Summary about Disease
Yellowish skin, clinically known as jaundice, is a condition characterized by the yellowing of the skin, whites of the eyes (sclera), and mucous membranes. This discoloration arises from an elevated level of bilirubin in the blood (hyperbilirubinemia). Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. Jaundice itself is not a disease, but rather a sign of an underlying medical condition affecting bilirubin metabolism, liver function, or bile flow.
Symptoms
Yellowing of the skin and whites of the eyes (sclera).
Dark urine (tea-colored).
Pale stools (clay-colored or light-colored).
Itching (pruritus).
Fatigue.
Abdominal pain (depending on the underlying cause).
Nausea or vomiting (depending on the underlying cause).
Causes
Jaundice can occur due to problems at various stages of bilirubin processing:
Pre-hepatic (before the liver): Excessive red blood cell breakdown (hemolysis), such as in hemolytic anemia, malaria, or sickle cell disease.
Hepatic (in the liver): Liver damage or disease, such as hepatitis (viral, alcoholic, autoimmune), cirrhosis, liver cancer, or genetic disorders like Gilbert's syndrome or Crigler-Najjar syndrome.
Post-hepatic (after the liver): Blockage of the bile ducts, such as by gallstones, tumors (pancreatic cancer, cholangiocarcinoma), or strictures.
Medicine Used
The treatment for jaundice focuses on addressing the underlying cause of the elevated bilirubin levels. The choice of medication varies greatly depending on the cause:
Pre-hepatic: Treatment may involve managing the underlying hemolytic condition with medications like corticosteroids, blood transfusions, or splenectomy in severe cases.
Hepatic: Treatment depends on the specific liver disease. Antiviral medications for hepatitis, abstinence from alcohol for alcoholic liver disease, immunosuppressants for autoimmune hepatitis, and supportive care for liver failure may be used.
Post-hepatic: Surgery or endoscopic procedures (e.g., ERCP) may be required to remove the obstruction (e.g., gallstones or tumors).
Other treatments:
Phototherapy: Used in newborns with jaundice to help break down bilirubin.
Ursodeoxycholic acid (UDCA): Can improve bile flow in certain liver conditions.
Is Communicable
Jaundice itself is not communicable. However, some of the underlying causes of jaundice can be contagious. For example, viral hepatitis (A, B, C, D, and E) are infectious and can be transmitted through various routes (e.g., contaminated food or water, sexual contact, blood contact).
Precautions
Precautions depend entirely on the underlying cause of the jaundice:
If caused by viral hepatitis: Practice good hygiene, including frequent handwashing, avoid sharing personal items, and get vaccinated against hepatitis A and B. Safe sex practices are crucial to prevent hepatitis B and C transmission.
If caused by alcohol-related liver disease: Abstain from alcohol consumption.
If caused by other liver conditions: Follow your doctor's recommendations regarding diet, medications, and lifestyle changes.
General precautions: Seek prompt medical attention if you develop symptoms of jaundice.
How long does an outbreak last?
The duration of jaundice depends entirely on the underlying cause and how quickly it is diagnosed and treated.
Newborn jaundice: Often resolves within 1-2 weeks.
Jaundice due to infection (e.g., hepatitis A): May last several weeks to months.
Jaundice due to chronic liver disease (e.g., cirrhosis): Can be a long-term, ongoing condition.
Jaundice due to gallstones: Resolves quickly after the gallstones are removed.
How is it diagnosed?
Diagnosis typically involves:
Physical examination: The doctor will look for yellowing of the skin and eyes.
Blood tests:
Bilirubin levels (total, direct, and indirect) to confirm jaundice and assess the type.
Liver function tests (LFTs) to evaluate liver health.
Complete blood count (CBC) to check for anemia or infection.
Hepatitis serology to test for viral hepatitis.
Imaging studies:
Ultrasound of the abdomen to visualize the liver, gallbladder, and bile ducts.
CT scan or MRI to further evaluate the liver and bile ducts.
ERCP (endoscopic retrograde cholangiopancreatography) to visualize and potentially treat bile duct problems.
Liver biopsy: May be necessary to determine the cause of liver damage.
Timeline of Symptoms
The onset and progression of symptoms depend on the cause:
Rapid onset (days to weeks): Often seen in acute hepatitis or bile duct obstruction.
Gradual onset (weeks to months): More common in chronic liver diseases like cirrhosis or slow-growing tumors.
Fluctuating: Some causes may result in symptoms that come and go. A typical timeline might look like this, depending on the cause: 1. Initial phase: Underlying cause begins (e.g., infection, liver damage, blockage). 2. Early symptoms: Fatigue, abdominal discomfort, dark urine, pale stools may appear. 3. Jaundice develops: Yellowing of the skin and eyes becomes noticeable. 4. Associated symptoms: Itching, nausea, vomiting may occur. 5. If untreated: Symptoms worsen, potentially leading to complications. 6. With treatment: Symptoms improve gradually as the underlying cause is addressed.
Important Considerations
Newborn jaundice: Is common, but should be monitored closely to prevent complications like kernicterus (brain damage due to high bilirubin levels).
Underlying cause: Identifying and treating the underlying cause is crucial for successful management.
Liver damage: Jaundice can indicate significant liver damage.
Medical advice: Seek medical attention promptly if you develop symptoms of jaundice. Self-treating can be dangerous.
Medication: Report all medication intake to the physician.