Jaundice in Adults: An Overview

What Is Jaundice?

Jaundice is the yellowish discoloration of the skin and mucous membranes, which is a symptom caused by an underlying disease where there is an increase in the levels of bilirubin in the blood. Bilirubin is a breakdown byproduct.

Normally, the liver excretes this bilirubin through the bile. Bilirubin is a byproduct of the breakdown of RBCs (red blood cells). It releases hemoglobin molecules during this process. The heme is then converted to bilirubin, which is then excreted by the liver by filtering the blood.

What Are the Common Conditions That Cause Jaundice?

The following internal conditions can cause yellowing of the skin:

1. Hepatitis - It is the inflammation of the liver, which can be due to infection (hepatitis A, B, C, D, and E), severe blood loss, autoimmune condition, alcohol, toxins, and medicines.

2. Thalassemia - An inherited blood disorder that leads to the formation of abnormal hemoglobin in the blood.

3. Pancreatic cancer - When the cells of the pancreas, which is an endocrine gland, grow out of control and result in cancer.

4. G6PD (Glucose-6-phosphate dehydrogenase deficiency) - G6PD deficiency in the blood can destroy red blood cells in the blood prematurely and result in hemolytic anemia.

5. Gallstones - High levels of bilirubin, bile, or cholesterol in the gallbladder can result in the formation of gallstones, which can obstruct the bile ducts.

6. Liver cirrhosis - The irreversible scarring of the liver is called cirrhosis.

7. Sickle cell anemia - It is also a genetic blood disorder where the red blood cells are crescent or sickle-shaped.

8. Liver cancer.

9. Acute pancreatitis - This is a medical emergency caused by inflammation of the pancreas.

10. Idiopathic autoimmune hemolytic anemia - It is a serious blood disorder where the red blood cells are destroyed faster than they are produced.

11. Yellow fever - This is a potentially fatal viral infection that is spread by mosquitoes.

12. Weil’s disease - It is a severe type of leptospirosis, which is a bacterial infection.

13. Dubin-Johnson syndrome - It is also an inherited condition that prevents bilirubin from being secreted from the liver.

14. Crigler-Najjar syndrome - It is an inherited condition that affects the enzyme needed for processing bilirubin.

15. Pseudojaundice - It is a harmless condition where the yellowing of the skin is due to an excess of beta-carotene, which is an orangish-red pigment found in carrots and other vegetables.

What Are the Types of Jaundice?

As mentioned earlier, jaundice is the result of too much bilirubin in the blood. This yellow pigment bilirubin is the byproduct of the red blood cell breakdown. The bilirubin from the blood reaches the liver, from where it passes through the bile duct. The bile duct also carries digestive enzymes to the small intestine, from where bilirubin exits the body through urine or feces.

There can be a problem in any of the stages in the multi-step process. Depending on the site of a problem, there are three types of jaundice.

1. Pre-hepatic (hemolytic jaundice).

2. Hepatic (hepatocellular jaundice).

3. Post-hepatic (obstructive jaundice).

Pre-Hepatic (Hemolytic Jaundice)

This type of jaundice is seen in conditions that increase the rate of hemolysis (the process of destruction of red blood cells). As the liver can only process a limited amount of bilirubin at once, it starts overflowing into the tissues.

The common conditions include malaria, sickle cell anemia, spherocytosis, and thalassemia. And the common symptoms are stomach pain, fever, chills, dark urine, pale stools, and itching. Drug abuse and hereditary blood disorders are some of the factors that increase the risk of this jaundice.

Hepatic (Hepatocellular Jaundice)

This type of jaundice results when the liver is damaged or impaired to filter out bilirubin from the blood. As this bilirubin cannot be filtered by your digestive system, the levels of bilirubin in the blood increases.

It is commonly seen in liver cirrhosis, viral hepatitis, primary biliary cirrhosis, alcoholic hepatitis, leptospirosis, and liver cancer. Loss of appetite, bloody nose, itching, weight loss, abdominal swelling, skin darkening, and vomiting are some of the common symptoms of this type. The factors that increase the risk include drug use, binge drinking, hepatotoxic drugs, and a history of liver disease.

Post-Hepatic (Obstructive Jaundice)

When the bile ducts are blocked, the bilirubin cannot be adequately drained, which results in this type of jaundice. Gallstones, pancreatic cancer, pancreatitis, bile duct cancer, and biliary atresia are some conditions that can cause this. Nausea, vomiting, dark urine, unintentional weight loss, itching, fever, and abdominal swelling are common symptoms. And the risk factors are obesity, consuming a diet low in fiber and high in fat, diabetes, aging, smoking, binge drinking, and exposure to industrial chemicals.

What Are the Symptoms of Adult Jaundice?

In some cases, the patient might not develop any symptoms of jaundice, and it might be diagnosed accidentally. Depending on the cause, the severity of symptoms varies. If the cause is an infection, then the common symptoms include:

1. Fever.

2. Chills.

3. Yellowish discoloration of the skin and eyes.

4. Night sweats.

5. Abdominal pain.

6. Abdominal swelling.

7. Cough and flu-like symptoms.

8. Dark urine.

9. Pale stools.

If the cause is not an infection, then the symptoms experienced are:

1. Abnormal weight loss.

2. Itchy skin (pruritus).

Jaundice that results from pancreatic or biliary tract cancer can cause abdominal pain.

How Is Jaundice Diagnosed?

• Complete blood count (CBC).

• Liver function tests.

• Urine test.

• Bilirubin test.

• Hepatitis panel.

• MRI/CT.

• Ultrasound of liver.

• Biopsy.

How Is Jaundice Treated?

The treatment depends on the condition that is causing the yellow discoloration.

In some cases, supportive care at home with watching is all that is needed. Whereas, in the case of anemia, blood transfusion is the protocol. In the case of infectious reasons, antibiotics will be prescribed. In obstructive jaundice, surgery will be necessary.

So, treatment varies depending on the cause, and it is advisable to consult your doctor in case you notice such a discoloration.

What Are the Possible Complications of Jaundice?

The following are some of the possible complications of jaundice:

• Constipation or diarrhea.

• Abdominal pain.

• Bloating.

• Vomiting.

Preventive Tips:

There are no specific prevention methods for jaundice, as there are various causes. Some of the things that might help are:

1. Maintaining a healthy diet.

2. Manage cholesterol.

3. Limit the consumption of alcohol.

4. Maintaining good hygiene to prevent some types of hepatitis.

5. Keeping blood sugar level in check.

For more information on jaundice, consult a gastroenterologist online now!