Jaundice
Jaundice, also called hyperbilirubinemia, or icterus, is described as yellow discoloration of the body tissues such as the skin or white of the eyes (sclera) due to high bilirubin levels (a yellow-orange bile pigment) in the bloodstream.
Bilirubin is a yellow chemical pigment present in the haemoglobin. Bilirubin pigment is produced by the hemolysis (breakdown of red blood cells) in the body and it is excreted by the liver. But in the case of liver dysfunction, the pigment is not excreted and gets accumulated in the blood, giving rise to jaundice.
The normal bilirubin level in adults is - Direct bilirubin (also called conjugated)- 0 to 0.3 mg/dL
- Total bilirubin- 0.3 to 1.9 mg/dL
- Normal indirect bilirubin in newborns is under 5.2 mg/dL within the first 24 hours of birth.
Newborn jaundice
Neonatal jaundice or neonatal hyperbilirubinemia is a condition in which the total serum bilirubin (TSB) is increased in an infant and the skin, sclera, and mucous membrane appear yellow in colour for the first few days of life.
Newborn jaundice that is mild, temporary, and self-limiting is called as "physiological jaundice." whereas the severe form is known as "pathological jaundice."
Infant jaundice occurs because the baby’s liver takes a few days to remove bilirubin from the blood. This process was previously done by the mother's liver during pregnancy.
Symptoms of Jaundice
The symptoms of jaundice include-
- The yellowish discolouration of the sclera (white area of the eye), or conjunctival icterus
- The skin tone appears yellow.
- The yellowish colour inside the mouth
- Urine colour is dark (bilirubinuria) or brown-colored.
- Stools are pale or clay-colored
- Bilirubin is a skin irritant; therefore, jaundice causes itching (pruritis).
- Yellow or green discolouration of teeth and dental hypoplasia in growing children.
- High fever
- Loss of appetite
- Stomach pain
- Loss of weight
- Vomiting
Types of jaundice
The types of jaundice are characterized by examining which part of the liver is malfunctioning and how it is affecting the excretion of bilirubin pigment from the blood circulation. The three major types of jaundice that can affect you are-
- Hepatocellular jaundice
- Hemolytic jaundice
- Obstructive jaundice
When to see a doctor?
The main reason for seeing a gastroenterologist is to determine the underlying cause of jaundice. Also, if you notice yellow skin color, sclera, or any of the above symptoms, contact your doctor immediately. Jaundice can indicate a serious health problem in adults. Ignoring the jaundice symptoms will only aggravate the severity of the disease or even death.
Get the best treatment for jaundice from our gastroenterologist at Medicover Hospitals.
Causes
Jaundice, or icterus, is caused by the accumulation of high levels of bilirubin in the bloodstream.
As bilirubin is treated in the liver, jaundice is a manifestation of liver disorder. The various causes are
- Viral infections like hepatitis A, B, C, D or E
- Liver cirrhosis or heavy alcohol consumption
- Autoimmune disorders - primary biliary cirrhosis
- Hereditary factors - Dubin–Johnson syndrome
- Specific medications include oral contraceptives, probenecid, chlorpromazine, rifampin, steroids, and herbal medications
- Pregnancy
- Gilbert syndrome
- Rotor syndrome
- Crigler–Najjar syndrome type 1 and 2
- Hyperthyroid
- Hepatic crisis in sickle cell disease
- Infiltrative diseases such as lymphoma, tuberculosis, amyloidosis, sarcoidosis
- Sepsis and hypoperfusion states
- Chronic liver disease
- Gallstones or gallbladder disorders cause bile duct blockage
- Blood disorders
- Pancreatic, gallbladder, liver cancer
- The jaundice of pregnancy
- Malaria
Risk Factors
The risk factors for jaundice are :
- Excessive consumption of alcohol
- Using illicit medications
- Taking drugs that may damage the liver
- Exposure to viral infections like hepatitis A , hepatitis B , or hepatitis C
- Vulnerability to certain industrial chemicals
Diagnosis of jaundice in infants
By doing physical examinations of the baby, paediatrics perform jaundice diagnosis in babies. Newborns should be examined for jaundice every 8 to 12 hours during the first 48 hours of life and continue it till they are 5 days old. The infant bilirubin tests include -
Light Meter
The paediatrician will use a light meter to check the transcutaneous bilirubin (TcB) level.
Blood test
To check bilirubin levels and give accurate results.
Diagnosis of jaundice in adults
By examining the jaundice signs and symptoms, the gastroenterologist can conclude the diagnosis.Other diagnosis options include -
Blood tests
Various blood tests are used to diagnose jaundice, they are the complete blood count (CBC), liver function tests (LFT’s), etc.
Imaging Tests
Ultrasonography of the abdomen, computerized tomography (CT) scan, magnetic resonance imaging (MRI), or other tests are done to monitor the flow of bile through the liver and also to check for any blockages.
Liver biopsy
A liver biopsy is done to check for liver diseases
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is done to diagnose and manage disorders pertaining to the liver, gallbladder, bile ducts, and pancreas.
Laparoscopy (uncommon)
This procedure is done to inspect the liver and gallbladder.
Treatment
The treatment approach for jaundice differs among newborns and adults. Also, based on every single condition and severity of the patient, the doctor adopts a more personalized treatment plan, which might vary in duration as well.
Jaundice treatment for infants
Mild jaundice subsides on its own after 1 or 2 weeks. Breastfeeding in infants should be done regularly. If the baby is not getting sufficient breast milk, the paediatrician may recommend supplementing with formula.
Other treatment options include -
Fluids
Giving fluids, as loss of fluids (dehydration) will cause high bilirubin levels
Phototherapy
It is a safe treatment procedure to cure newborn jaundice
Exchange blood transfusion
This procedure is preferred when there's no improvement. The high bilirubin levels do not come down even with phototherapy.
Intravenous immunoglobulin (IVIg)
IVIg stops antibodies targeting the red blood cells and decreases the need for an exchange transfusion.
Jaundice treatment for adults
Often, jaundice doesn't require treatment in adults, but it is a serious condition in newborns. Jaundice can be treated for its underlying causes and effects. Treatment for jaundice is the management of the underlying hepatobiliary or haematological disease.
Do’s and Don’ts of Jaundice
Jaundice is a medical condition with high bilirubin levels in the bloodstream. It is more severe in neonates than in adults. By following the do’s and don'ts, it is easy to prevent or lessen the severity of its symptoms.
| Do’s | Don’ts |
| Limit alcohol intake | Eat canned, packaged, and spicy food |
| Eat nutritious food | Take drugs that harm the liver |
| Take enough rest | Take illicit medications |
| Regular health check-ups | Go out of your home |
| Stay away from industrial pollution | Skip jaundice medicines |
Foods play an important role in the control and cure of jaundice. There are specific guidelines regarding food when suffering from jaundice
Foods to eat and avoid during jaundice
| Foods to Eat | Foods to Avoid |
| Stay hydrated - Drink water, lemon, grape juice, etc. | Sugar |
| Fresh fruits and vegetables | Salt |
| Coffee and tea | Alcohol |
| Whole grains | High-fat and fried foods |
| Nuts and legumes | Iron consumption |
If jaundice is not treated on time, it can lead to serious complications or even death. By taking the right medications and precautions for jaundice it is possible to control it or prevent it completely.
Jaundice Care at Medicover Hospitals
At Medicover Hospitals, we have the most trusted team of gastroenterologists and hepatologists working together to properly diagnose and treat jaundice at any stage. Our team adopts a multi-disciplinary approach in treating jaundice with the active participation of dieticians, specialist doctors, and others who contribute to adequate treatment and complete recovery of the patients. We provide world-class healthcare services at affordable costs in all our departments to offer superior treatment outcomes and experience to our customers.
