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Jaundice is a condition in which the color of the skin and whites of the eyes and other mucous membranes turn yellow. The yellowing is due to the increased levels of bilirubin in the body.
Bilirubin is a pigment produced from the breakdown of red blood cells. The liver processes bilirubin and passes it through bile ducts into the intestine.
Jaundice can happen from increased bilirubin production, decreased filtration through the liver, or blockage of the bile ducts.
What are the different types of jaundice?
Jaundice can mainly be divided into three types:
- Pre-hepatic: Increased production of indirect bilirubin from increased destruction of red blood cells
- Hepatic: Increased direct or indirect bilirubin from liver dysfunction
- Post-hepatic: Increased direct bilirubin from blockage of bile from the liver into the intestine
What are the causes of jaundice?
Bilirubin is released in the blood as a by-product of the daily breakdown of red blood cells. This primary form of bilirubin is called indirect bilirubin, which cannot be directly excreted from the body.
Indirect bilirubin is filtered from the blood by the liver and converted into direct bilirubin, which forms a major part of bile.
Bile passes through the bile ducts into the small intestine and is eventually excreted along with feces or urine, while some of the bilirubin is reabsorbed in the blood.
Jaundice happens when there is any defect or hindrance in this filtering process leading to a buildup of bilirubin. The causes of jaundice can range from minor problems with no symptoms or consequences to more serious ones.
1. Increased bilirubin production
If there is increased destruction of blood cells such as in hemolytic anemias or internal bleeding.
2. Liver dysfunction
If the liver is diseased due to an inflammation called hepatitis, which can be due to:
- Viruses such as hepatitis A, B, C, and D, herpes, cytomegalovirus, and many others
- Toxins such as alcohol
- Mushroom poisoning
- Medications and drugs, such as Tylenol
- Autoimmune diseases
- Slow inflammation leading to scarring called cirrhosis
- Liver tumors
- Liver cancer
- Metastatic tumors in the liver, which can destroy normal liver cells and decrease the liver function
3. Blockage of bile ducts
If the flow of bile from the liver to the intestine is interrupted due to blockage of the bile ducts, which can be caused by gallstones, tumors, strictures, and pancreatic cancer.
What are the symptoms of jaundice?
Excessive bilirubin can manifest visibility in the following ways:
- The whites of the eyes are the first to turn yellow.
- Your skin may also acquire a pale yellowish tint or even turn slightly greenish at high levels.
- Your urine may appear darker than usual.
This yellowish discoloration is unlikely to appear when the buildup of bilirubin is still relatively low. In such mild cases, lab tests are the only way to detect jaundice.
People with jaundice can also suffer from:
What is the normal bilirubin level?
- Bilirubin, total: 0.0 to 1.0 mg/dl
- Bilirubin, direct: 0.0 to 0.4 mg/dl
How is jaundice diagnosed?
Jaundice can be diagnosed based on physical examination from the yellow color of the skin and whites of the eyes (sclera), which is confirmed through certain lab tests. (1)
What lifestyle and dietary changes are recommended for people suffering from jaundice?
If someone has liver disease, then lifestyle changes such as the following should be made:
- Limiting alcohol
- Avoiding excessive medication use, such as excessive intake of Tylenol (>2 gm/day), which can lead to liver toxicity
- Consuming a healthy diet rich in fruits, vegetables, and protein, which is also good for your liver (2)
Is jaundice a fatal disease?
Jaundice is a symptom of many diseases, which can range from benign or mild without any major impact on body function to very dangerous and fatal diseases.
Is neonatal jaundice a serious condition?
Low levels of increased bilirubin may be benign. However, high levels of bilirubin (>25 mg/dl) in neonates can cause brain damage. (3)
How long does jaundice normally last?
This depends on the cause. Some conditions are reversible, and jaundice can resolve if the underlying cause resolves, such as hepatitis A, a drug or toxin reaction, and blockage of the bile duct, which can be unblocked.
However, many liver problems, such as hepatitis B and C and liver cirrhosis, are chronic and can be long-lasting.
Can high levels of alcohol also cause jaundice?
Yes, high alcohol with >7 drinks/week in women and >14 drinks/week in men can be toxic to the liver and can cause liver damage and jaundice.
What are the best natural remedies for jaundice?
The causes of jaundice are quite extensive. Hence, the treatments are quite different. But there is no evidential support for any natural remedy that can cure jaundice.
Can anemia cause jaundice?
Yes, hemolytic anemias can cause jaundice. In this condition, there is increased destruction of blood cells and internal bleeding called a hematoma.
How can jaundice be prevented?
Jaundice can be prevented by:
- Avoiding risk factors that cause liver diseases, such as avoiding excessive alcohol intake and use of intravenous drugs, which are risk factors for viral hepatitis.
- Getting immunization for hepatitis A and B, which is recommended to all newborns in the USA and also adults who are not immunized previously.
What can be the health consequences of leaving jaundice untreated?
As some of the causes of jaundice can be life-threatening, early assessment is very important. If there is any delay in assessment and treatment, the disease can progress and can lead to poor health outcomes. (4)
Can jaundice relapse?
Yes, depending on the reason. Any chronic liver disease can get worse and cause recurring jaundice.
Is jaundice contagious?
Yes, jaundice can be contagious if it is caused by an infectious disease such as viral hepatitis, bacterial sepsis, or leptospirosis.
Hepatitis A can spread through food, whereas hepatitis B and C usually are contagious through blood or body fluids including intravenous drugs use, tattoos, blood transfusions, mother to fetus transmission, and sexual transmission.
How can one know if the jaundice is getting better?
Clearing of the yellow color of the skin and eyes is consistent with improving jaundice. Further diagnostic testing can reveal how better jaundice has become.
Can jaundice be a symptom of liver cancer?
Yes, liver cancer can cause jaundice by blocking the bile ducts (obstructive jaundice) or by destroying the normal function of the cells of the liver (liver infiltration) and decreasing the liver’s processing ability for bilirubin.
People of all ages can develop jaundice due to a wide variety of reasons, which may be benign or serious.
It is imperative to get yourself medically evaluated at the earliest sign of trouble to rule out any serious underlying cause.
Excess bilirubin can be highly toxic, and timely treatment is key to avoid long-term liver damage or other potential complications.