces bile, which is essential for emulsifying fats. Bilirubin is a key component of bile. For detoxification, the liver converts toxic unconjugated bilirubin into a harmless, excretable form. If the liver is damaged (e.g., by hepatitis or alcohol), it cannot perform this conversion efficiently. As a result, toxic bilirubin builds up in the blood, causing the yellowing of jaundice and indicating a critical failure in the liver's detoxification and excretory functions.
6. Why is jaundice common in newborns, and how does it differ from jaundice in adults?
Jaundice in newborns (neonatal jaundice) is common and often physiological, meaning it's not caused by a disease. A newborn's liver is still immature and the enzyme responsible for conjugating bilirubin (UDP-glucuronyl transferase) is not fully active. This, combined with a higher rate of red blood cell turnover, leads to a temporary buildup of bilirubin that usually resolves on its own. In contrast, jaundice in adults is almost always pathological, signifying an underlying problem like liver disease, a blocked bile duct, or a haemolytic disorder that requires immediate medical investigation and treatment.
7. Why is it critical to treat the underlying cause of jaundice and not just the symptom?
Treating jaundice as just a symptom is a critical mistake because the yellowing itself is only a warning sign of a potentially serious underlying condition. The root cause determines the treatment and prognosis. For example, if jaundice is due to gallstones blocking a bile duct, surgery may be needed. If it's caused by hepatitis, antiviral medications are required. Ignoring the cause and only managing symptoms can lead to severe complications like liver failure, sepsis, or the progression of cancer. Therefore, diagnosing and treating the root problem is the only way to resolve jaundice and prevent life-threatening outcomes.
8. What general dietary changes are recommended for a person recovering from jaundice?
Since jaundice is linked to liver health, a diet that is easy on the liver is crucial for recovery. While a doctor's advice is primary, general recommendations include:
- Hydration: Drink plenty of water, fresh juices, and clear soups to help flush out toxins.
- Easily Digestible Foods: Focus on fruits, vegetables, and whole grains like oats and porridge.
- Lean Proteins: Include sources like lentils, tofu, and fish, which are easier for the liver to process than red meat.
- Foods to Avoid: It is essential to avoid alcohol, as it is directly toxic to the liver. Additionally, one should stay away from fatty, fried, and processed foods, as well as refined sugars, which put extra strain on the liver.
9. Can jaundice go away on its own?
Whether jaundice can resolve on its own depends entirely on the cause. Mild physiological jaundice in newborns often improves and disappears within a few weeks as the baby's liver matures. However, in adults, jaundice is a sign that something is wrong. It will not go away until the underlying medical condition—be it an infection, a blockage, or liver damage—is properly treated. Leaving adult jaundice untreated can be dangerous, so medical consultation is always necessary.
