What is jaundice?

Jaundice occurs when the skin, sclera (whites of the eyes) and mucous membranes turn yellow. This yellow color is due to a high level of bilirubin, a yellow-orange bile pigment. Bile is fluid secreted by the liver. Bilirubin is formed from breakdown of red blood cells.

What are the symptoms of jaundice?

Sometimes, there may not be symptoms and the condition may be found accidentally. The severity of symptoms depends on the underlying causes and how quickly or slowly the disease progresses.

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

• Fever
• Chills
• Abdominal pain
• Flu-like symptoms
• Change in skin color

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

• Chronic hepatitis
• Pyoderma gangrenosum (a type of skin disease)
• Acute hepatitis B or C
• Polyarthralgias (inflammation of the joints)

What causes jaundice?

Jaundice can be caused by a problem in any of the three phases in bilirubin production.

Before the production of bilirubin, you may have what is 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 bloodstream before their normal lifespan is over)

During production of bilirubin, some causes of jaundice are:

• Viruses:
  • Hepatitis A
  • Chronic Hepatitis B and C
  • Epstein-Barr virus infection (infectious mononucleosis)
• Alcohol
• Autoimmune disorders
• Rare genetic metabolic defects
• Medicines:
  • Acetaminophen
  • Penicillins
  • Oral contraceptives
  • Chlorpromazine (Thorazine®)
  • Estrogenic or anabolic steroids

After bilirubin is produced, jaundice may be caused by:

• Gallstones
• Inflammation of the gallbladder
• Gallbladder cancer
• Pancreatitis

What is the risk that you will develop jaundice?

During the production of bilirubin, middle-aged women and men, in general, are more affected. People who have hepatitis and drink excessive alcohol are also at increased risk.

How will a doctor diagnose your jaundice?

Your doctor will diagnose jaundice by checking for signs of liver disease such as:

• 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 that is positive for bilirubin indicates the presence of conjugated jaundice. The findings of urinalysis should be confirmed by serum testing. The serum testing will include:

• Complete blood count (CBC)
• 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 to further confirm diagnosis.

What are the treatments for jaundice?

The causes and complications can be treated. However, jaundice usually does not require treatment in adults (it is a more severe problem in infants). Itching, if bothersome, may be eased by cholestyramine.

What are some of the complications/side effects of the treatments of jaundice?

• Constipation
• Bloating
• Stomach pain
• Gas
• Upset stomach
• Vomiting
• Diarrhea

How can you prevent jaundice?

Since there are many causes of jaundice, it is hard to provide specific prevention measures. Some general tips include:

• Avoid hepatitis infection
• Stay within recommended alcohol limits
• Maintain a healthy weight
• Manage your cholesterol