Jaundice

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Jaundice
Synonyms	Icterus
Pronounce	N/A
Specialty	N/A
Symptoms	Yellowing of the skin, yellowing of the eyes, dark urine, pale stools, itching
Complications	Kernicterus, liver failure
Onset	Can occur at any age
Duration	Varies depending on cause
Types	N/A
Causes	Liver disease, bile duct obstruction, hemolysis
Risks	Alcohol use disorder, hepatitis, gallstones
Diagnosis	Blood test, liver function test, imaging studies
Differential diagnosis	Carotenemia, hepatitis, Gilbert's syndrome
Prevention	N/A
Treatment	Depends on the underlying cause (e.g., medication, surgery, lifestyle changes)
Medication	Cholestyramine, ursodeoxycholic acid
Prognosis	N/A
Frequency	Common
Deaths	Varies depending on underlying cause

New born baby being treated for jaundice

Old jaundice

Jaundice

Heme Breakdown

Jaundice types

Bilirubin pigment in cholestatic liver 40X

Jaundice (also called icterus) is a medical condition characterized by the yellowing of the skin, the sclera (whites of the eyes), and sometimes other tissues due to elevated levels of bilirubin in the blood. This yellow discoloration occurs when the liver is unable to effectively process and remove bilirubin, a byproduct of the breakdown of red blood cells. Jaundice is commonly associated with liver diseases but can also result from infections, bile duct obstruction, or increased red blood cell destruction.

Yellowing of the eyes caused by jaundice from hepatitis.

Causes of Jaundice

Jaundice is caused by an imbalance in the production, processing, or elimination of bilirubin. Common causes include:

Liver Disorders

• Hepatitis – Viral or autoimmune inflammation of the liver.
• Cirrhosis – Liver scarring due to long-term damage (e.g., from alcohol, fatty liver disease, or infections).
• Liver cancer – Malignancies affecting liver function.
• Liver failure – Severe liver dysfunction preventing bilirubin processing.

Increased Red Blood Cell Breakdown

• Hemolytic anemia – Rapid breakdown of red blood cells due to inherited disorders, infections, or immune reactions.
• Sickle cell disease – A genetic disorder that causes red blood cells to break down prematurely.
• Malaria – A parasitic infection that destroys red blood cells.

Bile Duct Obstruction

• Gallstones – Hardened deposits blocking the bile ducts.
• Pancreatic tumors – Growths that obstruct bile flow.
• Biliary atresia – A congenital defect affecting bile duct formation.

Neonatal Jaundice

Newborns frequently experience jaundice due to immature liver function. This type of jaundice often resolves on its own or with phototherapy.

Symptoms

The signs and symptoms of jaundice vary based on the underlying cause but may include:

Primary Symptoms

• Yellow discoloration of the skin, eyes, and mucous membranes
• Dark-colored urine
• Pale or clay-colored stools

Additional Symptoms

• Fatigue – Weakness and lack of energy
• Fever – If caused by infection
• Loss of appetite – Often seen in liver diseases
• Nausea & vomiting – Common in hepatobiliary disorders
• Abdominal pain – Particularly with gallstones or liver inflammation
• Itching (pruritus) – Seen in obstructive jaundice due to bile acid buildup

Diagnosis

Doctors diagnose jaundice through a combination of clinical examination and laboratory tests:

Physical Examination

• Checking for yellowing of the skin and eyes.
• Examining the abdomen for liver or spleen enlargement.

Types of Jaundice

Type	Cause	Features
Hemolytic Jaundice	Excessive destruction of red blood cells leading to increased bilirubin production.	Associated with anemia, dark urine, and pale stools.
Hepatocellular Jaundice	Liver diseases that impair bilirubin metabolism (e.g., hepatitis, cirrhosis).	Liver dysfunction symptoms, such as fatigue and abdominal pain.
Obstructive Jaundice	Blocked bile ducts preventing bilirubin excretion.	Dark urine, pale stools, and intense itching.

Laboratory Tests

• Bilirubin test – Measures levels of direct and indirect bilirubin.
• Liver function tests (LFTs) – Assess liver enzyme levels.
• Complete blood count (CBC) – Detects infections or anemia.
• Hepatitis panel – Identifies viral liver infections.
• Coagulation tests – Checks for clotting issues linked to liver disease.

Imaging Tests

• Ultrasound – Evaluates liver and bile ducts.
• CT scan or MRI – Detects tumors or obstructions.
• Liver biopsy – Identifies liver damage or disease.

Treatment

The treatment of jaundice depends on the underlying cause. Some common approaches include:

Medications

• Antiviral drugs – For hepatitis B or C.
• Steroids – For autoimmune liver diseases.
• Antibiotics – If jaundice is due to bacterial infections.

Surgery or Procedures

• Gallstone removal – If bile duct obstruction is present.
• Liver transplant – In severe cases of liver failure.
• Endoscopic retrograde cholangiopancreatography (ERCP) – Removes bile duct obstructions.

Phototherapy for Newborns

• Blue light therapy – Helps break down excess bilirubin in neonatal jaundice.

Lifestyle and Dietary Management

• Avoid alcohol – To prevent liver damage.
• Maintain hydration – Helps flush out toxins.
• Eat a balanced diet – Supports liver health.

Prevention

Preventative measures vary depending on the type of jaundice:

• Vaccination – Against hepatitis A and B
• Avoid excessive alcohol consumption – To protect liver function
• Safe food and water practices – Prevents infections like hepatitis
• Regular medical check-ups – Early detection of liver diseases
• Manage underlying conditions – Such as gallstones or anemia

Jaundice Gallery

• 
  Obstructive biliary dilation
• 
  Kayser-Fleischer ring, associated with liver disease

See Also

• Hepatitis
• Cirrhosis
• Gallstones
• Hemolytic anemia
• Liver function tests

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