Jaundice: Difference between revisions

Revision as of 21:05, 19 March 2025

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.

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.

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.

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.

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
Obstructive biliary dilation (ultrasound)
Kayser-Fleischer ring, associated with liver disease

@@ Line 1: / Line 1: @@
 [[Image:Jaundice phototherapy.jpg|thumb|220px|right|New born baby being treated for jaundice]]
-'''Jaundice'''  (also called '''icterus''') is when the [[skin]] and the whites of the eyes become a yellow color.<ref name="mn">{{cite web|url=http://www.medicinenet.com/jaundice/article.htm|title=Jaundice signs, symptoms and treatment|last=Marks|first=Jay|work=MedicineNet|language=English|accessdate=2010-05-04}}</ref> People with jaundice have a problem with their [[liver]], which stops it from removing dead [[red blood cell]]s properly. These blood cells contain a chemical called [[bilirubin]].<ref name=mn/> Bilirubin causes the yellow coloring of the skin. Jaundice is common in newly born [[baby|babies]]. It usually starts the second day after birth.<ref name="kidshealth">{{cite web|url=http://kidshealth.org/parent/pregnancy_newborn/common/jaundice.html|title=Jaundice in Healthy Newborns|work=The Nemours Foundation|language=English|accessdate=2010-05-15}}</ref>
+[[File:Old_jaundice.jpg|Old jaundice|left|thumb]]
+[[File:Jaundice.jpg|Jaundice|thumb]]
+[[File:Heme_Breakdown.png|Heme Breakdown|left|thumb]]
+[[File:Jaundice-types.png|Jaundice types|thumb]]
+[[File:Bilirubin_pigment_in_cholestatic_liver_40X.jpg|Bilirubin pigment in cholestatic liver 40X|thumb]]
-Jaundice can also be caused by other diseases, like [[malaria]], [[hepatitis]], or gallstones.
+'''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.
-Jaundice is the most common of all liver problems. The yellow colour of the skin and mucous membranes happens because of an increase in the bile pigment, bilirubin, in the [[blood]].<ref name="kidshealth"/>
+[[File:Jaundice eye.jpg|thumb|250px|Yellowing of the eyes caused by jaundice from hepatitis.]]
-The [[bile]], made by the liver, is a vital [[digestion|digestive]] fluid needed for proper nutrition. It also stops decaying changes in food. If the bile is stopped from entering the [[intestine]]s there is an increase in gases and other products. Normally, the production of bile and its flow is constant.
+== Causes of Jaundice ==
+Jaundice is caused by an imbalance in the production, processing, or elimination of bilirubin. Common causes include:
-==Types of Jaundice==
+=== Liver Disorders ===
-There are three types of jaundice:
+* '''Hepatitis''' – Viral or autoimmune inflammation of the liver.
-* haemolytic jaundice - caused by destruction of red blood cells. This causes increased bilirubin formation and [[anaemia]]
+* '''Cirrhosis''' – Liver scarring due to long-term damage (e.g., from alcohol, fatty liver disease, or infections).
-* obstructive jaundice  - caused by a blockage in the pathway where bilirubin is made in the liver cells and where bile goes into the [[duodenum]]
+* '''Liver cancer''' – Malignancies affecting liver function.
-* hepatocellular jaundice - caused by damage to liver cells. The damage could be from a viral infection or toxic drugs.
+* '''Liver failure''' – Severe liver dysfunction preventing bilirubin processing.
-Yellow discoloration of the skin and the whites of the [[eye]]s happens in all types of jaundice.
+=== 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.
-==Symptoms==
+=== Bile Duct Obstruction ===
-[[Image:Jaundice eye.jpg|thumb|220px|right|Yellow eyes caused by jaundice from hepatitis]]
+* '''Gallstones''' – Hardened deposits blocking the bile ducts.
-The symptoms of jaundice are:<ref name="js">{{cite web|url=http://www.jaundicesymptoms.net | title=Jaundice signs and symptoms||work=MedicineNet|language=English|accessdate=2010-09-09}}</ref>
+* '''Pancreatic tumors''' – Growths that obstruct bile flow.
-* extreme weakness
+* '''Biliary atresia''' – A congenital defect affecting bile duct formation.
-* headache
-* fever
+=== Neonatal Jaundice ===
-* loss of appetite
+Newborns frequently experience jaundice due to immature liver function. This type of jaundice often resolves on its own or with phototherapy.
-* tiredness
-* severe [[constipation]]
+== Types of Jaundice ==
-* nausea
+{| class="wikitable" style="width:100%; text-align:center;"
-* yellow coloration of the eyes, [[tongue]], skin and [[urine]].
+! Type
-* dull pain in the liver region.
+! Cause
-* Obstructive jaundice may also cause intense itching.
+! 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.
+|}
+== 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 ==
-Diagnosis of jaundice typically involves:
+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.
-* A physical examination to assess the extent of yellowing and look for signs of liver disease
+=== Laboratory Tests ===
-* Blood tests to measure bilirubin levels and determine the cause of jaundice
+* '''Bilirubin test''' – Measures levels of direct and indirect bilirubin.
-* Imaging studies, such as ultrasound or CT scan, to evaluate the liver and bile ducts
+* '''Liver function tests (LFTs)''' – Assess liver enzyme levels.
-* Liver function tests to assess the overall health of the liver
+* '''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 ==
-Treatment for jaundice depends on the underlying cause. Some possible treatments include:
+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.
-* '''Medication''': For infections or liver diseases, medications may be prescribed to manage the underlying condition.
+== Prevention ==
-* '''Surgery''': In cases of blocked bile ducts, surgery may be necessary to remove the obstruction, such as gallstones or tumors.
+Preventative measures vary depending on the type of jaundice:
-* '''Phototherapy''': For newborns with jaundice, exposure to a special type of light helps break down bilirubin in the skin, making it easier to eliminate from the body.
-* '''Blood transfusion''': In severe cases of anemia or inherited disorders, a blood transfusion may be necessary to replace damaged red blood cells.
+* '''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 ==
+<gallery>
+File:Obstructivebiliarydilation.png|Obstructive biliary dilation
+File:Obstructivebiliarydilation2.png|Obstructive biliary dilation (ultrasound)
+File:Kayser-Fleischer_ring.jpg|Kayser-Fleischer ring, associated with liver disease
+</gallery>
-== '''See also''' ==
+== See Also ==
 * [[Hepatitis]]
 * [[Cirrhosis]]
 * [[Gallstones]]
 * [[Hemolytic anemia]]
+* [[Liver function tests]]
+{{Medical condition classification and resources
+| ICD10          = {{ICD10|R|17||r|10}}
+ | ICD9           = {{ICD9|782.4}}
+ | OMIM           =
+ | MedlinePlus    = 003243
+ | eMedicineSubj  =
+ | eMedicineTopic =
+ | DiseasesDB     = 7038
+ | MeshID         = D007565
+}}
+{{Digestive system and abdomen symptoms and signs}}
 {{stub}}
+[[Category:Symptoms and signs: Digestive system and abdomen]]
 [[Category:Medical conditions]]
 [[Category:Gastroenterology]]
 [[Category:Hepatology]]
-== Jaundice ==
-<gallery>
-File:Old_jaundice.jpg|Old jaundice
-File:Jaundice.jpg|Jaundice
-File:Jaundice-types.png|Jaundice types
-File:Bilirubin_pigment_in_cholestatic_liver_40X.jpg|Bilirubin pigment in cholestatic liver 40X
-File:Heme_Breakdown.png|Heme Breakdown
-File:Obstructivebiliarydilation.png|Obstructive biliary dilation
-File:Obstructivebiliarydilation2.png|Obstructive biliary dilation 2
-File:Kayser-Fleischer_ring.jpg|Kayser-Fleischer ring
-</gallery>