Symptoms of Jaundice and how to deal with them
When there is yellowish tinge to the skin and the whites of the eyes—that’s when people say someone is jaundiced. The word ‘jaundice’ comes from Latin Galbinus—meaning greenish-yellow. But what exactly is jaundice, and when does it occur? Read on to know about this condition:
What is Jaundice?
When there is a high amount of yellow-orange pigment called ‘bilirubin’ in the body, it binds to the mucous membranes and whites of the eye and gives them a yellow hue. Bilirubin production is a normal physiological phenomenon; however, the disease arises when the body cannot get rid of this bilirubin, due to any cause.
Causes of Jaundice
There are three phases of bilirubin production: pre-production, during production, and post-production. Bilirubin is derived from the breakdown of normal red blood cells, therefore, increased breakdown of red blood cells due to any cause can lead to a rise in pre-production or unconjugated bilirubin and hence, jaundice. You may have seen the term ‘total bilirubin’ in certain investigations of the liver. This term is used for the sum of both conjugated and unconjugated bilirubin. Haemolytic anaemias are a common cause of unconjugated bilirubin rise and pre-production jaundice.
Diseases of the liver itself can hamper the production phase or conjugation process of bilirubin, and lead to increased levels in the blood. These can include viral infections of the liver like hepatitis A, chronic hepatitis B and C, EBV (infectious mononucleosis), alcoholic liver disease, rare metabolic defects, and certain medications that cause liver toxicity.
Post-production or conjugation, bilirubin can rise when there is a blockage or obstruction in the bile ducts, as bilirubin is normally released in the bile and if this is blocked bilirubin levels in the body rise. Gallstones are the most common reason for bile tract obstruction. Other causes can include inflammation of the gallbladder, pancreatic mass, gallbladder cancer.
Symptoms of jaundice
Jaundice is not an isolated finding and not an illness on its own, rather it’s a symptom of the disease. There is characteristic yellow tinting of skin, eyes and mucous membranes in jaundice. If the blood bilirubin levels are really high, the whites of the eyes can turn brown or orange.
In most acute or short-term cases (usually caused by infection) there is accompanying fever, chills, dark-coloured urine, flu-like symptoms and abdominal pain. In our country, hepatitis is the most common cause of jaundice, and with such underlying causative factors, there is accompanying fatigue and vomiting.
If jaundice is not caused by infection, the symptoms profile is somewhat varied, with weight loss, itchy skin and abdominal pain. For cancers associated with gallbladder and pancreas, weight loss and abdominal pain are the commonest symptoms.
Some people assume they have jaundice when they experience mild yellowing of skin. However, it should be remembered that jaundice affects not only the skin but also the eyes and the mucous membranes. If only the skin is yellow-tinted, then it could be due to having too much beta carotene in the system, such as with excessive intake of carrots, sweet potatoes and pumpkins. Excess of this antioxidant is not a cause of jaundice.
Diagnosis of jaundice
Jaundice can be diagnosed through laboratory investigations by checking blood levels of bilirubin. Amongst the blood investigations that your doctor will recommend, there would be a Complete Blood Count (CBC), Liver Function Tests (LFTs), and hepatitis profile. Imaging tests such as ultrasonography, CT scan or MRI can also be advised at the discretion of your healthcare provider. The diagnosis of jaundice is the first step towards its treatment, it is thus necessary to get the diagnostic tests from an authentic laboratory. Dr. Essa laboratory and diagnostic is one such facility that can help you in this regard and provide you with authentic results.
Sometimes biopsy can also be done by the doctor to make a diagnosis.
Treatment of jaundice
As mentioned before, jaundice itself is a symptom of an underlying disorder and not the disease; therefore, the underlying condition needs treatment instead of jaundice itself. The treatment protocol is thus determined by the causative disorder. Moreover, unlike jaundice in children, adult jaundice usually gets better on its own.
Even in children, most jaundice cases resolve within one to two weeks according to the American Liver Foundation. For moderate jaundice cases, babies are treated with phototherapy in the hospital or even at home to help remove the extra bilirubin. The light waves used in phototherapy get absorbed by the baby’s skin and blood, and this in turn helps the bilirubin to turn into waste products that are to be eliminated. During this therapy, children may have frequent bowel movements with green-coloured stools. This is just one way for the bilirubin to exit the body. For severe cases, other therapies like blood transfusions are done.
Acute viral hepatitis usually goes away on its own without treatment. As the condition of the liver improves, its ability to conjugate and clear bilirubin returns and hence jaundice gets better. In some cases, however, hepatitis can become chronic even if jaundice disappears. This is why a thorough hepatitis profile is needed when there is jaundice.
As the condition of the liver improves, the itching also gets better. However, your healthcare provider can prescribe medication like cholestyramine to improve this symptom.
If jaundice is caused by blocked bile ducts, a non-surgical procedure like ERCP—endoscopic retrograde cholangiopancreatography—can be done to relieve the obstruction. In ERCP, instruments are threaded through the endoscope, and guided to the bile duct whereby blockages like impacted stones can be removed safely and non-surgically.
Get thorough bi-annual physicals to keep illnesses at bay and consult a credible radiology lab in Karachi, Lahore or Islamabad if you are suspicious that you have jaundice so that you can get treatment in time.