Jaundice

Jaundice – Causes, Symptoms, Diagnosis & Treatment

Jaundice refers to the yellow discoloration of the skin, the whites of the eyes, and body fluids caused by elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment formed by the breakdown of red blood cells and is normally processed by the liver. When there is an underlying condition affecting this process, bilirubin builds up in the body, leading to jaundice.

Symptoms of Jaundice

Jaundice may present with a range of symptoms, including:

• Yellowing of the skin and eyes

• Dark-colored urine

• Pale or clay-colored stools

• Loss of appetite

• Unexplained weight loss

• Fatigue or weakness

• Nausea and vomiting

• Fever or chills

• Confusion or changes in mental alertness (in severe cases)

• Abdominal pain or discomfort, especially in the upper right side

Types and Causes of Jaundice

Jaundice is typically classified into three main categories based on the underlying cause:

1. Pre-Hepatic (Hemolytic) Jaundice

This type occurs before bilirubin is transported to the liver and is often due to excessive breakdown of red blood cells (hemolysis). Common causes include:

• Hemolytic anemia

• Malaria

• Genetic blood disorders (e.g., sickle cell disease, thalassemia)

2. Hepatic (Hepatocellular) Jaundice

This occurs due to liver damage, impairing the liver’s ability to process and excrete bilirubin. Causes include:

• Hepatitis (A, B, C, E)

• Alcoholic liver disease

• Non-alcoholic fatty liver disease (NAFLD)

• Liver cirrhosis

• Drug-induced liver injury

• Autoimmune hepatitis

3. Post-Hepatic (Obstructive) Jaundice

This type is caused by obstruction in the bile ducts, preventing the excretion of bilirubin. Common causes include:

• Gallstones

• Pancreatic or bile duct tumors

• Bile duct strictures or cysts

• Parasites (e.g., liver flukes)

Diagnosis of Jaundice

Accurate diagnosis is essential to determine the cause of jaundice. The diagnostic process typically includes:

• Physical examination – to check for yellowing and abdominal tenderness

• Blood tests – to assess liver function, bilirubin levels, and identify infections

• Urine tests – to detect bilirubin in urine

• Ultrasound of the abdomen – to evaluate liver, gallbladder, and bile ducts

• CT scan or MRI – to identify structural abnormalities

• Endoscopic Retrograde Cholangiopancreatography (ERCP) – in case of suspected bile duct obstruction

Treatment of Jaundice

Treatment depends on the underlying cause:

• Pre-Hepatic Jaundice: Managed by treating the source of red blood cell breakdown, such as infections or blood disorders.

• Hepatic Jaundice: Requires treatment of liver inflammation, infections, or liver disease. Lifestyle changes like avoiding alcohol and adopting a liver-friendly diet are often recommended.

• Post-Hepatic Jaundice: Typically requires interventional procedures such as endoscopy (ERCP) to remove gallstones or surgical treatments for bile duct obstructions or tumors.

Supportive measures may include:

• Staying well-hydrated

• Avoiding alcohol and hepatotoxic drugs

• Maintaining a balanced diet

• Regular follow-up to monitor liver function

When to Seek Medical Attention

Immediate medical evaluation is necessary if jaundice is accompanied by:

• Severe abdominal pain

• Persistent vomiting

• High-grade fever

• Confusion or disorientation

• Blood in vomit or stool

Conclusion

Jaundice is not a disease but a sign of an underlying health issue that may require immediate medical attention. Early diagnosis and targeted treatment are key to managing jaundice effectively and preventing complications. For persistent symptoms or recurring episodes, consultation with a liver and digestive health specialist is essential.