What is Jaundice? Symptoms, Causes, Diagnosis, Treatment & Prevention

Image by jcomp on Freepik Jaundice is a disease of the liver affecting infants and older individuals. A yellow colour tinge appears on the body's mucous membranes and fluids. It can be diagnosed through bilirubin level analysis, and its management depends on the causes and associated complications.

What is jaundice?

Jaundice, also known as icterus, is an illness in which the liver fails to convert bilirubin produced from the breakdown of red blood cells into conjugated bilirubin to be eliminated from the body. Bilirubin contains a yellow pigment that gives the body a yellow appearance, particularly the eyes, tongue, sweat, urine, and skin. Urine and stools may become lighter in colour than usual, or sometimes darken. The yellow colour may transform to green in chronic stages of jaundice. It can occur in individuals of all ages, but is particularly seen in newborn babies and older people.

What are the stages/types of jaundice?

There are three types of jaundice:

• Pre-hepatic

  jaundice implies bilirubin dysfunction occurring before the liver converts it. There is an accumulation of excess unconjugated bilirubin called hyperbilirubinemia.

• Hepatic

  jaundice is caused by liver disorders. Healthy tissue is converted into fibrous tissue, causing liver dysfunction.

• Post-hepatic

  jaundice is the accumulation of conjugated bilirubin after the liver has processed it. The conjugated bilirubin is not excreted out by the body, leading to jaundice.

What causes jaundice?

The causes of jaundice can be classified as follows:

Infant jaundice

• Physiological jaundice: Jaundice in newborn babies is considered a normal physiological process, as the baby's liver cannot clear the bilirubin as efficiently as expected. It may take 3-5 days to function normally. During this period, the baby experiences symptoms of jaundice.
• Breastfeeding jaundice: Breast milk helps flush out bilirubin when the baby's body digests it. It has been found that insufficient breast milk intake by the newborn can cause an accumulation of bilirubin, causing jaundice.
• G6PD deficiency: Glucose-6-Phosphate Dehydrogenase is responsible for the optimal functioning of red blood cells. Red blood cells malfunction when there is G6PD deficiency, leading to excess production and accumulation of bilirubin.
• Blood group mismatch: When the baby and mother's blood group does not match, it can trigger a reaction in the baby's body. The mother's blood cells identify the baby's red blood cells as an enemy and start killing them, producing excess bilirubin, leading to jaundice.

Older adult jaundice

• Haemolytic anaemia: Excessive premature shedding of red blood cells into the bloodstream causes bilirubin to be produced in greater quantities, causing jaundice.
• Cancer: Cancer of the pancreas and gallstones can cause jaundice.
• Gallstones: A gallstone can obstruct the flow of bile or conjugated bilirubin out of the body.
• Viral infections: like Hepatitis A, B, and C and the Epstein Barr virus can affect liver function and cause jaundice.
• As a side effect of medications like steroids, oral contraceptive pills, and penicillin, among others.
• As a complication of diabetes and obesity.

What are the signs and symptoms of jaundice?

The following are the jaundice symptoms and signs in infants and adults. Take a look:

Infants

• Yellow to orange discolouration of eyes, skin, tongue, and urine.
• Inability to sleep.
• Irritability.
• Loss of appetite.
• Infrequent motions.
• Tendency to cry all the time.
• Body arches like a bow.
• Fussiness.

Older Adults

• Yellow staining of skin, eyes, and urine.
• Clay or black coloured stools.
• Fever, weakness, and lethargy.
• Itchy skin.
• Loss of appetite.
• Weight loss.
• Blood in vomit, stools, and urine.

How is jaundice diagnosed?

Here’s how jaundice is diagnosed in infants and adults:

Infants

• Newborn babies are checked every 8 to 12 hours for signs and symptoms of jaundice.
• A light metre is used to check for transcutaneous bilirubin levels.
• A blood test can confirm the exact value of bilirubin in the body.

Adults

• Blood tests can confirm the presence of viral infections, blood counts, liver and kidney function.
• Ultrasonography, CT scan, and MRI to assess the pathway and flow of bile in the body.
• A laparoscopic examination can determine the exact cause of jaundice.

What are the treatment and medication options for jaundice?

Infants

• Mothers are encouraged to breastfeed more often to help clear the bilirubin load in the baby's body.
• Light therapy is utilised to expose the baby to green-blue light. Light helps the body to break down bilirubin and excrete it from the body.
• A blood transfusion may be done in cases where jaundice resulted from a blood group mismatch between mother and baby.

Adults

• Alternative treatments are also done like herbal medicine.
• Treatment in adults depends on the cause of jaundice.
• A blood transfusion may be done to correct the deficiency of red blood cells in hemolytic anaemia.
• Viral infections like hepatitis are treated with medications and fluid transfusions.
• Any obstruction within the liver or bile duct is managed surgically to release the bile duct.
• Cancers are managed with radiotherapy and chemotherapy and require long-term rehabilitation.

How do you prevent jaundice?

It is essential to recognise jaundice symptoms and visit a medical professional immediately. These measures can help in the prevention of jaundice:

• Drink alcohol in moderation.
• Get vaccinated against hepatitis.
• Screen and monitor a baby for jaundice and early treatment.
• Practice hygiene at home while handling food and be careful about eating out.
• Have safe sex.
• Eat healthy food and set a routine for light exercises every day.
• Avoid illicit use of over-the-counter and prescription medications.

Frequently Asked Questions

• What are the danger signs of jaundice?

  In infants, signs of distress include fussiness, difficulty in eating, passing motions, irritability, etc. Whereas, in adults, the danger signs are dark-coloured urine and stools, fever, loss of weight, and appetite.

• How long does it take to recover from jaundice?

  It usually takes anywhere between 10 days to a month to become symptom-free. Long-standing cases of associated liver disease may take longer, sometimes more than six months. If you are suffering for a month then consult with a doctor.

• Can jaundice be cured?

  Yes. It often does not require special treatment, except for cancers, obstructions, and infections.

• Can jaundice spread?

  In most cases, jaundice cannot spread from one person to the other. But when the cause of jaundice is an infection that can spread, it is indirectly contagious.

• What stage of liver disease is jaundice?

  End-stage liver disease often causes jaundice, with yellowish discolouration as the most prominent sign.

• Does jaundice cause death?

  Jaundice is not life-threatening, but negligence and non-compliance to treatment can lead to death in rare cases.

• Does a virus cause jaundice?

  Yes, viral infections are one of the causes of jaundice. Hepatitis A, B, and C can cause jaundice.

• Does jaundice mean liver failure?

  Jaundice in itself does not mean liver failure. But, long-standing jaundice can be a sign of impending liver failure or a complication of other associated diseases.