Jaundice

Jaundice is a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment. Jaundice has many causes, including hepatitis, gallstones and tumors. In adults, jaundice usually doesn't need to be treated.

Causes #

Before the production of bilirubin, you may have what’s called unconjugated jaundice due to increased levels of bilirubin caused by:

Reabsorption of a large hematoma (a collection of clotted or partially clotted blood under the skin). Hemolytic anemias (blood cells are destroyed and removed from the bloodstream before their normal lifespan is over). During production of bilirubin, jaundice can be caused by:

• Viruses, including Hepatitis A, chronic Hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis).

• Alcohol.

• Autoimmune disorders.

• Rare genetic metabolic defects.

• Medicines, including acetaminophen toxicity, penicillins, oral contraceptives, chlorpromazine (Thorazine®) and estrogenic or anabolic steroids.

After bilirubin is produced, jaundice may be caused by obstruction (blockage) of the bile ducts from:

• Gallstones.

• Inflammation (swelling) of the gallbladder.

• Gallbladder cancer.

• Pancreatic tumor.

Symptoms #

If you have a short-term case of jaundice (usually caused by infection), you may have the following symptoms and signs:

• Fever.

• Chills.

• Abdominal pain.

• Flu-like symptoms.

• Change in skin color.

• Dark-colored urine and/or clay-colored stool.

If jaundice isn’t caused by an infection, you may have symptoms such as weight loss or itchy skin (pruritus). If the jaundice is caused by pancreatic or biliary tract cancers, the most common symptom is abdominal pain. Sometimes, you may have jaundice occurring with liver disease if you have:

• Chronic hepatitis or inflammation of the liver.

• Pyoderma gangrenosum (a type of skin disease).

• Acute hepatitis A, B or C.

• Polyarthralgias (inflammation of the joints).

Diagnosis #

• Bruising of the skin.

• Spider angiomas (abnormal collection of blood vessels near the surface of the skin).

• Palmar erythema (red coloration of the palms and fingertips).

• Urinalysis (urine testing) that’s positive for bilirubin shows that the patient has conjugated jaundice. The findings of urinalysis should be confirmed by serum testing. The serum testing will include a complete blood count (CBC) and bilirubin levels.

• Your doctor will also do an exam to determine the size and tenderness of your liver. He or she may use imaging (ultrasonography and computer tomographic (CT) scanning) and liver biopsy (taking a sample of the liver) to further confirm diagnosis.

Complications #

• Constipation.

• Bloating.

• Stomach pain.

• Gas.

• Upset stomach.

• Vomiting.

• Diarrhea.

Prevention #

• Avoid hepatitis infection.

• Stay within recommended alcohol limits.

• Maintain a healthy weight.

• Manage your cholesterol.

Treatment #

Jaundice usually doesn’t require treatment in adults (it’s a more severe problem in infants). The causes and complications of jaundice can be treated. For instance, if itching is bothersome, it may be eased by cholestyramine