What is Jaundice?
Jaundice is a condition that usually occurs when the liver is unable to efficiently process red blood cells when they break down. When people have jaundice their skin and eyes usually have a yellow tinge caused by too much bilirubin in the blood. Bilirubin, which is yellow in colour, is considered as a waste substance and it remains in the blood stream after iron is removed from the blood. When these cells die the liver filters bilirubin out of the blood stream but when the liver is not functioning as it is supposed to, the levels of bilirubin increase in the blood stream causing jaundice.
While there are several Signs and Symptoms of jaundice, the underlying cause of jaundice determines how severe the Symptoms are or how quickly or slowly the illness is developing.
If you have jaundice that is caused by an infection you may have the following Symptoms:
- Abdominal pain
- Changes in the colour of the skin
- Flu-like Symptoms
- Dark coloured urine
If the jaundice is not caused by an infection, the Symptoms you have may include itchy skin and weight loss. When the jaundice is caused by biliary tract or pancreatic cancers, abdominal pain is a very common Symptom.
Who is at Risk?
While jaundice is not very common in adults, there are certain lifestyle conditions, illnesses and other factors that may put you at Risk of contracting jaundice. Some of the jaundice Risk Factors are:
- Liver Disease as a result of alcohol- people who drink excess alcohol on a regular basis over a long period of time can cause severe damage to their liver. The two main Diseases that result from this are alcohol hepatitis and cirrhosis of the liver.
- Hepatitis- this is an infection that is usually caused by a virus. While this condition can be acute (short-lived) or chronic, in which it generally lasts for more than six months. Autoimmune disorders or drugs can also cause hepatitis. Over a period of time it can cause damage to the liver and eventually lead to jaundice.
- Blocked bile ducts- bile ducts are narrow tubes that carry bile from the gall bladder and liver to the small intestine. When there is an occurrence of gall stones, cancer or in certain cases a liver Disease, these ducts get blocked and can result in jaundice.
- Pancreatic Cancer- This type of cancer blocks the bile duct and this Causes jaundice.
- Medication- certain medication like birth control pills, acetaminophen, steroids and certain other medicines have been linked to liver damage.
When bilirubin is passed onto the liver from the bloodstream, it then passes into the bile ducts which carry it to the small intestine and eventually bilirubin exits the body through urine or stool. There are three types of jaundice and these are categorized by the stage they happen in during the process of filtering out bilirubin.
- Pre-hepatic- is before the liver. This is caused by an increased rate at which the red blood cells are broken down and are releasing haemoglobin and converting into bilirubin. Since the liver has a limited capacity to process bilirubin at one go, the excess overflows into the body tissues. Some of the common Causes of this type of jaundice are Malaria, Sickle cell anemia, spherocytosis and thalassemia.
- Hepatic jaundice- is in the liver. When the liver tissue is scarred (known as cirrhosis) or dysfunctional, it affects the process of filtering out bilirubin by the liver and therefore increasing the levels in the bloodstream. Some of the common Causes of this type are liver cirrhosis, viral hepatitis, primary biliary cirrhosis, alcoholic hepatitis and liver cancer.
- Post-hepatic is after the liver. This is caused when there is a blockage and the bilirubin cannot be drained into the bile ducts and digestive tract.
How is jaundice Diagnosed?
A jaundice test typically includes a urine test which if it is positive for bilirubin indicates that you have jaundice. These findings can be further confirmed by a serum test which includes a complete blood count which tests bilirubin levels. In certain cases the doctor might suggest a CT scan or an ultrasound to determine the size and tenderness of the liver. In some cases a liver biopsy (taking a sample of the liver) may be recommended.
How is Jaundice Treated?
In cases of pre-hepatic jaundice, depending on the underlying cause the doctor may prescribe medication like in the case of malaria. For sickle cell anemia – blood transfusions, rehydrating IV fluid and medications.
For people suffering from jaundice due to liver cirrhosis and alcoholic hepatitis the doctor will suggest quitting alcohol, IV antibiotics and a low protein diet. If it’s due to a viral hepatitis- medication, hepatitis vaccination and plenty of rest and fluids. Jaundice caused by biliary cirrhosis can be Treated with bile acids that aid digestion and bile lowering medication.
For post-hepatic Causes of jaundice like gallstones the doctor will recommend changing your diet, removing the gallstones and medication to dissolve the gallstones. For pancreatic cancer-surgery to remove the cancerous tissue and chemotherapy or radiation. For pancreatitis the Treatment recommended is rest, IV fluid and surgery to remove any cause of inflammation.
Prevention of jaundice
Jaundice can be caused by several factors so there are no specific measures of Prevention. But some general tips are:
- Maintain a healthy lifestyle
- Keep you alcohol intake to a limit
- Manage your cholesterol
- Keep your weight under control
- Vaccinate against hepatitis
- Drink clean water
- Maintain proper hygiene at home