Jaundice

What is Jaundice?

Jaundice is a medical condition characterized by a yellowish discoloration of the skin, eyes (sclera), and mucous membranes. It occurs due to elevated levels of bilirubin in the blood—a yellow pigment formed from the breakdown of red blood cells. Jaundice itself is not a disease but a sign of an underlying condition, usually involving the liver, gallbladder, or pancreas. It can affect people of all ages, from newborns to the elderly, and may indicate anything from mild liver stress to serious conditions like hepatitis, bile duct obstruction, or liver failure. Early diagnosis and treatment are crucial to manage the root cause and prevent complications. Additional symptoms may include dark urine, pale stools, and fatigue. Prompt medical attention is essential if jaundice appears suddenly or is accompanied by other warning signs.

Common Symptoms and Signs

The most recognizable symptom is yellowing of the skin and eyes, but jaundice may also be accompanied by:

  • Fatigue and weakness
  • Dark-colored urine
  • Pale or clay-colored stools
  • Itchy skin (pruritus)
  • Abdominal pain or swelling
  • Nausea and vomiting
  • Loss of appetite
  • Weight loss
  • Fever (in infections like hepatitis)

In infants, jaundice may appear within the first week of life and should be closely monitored.

Symptoms and Signs of jaundice

Causes and Types

Jaundice is classified based on where the disruption occurs in bilirubin metabolism:

a. Pre-Hepatic (Hemolytic) Jaundice

  • Caused by excessive breakdown of red blood cells
  • Leads to increased production of unconjugated bilirubin
  • Causes: Hemolytic anemia, malaria, sickle cell disease, thalassemia

b. Hepatic (Hepatocellular) Jaundice

  • Caused by liver cell damage, impairing bilirubin processing
  • Causes: Hepatitis (A, B, C), alcohol-related liver disease, cirrhosis, liver cancer

c. Post-Hepatic (Obstructive) Jaundice

  • Caused by blockage in bile ducts preventing bilirubin from being excreted
  • Causes: Gallstones, pancreatic cancer, bile duct tumors, strictures

d. Neonatal Jaundice

  • Common in newborns due to immature liver function
  • Usually resolves on its own but may require phototherapy if severe

Diagnosis and Tests

Diagnosing jaundice involves identifying its type and underlying cause through:

  • Physical Examination: Noting yellowing of skin/eyes, liver enlargement
  • Blood Tests:
    • Liver function tests (LFTs)
    • Bilirubin levels (total, direct, indirect)
    • Complete blood count (CBC)
    • Hepatitis panel
  • Imaging Tests:
    • Ultrasound of liver and bile ducts
    • CT scan or MRI if tumors or blockages are suspected
  • Liver Biopsy: In cases of chronic liver disease or unclear diagnosis

Prompt testing helps avoid liver damage and manage underlying diseases effectively.

Treatment and Management

Treatment of jaundice depends on the cause:

For Hemolytic Jaundice:

  • Treat underlying anemia or infection
  • Blood transfusions in severe cases

For Hepatic Jaundice:

  • Antiviral drugs (for hepatitis)
  • Avoid alcohol
  • Liver-protective medications
  • Dietary adjustments (low-fat, liver-friendly foods)

For Obstructive Jaundice:

  • Surgery or ERCP to remove gallstones or tumors
  • Stenting of bile ducts if blocked

For Neonatal Jaundice:

  • Phototherapy (light treatment)
  • In rare cases, exchange transfusions

In all types, hydration, balanced nutrition, and regular follow-up are important for recovery.

Home Care and Lifestyle Support

Supportive care plays a key role, especially for chronic liver conditions:

For Adults with Jaundice or Liver Conditions

  • Stay well-hydrated and eat a liver-friendly diet (fruits, vegetables, whole grains)
  • Avoid alcohol, spicy, and fatty foods
  • Get adequate rest and avoid overexertion
  • Take only prescribed medications—avoid self-medication
  • Maintain good hygiene to prevent infections like hepatitis
  • Monitor symptoms like fatigue, dark urine, or worsening yellowing
  • Follow up regularly with your healthcare provider

For Infants and Young Children with Jaundice

  • Ensure frequent and adequate breastfeeding or formula feeding
  • Monitor bilirubin levels as advised by the pediatrician
  • Keep the baby in indirect sunlight (if recommended) to help reduce bilirubin
  • Avoid delay in feeding or long gaps between meals
  • Look for signs like increased sleepiness, poor feeding, or worsening yellowing
  • Report any fever, vomiting, or change in behavior immediately
  • Attend all scheduled pediatric visits and lab checks

Prevention Tips

While not all forms of jaundice are preventable, you can reduce the risk with these steps:

  • Vaccination: Get vaccinated for Hepatitis A and B
  • Avoid sharing needles or razors to prevent hepatitis infections
  • Drink clean, filtered water and avoid undercooked shellfish
  • Limit alcohol intake
  • Practice safe sex
  • Use liver-friendly medications only under doctor supervision
  • Manage chronic conditions like diabetes or obesity to reduce liver strain
  • Maintain a healthy weight and avoid high-fat diets
  • Avoid exposure to toxic chemicals or drugs that harm the liver

Early treatment of infections and regular health check-ups can help prevent serious liver complications that lead to jaundice.