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.

A strong liver starts with the best foods for liver health, but recognizing early signs of liver issues is just as important—learn more about jaundice: stages, causes, and symptoms in infants & adults.

What is jaundice?

Jaundice is a condition marked by the yellow discoloration of the skin, eyes, and mucous membranes caused by elevated bilirubin levels.

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.

Stages of Jaundice (Types of Jaundice)

Understanding the stages helps in early detection and effective treatment. There are three stages/types of jaundice:

1. Pre-hepatic Jaundice

• Caused by excessive breakdown of red blood cells before bilirubin reaches the liver
• Characterized by elevated unconjugated (indirect) bilirubin
• Common causes: hemolytic anemia, blood group incompatibility

2. Hepatic Jaundice

• Results from liver dysfunction affecting bilirubin metabolism
• Can involve both unconjugated and conjugated bilirubin increase
• Causes include viral hepatitis, liver inflammation, genetic disorders, alcohol-related liver disease

3. Post-hepatic Jaundice

• Caused by obstruction after bilirubin conjugation in the liver
• Leads to buildup of conjugated (direct) bilirubin
• Common causes: gallstones, bile duct obstruction, pancreatic cancer

What Causes Jaundice?

Jaundice results from various underlying conditions differing between infants and adults.

Causes of Jaundice in Infant

• 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.

Causes of Jaundice in Adults

• 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, Hepatitis B, and Hepatitis 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.

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Jaundice Symptoms in Infants and Adults

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

Symptoms of Jaundice in 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.

Symptoms of Jaundice in 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.

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How Is Jaundice Diagnosed?

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

Diagnosis of Jaundice in 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.
• Evaluation for underlying causes including blood group incompatibility and hemolysis

Diagnosis of Jaundice in Adults

• Blood tests for total and direct bilirubin, liver enzymes (AST, ALT, ALP, GGT)
• Complete blood count (CBC) to check for hemolysis
• Hepatitis viral markers
• Imaging techniques: ultrasonography, CT scan, MRI, or Magnetic Resonance Cholangiopancreatography (MRCP) to check biliary obstruction
• Liver biopsy if needed to determine liver tissue status

Jaundice Treatment and Medication Options

Treatment of Infants Jaundice

• 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.
• Monitoring and supportive care

Treatment of Adults Jaundice

• 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.

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Jaundice Recovery Time

• Recovery depends on the underlying cause, severity, and patient’s overall health
• Mild jaundice (e.g., physiological in infants or minor infections): typically recovers within 1-2 weeks
• Moderate cases may take 2-4 weeks with proper treatment
• Severe or chronic liver disease-related jaundice can take several months; ongoing monitoring and treatment are essential
• Recovery in infants is usually faster than in adults
• Follow-up with specialists like gastroenterologists or hepatologists advised for persistent jaundice beyond 2-4 weeks

How to Prevent Jaundice

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

• Limit or avoid alcohol consumption
• Vaccination against hepatitis A and B
• Screen and monitor a baby for jaundice and early treatment.
• Practice safe hygiene and food safety to prevent infections
• Have safe sex.
• Eat healthy food during jaundice and set a routine for light exercises every day.
• Avoid illicit use of over-the-counter and prescription medications.

Frequently Asked Questions About Jaundice

1. 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.

2. 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 gastroenterologist, hepatologist, or internal medicine specialist.

3. Can jaundice be cured?

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

4. 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.

5. What stage of liver disease is jaundice?

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

6. Does jaundice cause death?

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

7. Does a virus cause jaundice?

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

8. 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.