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Other Names:
Yellow Skin, Icterus, Yellow Eyes
Jaundice

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Definition

Jaundice is a health condition characterized by yellow discoloration of the skin, the mucous membranes, and the white (sclera) of eyes. This yellow discoloration is due to accumulation of a yellow pigment called bilirubin. Bilirubin is a product that is released by old red blood cells that breakdown and die. The bilirubin from the dead red cells is further processed by liver and is excreted from the body in the stool. Jaundice is the hallmark symptom of diseases that affect the liver and the biliary system.

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Types

  • Hemolytic Jaundice - This type of jaundice results from the the breakdown of excessive numbers of red blood cells. The bilirubin that is released from the breakdown of these large numbers of cells exceeds the livers capacity to process it and help the body get rid of it in stool. Thus the yellow pigment, which is bilirubin accumulates in the body and becomes visible in the form of yellow coloration (jaundice) of skin and the whites of eye. Example of hemolytic jaundice is jaundice appearing in a condition called hemolytic anemia, where the red blood cells are excessively destroyed by the body. Jaundice that is seen in most babies during the first week of life, (physiologic jaundice) is also of hemolytic type but is a normal and physiological phenomenon. Since many red blood cells are broken down very quickly and the baby's liver is unprepared to handle the load, jaundice appears which clears off in the next 3-5 days.
  • Non-hemolytic Jaundice - This kind of jaundice occurs due to the liver being damaged or overloaded or by the inability to move the bilirubin through the biliary tract to the gut. This kind of jaundice can also be called pathologic jaundice as it can be a result of a serious and life threatening conditions like blood incompatibilities, blood diseases, genetic syndromes, hepatitis, cirrhosis, bile duct blockage, other liver diseases, infections or medications. Non-hemolytic jaundice (hyper-carotenemia or carotenemia) can also result by consuming too much beta-carotene which is the yellow orange pigment present in carrots. The differentiation feature is that in hyper-carotenemia, the whites of the eyes remain white whereas, in actual jaundice there is a yellowish coloration of the whites of the eye.
  • Deficiency of bilirubin-processing enzymes in the liver - This is a hereditary disorder in which mild jaundice develops due to low levels of some the bilirubin processing enzymes.

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Causes

  • Viral Hepatitis
    • Hepatitis A
    • Hepatitis B
    • Hepatitis C

  • Blockage in Bile ducts
    • Gallstones
    • Bile duct tumor
    • Inflammation of the bile duct e.g. Sclerosing cholangitis
    • Bile duct stricture or narrowing
    • Biliary atresia

  • Liver Cirrhosis (alcoholic cirrhosis)
  • Primary Biliary Cirrhosis
  • Cancer of the:
    • Pancreas
    • Liver
    • Gallbladder

  • Chronic active hepatitis
  • Autoimmune hepatitis
  • Malaria
  • Medications like erythromycin, sulfa drugs, antidepressants, anti-cancer drugs, Aldomet, rifampin, steroids, acetaminophen (tylenol), chlorpropamide, tolbutamide, oral contraceptives, testosterone, propylthiouracil
  • Inadequate blood flow to the liver (ischemic hepatocellular jaundice)
  • Drug abuse
  • Jaundice of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy)
  • Hemolytic anemia
  • Hereditary disorders due to deficiency of bilirubin processing enzymes in the liver such as Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes
  • Choledochal cysts
  • Alagille Syndrome
  • Zellweger Syndrome

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Implications

Persistent and long term diseases of the liver can lead to permanent damage and liver failure. Liver failure is a serious and life threatening condition. The damage to the liver develops slowly and progressively over a period of years due to causes such as alcohol abuse or infection with hepatitis virus. it. Liver failure can also be acute i.e. the damage occurs over a period of days or weeks. The common reasons for acute liver failure include hepatitis virus infections, drugs, pregnancy, autoimmune disease, and sudden low blood flow to the liver. Untreated, chronic hepatitis B and C can cause cirrhosis and liver cancer. Hepatitis B infection can be passed on the baby if the mother acquires the infection during pregnancy.

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What You Can Do

  • Follow physicians prescribed treatment and advice to treat the underlying cause of jaundice
  • Cut down or stop alcohol consumption
  • Reduce the amounts of fats that you and your family consume in diet. The risk of gallbladder disorders including gallstones, a liver-related disease can be reduced by avoiding high-fat and cholesterol foods.
  • Cut down on the amount of deep-fried and fatty foods you and your family consume.
  • Eat a well balanced and nutritious diet
    • Meat, fish and poultry provide protein, vitamin A, iron, vitamin B12, niacin, fiber, thiamin
    • Breads, rice and cereals provide carbohydrates, niacin, thiamin, iron, riboflavin, fiber
    • Fruits and vegetables provide vitamin A, vitamin C, iron, fiber, folic acid
    • Milk and milk products provide calcium, riboflavin, niacin, folic acid, vitamin A, vitamin B12, vitamin D
    • Fresh fruits, vegetables and whole grain breads provide dietary fiber

  • Try to maintain a healthy body weight as being over weight has a direct correlation to the development of gallbladder disorders.
  • A regular exercise routine is very vital for being healthy and fit.
  • Liver transplant - This is a surgical procedure to replace your liver with the one that has been donated by someone else. The donated liver can come from someone who has died recently or a living family member. If the liver tissue is taken from a living family member, a small part of the liver tissue is removed and transplanted into the patient to allow new cells to form and regenerate from the transplanted tissue.

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Jaundice