What is Jaundice? Symptoms, Causes, Diagnosis & Treatment

Jaundice is a health condition characterised by the yellowing of your skin, nails, mucous membranes, and the white portion of your eyes (sclera). It happens when your blood bilirubin (a bile pigment) level increases.

The common jaundice causes are gallbladder stones, hepatitis, and tumours. Symptoms of jaundice include abdominal pain, fever, chills, pale stools, and yellow urine.

Your doctor will assess your jaundice symptoms and perform a urinalysis and several blood tests to diagnose the condition and plan the jaundice treatment based on jaundice causes. The treatment is based on the underlying cause(s).

Medically, jaundice is called icterus or hyperbilirubinemia. Although adults do not require any treatment, it could be a severe condition in infants.

What is a Jaundice?

A yellow discolouration of body tissues, including skin, nails, sclera, and mucus membranes, is called jaundice. It happens due to the accumulation of bilirubin in the blood.

Bilirubin is a yellowish-orange bile pigment that forms when red blood cells break down. In most cases, jaundice indicates issues with your bile ducts or liver. When your liver works inefficiently, it causes bilirubin to build up in the blood, which would otherwise get eliminated through stool and urine.

The normal bilirubin level in the blood is less than 1mg/dL. Blood bilirubin levels around 3mg/dL are indicative of jaundice. In infants, jaundice is the likely diagnosis if the bilirubin levels reach 5 mg/dL.

What are the stages/types of jaundice?

There are three types of jaundice:

Pre-hepatic: In this type of jaundice, there is increased blood hemolysis. Hemolysis is a process where red blood cells break down, release haemoglobin, and convert it into bilirubin. As your liver cannot process all the bilirubin at a time, the bile pigment overflows and spreads to the bodily tissues causing jaundice. Some causes of pre-hepatic jaundice include malaria, sickle cell anaemia, thalassemia, and spherocytosis.

Hepatic/Hepatocellular jaundice occurs when your hepatic cells become dysfunctional or get damaged or scarred (cirrhosis). It decreases your livers efficiency in draining excess bilirubin from the blood. As the bile pigment fails to reach the digestive tract for excretion, it accumulates in your blood, leading to jaundice. The main causes of hepatic jaundice are liver cirrhosis, viral hepatitis, alcoholic hepatitis, biliary cirrhosis (primary), and liver cancer.

Post-hepatic jaundice, also known as obstructive jaundice, occurs when bilirubin fails to filter out properly into your digestive system or bile ducts owing to a blockage. The common post-hepatic jaundice causes include gallstones, bile duct cancer, pancreatic cancer, pancreatitis, and biliary atresia.

What causes jaundice?

When the body is unable to process the excess bilirubin, it accumulates in your body, causing your eyes and skin to become yellowish. You may develop jaundice due to an underlying condition that either leads to excessive bilirubin production or prevents your liver from filtering or eliminating the same.

The possible causes of jaundice are likely to include the following:

• Certain medications
• Autoimmune disorders
• Nonalcoholic fatty liver disease
• Excessive alcohol consumption
• Gallbladder stones
• Pancreatic cancer
• Liver cirrhosis
• Hemolytic anaemia
• Hepatitis
• Liver infections

Bilirubin production in newborn babies is more than in adults due to the more rapid breakdown of RBC in the first couple of days of their life. Generally, the liver eliminates bilirubin from the blood and moves it to the digestive system. However, the immature liver of newborns cannot filter the same fast enough, leading to bilirubin buildup in the blood. This ailment is called physiologic jaundice. Other causes of jaundice in newborns include:

• Sepsis
• Viral infections
• Bacterial infections
• Biliary atresia
• Liver malfunction
• Enzyme deficiency
• Rh incompatibility (the mothers blood does not match the babys blood)

What are the signs and symptoms of Jaundice?

Many people do not experience jaundice symptoms. The jaundice doctor may diagnose the condition accidentally while checking for other diseases.

If your jaundice is due to an infection, you may experience the following jaundice symptoms:

• Episodes of fever
• Abdominal pain
• Chills
• Discolouration of skin
• Dark or yellowish urine
• Pale stools (clay-coloured)

If an infection is not the underlying cause behind your jaundice, you are likely to develop symptoms like pruritus (a skin condition), and you may also experience weight loss.

If biliary tract or pancreatic cancer is the reason you have jaundice, abdominal pain is one of the most common symptoms.

In case of a liver condition leading to jaundice, you may develop the following signs and symptoms:

• Joint inflammation (Polyarthralgias)
• Chronic hepatitis
• Acute hepatitis (A, B, or C)
• Pyoderma gangrenosum (a skin ailment)

How is jaundice diagnosed?

In infants, the following tests help diagnose jaundice:

• Light meter test: During this test, the doctor places a light meter on the head of the baby to analyze the TcB (transcutaneous bilirubin) level
• TSB (total serum bilirubin) test: The doctor takes a blood sample from the newborns heel to perform this test

In adults, the doctor may recommend the following tests to diagnose jaundice:

• Blood tests, including liver function test (LFT), complete blood count (CBC), hepatitis tests, liver enzyme tests, and blood cultures
• Imaging tests, such as ultrasonography (USG), CT scan, and MRI to find blockages (if any) in the bile ducts and the flow of bile juice
• Endoscopic Retrograde Cholangiopancreatography (ECRP) to evaluate your bile ducts using an endoscope

What are the treatment and medication options for Jaundice?

Jaundice can be a sign of any underlying health condition. Therefore, your doctor is likely to treat the cause as the first step to jaundice treatment.

• Alcohol-induced cirrhosis: If drinking excessive alcohol is the reason for your liver condition, you will need to stop drinking alcohol to resolve the problem
• Hemolytic anaemia: In hemolytic anaemia, your red blood cells break down at a faster rate than usual, causing bilirubin buildup in your blood. In such cases, you may be prescribed a blood transfusion as jaundice treatment.
• Drug reactions: Certain medications may cause harm to your liver, such as acetaminophen or illicit drugs. In such cases, your doctor will immediately stop them and prescribe other medicines to counter the toxicity.
• Gallbladder stone: Jaundice due to gallstone may require a gallbladder removal surgery.
• Liver cirrhosis is a chronic liver condition and occurs due to several underlying causes. The treatment will depend on the disease you may have. However, in most cases, diuretics or corticosteroids are recommended.
• Liver cancer: In liver cancer, your jaundice treatment plan is likely to include chemotherapy, radiation, and other supportive therapies and medications.
• Primary sclerosing cholangitis (PSC) is a liver condition related to ulcerative colitis. The treatment program may include medications such as diphenhydramine, antibiotics, and cholestyramine. In severe cases, your doctor may recommend surgery to open your bile ducts and implant a stent, or even perform a liver transplant.
• Viral infection: No treatment is required. Your body will fight the virus and eliminate the bilirubin on its own.

How do you prevent Jaundice?

Prevention of jaundice depends on several factors, including your lifestyle, food habits, and diet. Some of the most useful preventive measures include the following:

• Make sure to get your Hepatitis B vaccination done. It is the best prevention for jaundice
• Do carry your own water in a clean bottle or always drink water from reliable places
• Always eat at clean and hygienic places when eating outside
• Drink alcohol in moderation
• Make sure to practice safe and healthy sex. Hepatitis B is a transmissible health condition and can transfer to another person via unprotected sexual intercourse and many other ways
• If you suspect that you may have jaundice, make sure to visit your doctor. Early diagnosis can help in the prevention of jaundice before it becomes severe

Frequently Asked Questions (FAQs)

1. What are the danger signs of jaundice in infants?

In infants with jaundice, you should call your doctor if:

• The skin of your baby turns more yellow
• The sclera of your baby appears yellow
• Your baby is feeding poorly and not gaining weight
• Your baby is crying inconsolably
• Your baby develops some other symptoms that you may be concerned about

2. How long is jaundice recovery?

In general, your body may need a minimum of 6-months to completely recover from jaundice. Meanwhile, your doctor will continue taking routine tests to check liver function.

3. Can jaundice be cured?

In adults, jaundice is not treated, but the underlying condition is. For example - in the case of acute viral hepatitis, jaundice cures as soon as the liver heals. If you have a blockage in your bile duct, you may need surgery to remove the blockage. If your baby develops mild jaundice, it will go away on its own within two to three weeks. Severe infant jaundice cases need longer hospitalisation.

4. Can jaundice be spread?

No, jaundice is not a communicable or contagious condition. However, underlying causes, for example, Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E, can spread from one person to another.

5. Which stage of liver disease is jaundice?

The symptoms you may experience with an end-stage liver condition include the following:

• Jaundice
• Reduction in brain function
• Increased risk of bleeding
• Accumulation of fluid in the abdomen

6. Does jaundice cause death?

According to many medical professionals, jaundice is not a health condition in itself but a sign of a health condition that is hampering the metabolic functions of your body. If left untreated, jaundice can lead to minor health complications to life-threatening ones.

7. Is jaundice caused by a virus?

Viruses, such as Hepatitis A, B, C, and infectious mononucleosis (Epstein-Barr virus infection), can cause jaundice.

8. Does jaundice mean liver failure?

Liver failure means a severe decline in liver function. It occurs when a considerable portion of the organ is damaged because of any liver disorder. The symptoms of liver function may include jaundice, impaired brain function, weakness, fatigue, not feeling well, loss of appetite, etc.