Jaundice

Summary about Disease


Jaundice is a condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes. This yellow discoloration is caused by an elevated level of bilirubin, a yellow pigment, in the blood. Bilirubin is a waste product formed from the breakdown of red blood cells. Jaundice can indicate an underlying problem with the liver, gallbladder, or red blood cells. It is more common in newborns, but can affect people of all ages.

Symptoms


The most prominent symptom is yellowing of the skin and whites of the eyes. Other symptoms may include:

Dark urine

Pale stools (clay-colored)

Itching (pruritus)

Fatigue

Abdominal pain

Weight loss

Fever (depending on the underlying cause)

Causes


Jaundice occurs when there is too much bilirubin in the blood. This can happen due to:

Pre-hepatic Causes: Excessive breakdown of red blood cells (hemolysis) - such as in hemolytic anemia

Hepatic Causes: Liver disease or damage (e.g., hepatitis, cirrhosis, liver cancer) - Liver's inability to metabolize bilirubin

Post-hepatic Causes: Blockage of the bile duct (e.g., gallstones, tumors) - Prevents bilirubin from being excreted Other causes include:

Gilbert's syndrome (a genetic disorder)

Certain medications

Newborn jaundice (immature liver function)

Medicine Used


Treatment for jaundice depends entirely on the underlying cause. There is no single medication that "cures" jaundice. The focus is on addressing the root problem. Examples include:

For infections (e.g., hepatitis): Antiviral medications

For bile duct obstruction: Surgery or endoscopic procedures to remove the blockage.

For autoimmune conditions: Corticosteroids or other immunosuppressants

For drug-induced jaundice: Discontinuation of the offending medication

For newborn jaundice: Phototherapy (light therapy) to help break down bilirubin. In severe cases, blood transfusion.

Is Communicable


Jaundice itself is not communicable. However, some of the underlying causes of jaundice can be communicable. For instance:

Hepatitis A, B, and C are viral infections that can cause jaundice and are communicable. Hepatitis A is typically transmitted through contaminated food or water, while Hepatitis B and C are transmitted through blood and bodily fluids.

Precautions


Precautions depend on the cause of the jaundice. General precautions may include:

If caused by viral hepatitis: Practice good hygiene, wash hands frequently, avoid sharing personal items (razors, toothbrushes), and get vaccinated against hepatitis A and B.

If caused by alcohol-related liver disease: Abstain from alcohol.

If caused by medication: Discontinue the medication (under medical supervision).

General: Maintain a healthy diet, stay hydrated, and follow your doctor's recommendations.

How long does an outbreak last?


Jaundice itself is not an outbreak. If the jaundice is caused by an infectious agent like Hepatitis A, then you will need to investigate Hepatitis A outbreaks

How is it diagnosed?


Diagnosis typically involves:

Physical Examination: Doctor will assess the skin, eyes, and abdomen.

Blood Tests:

Bilirubin levels (total, direct, and indirect)

Liver function tests (LFTs) - ALT, AST, alkaline phosphatase, GGT

Complete blood count (CBC)

Hepatitis viral serology (if infection suspected)

Imaging Studies:

Ultrasound of the abdomen (to check for gallstones or bile duct obstruction)

CT scan or MRI of the abdomen (for more detailed imaging of the liver and biliary system)

Liver Biopsy: In some cases, a liver biopsy may be necessary to determine the cause of liver damage.

Timeline of Symptoms


The timeline of symptoms depends on the underlying cause.

Newborn Jaundice: Typically appears within 2-4 days after birth and resolves within 1-2 weeks.

Hepatitis A: Symptoms may appear 2-6 weeks after infection. Jaundice usually lasts for a few weeks and then resolves.

Gallstones: Jaundice may come and go, depending on whether the gallstone is blocking the bile duct.

Chronic Liver Disease (e.g., cirrhosis): Jaundice may develop gradually over time as liver function declines.

Important Considerations


Jaundice in newborns needs prompt evaluation and management to prevent brain damage (kernicterus).

Jaundice can be a sign of serious underlying medical conditions. It's crucial to seek medical attention for proper diagnosis and treatment.

Self-treating jaundice is not recommended. The underlying cause needs to be identified and addressed by a healthcare professional.

The treatment of jaundice is dependent on the cause of the elevated bilirubin and can vary widely from observation, phototherapy, medications, surgery or supportive care.