Jaundice Symptoms and Their Clinical Significance

A medical condition which has a yellow skin appearance along with the whites of eyes and mucous membrane is known as Jaundice. This occurs due to an increase in the level of bilirubin. Bilirubin is a yellow-orange pigment present in the bloodstream as a waste material after iron is removed from blood. Abnormal level of bilirubin changes the colour appearance to brown.

Cause of Jaundice

Jaundice is caused due to an inflammation of liver or obstructed bile duct. Many other factors also constitute jaundice. In technical terms it is known as icterus. Jaundice occurs more often in newborn babies and is termed as neonatal jaundice. The neonatal jaundice is caused as the newborn liver is not fully developed and is less effective in processing bilirubin from the blood.

The main function of the liver is to filter the waste material from blood. Conjugated bilirubin is formed as it reaches the liver, and this formed because of chemicals attaching to bilirubin.

In normal conditions, the liver produces a digestive juice called bile. The conjugated bilirubin enters the bile and then exits from the body. The brown faecal matter is because of the bilirubin.

In Abnormal conditions, the bilirubin is leaked into the surrounding tissues which is known as Hyperbilirubinemia which causes the yellow colour in the skin and eyes.

Symptoms of Jaundice

Symptoms of jaundice are as follows:

• Appearance of yellow colour on the skin, whites of eyes and mucous membrane.

• Passage of dark urine and itchiness. 

In the initial stages of jaundice, following symptoms occur

• Fever

• Abdominal pain

• Vomitings

• Weight loss

• Drowsiness, agitation, and confusion

Symptoms of Jaundice in Infants

A common health issue faced by infants is jaundice. Around 60% of newborns experience jaundice which increases the percentage of premature deliveries before 37 weeks of pregnancy. The jaundice symptoms are usually shown within 72 hours of birth.

Due to the starting stages of body growth in infants, it is difficult to analyse the symptoms unlike adults. Physical examination on the body such as slightly pressing on the chin of the body should be done to check for jaundice.

Additional symptoms include:

• Crying loudly

• Change in skin tone

• Poor feeding

• Urine colour changes to yellow

• Sleepiness and lethargic

The symptoms of jaundice usually resolve naturally without the intervention of treatment within 2 weeks. Abnormal levels in bilirubin in some cases are treated by either a blood transfusion or phototherapy. The risk of any treatment in infants is due to a condition called Kernicterus which is a rare type of permanent brain damage.

Types of Jaundice

Jaundice is mainly treated by the underlying cause of it. The treatment is given according to the symptoms rather than making it a common pattern for the disease.

The different kinds of jaundice observed according to the symptoms are:

• Hepatocellular Jaundice: This occurs due to the damage or injury to the liver. Main cause of liver damage is due to the infections, excessive consumption of alcohol, and parasitic infections. Treatment is provided by liver surgery or transplantation which helps to control further damage.

• Hemolytic Jaundice: In this kind of jaundice the symptoms appear as increase in the level of bilirubin which occurs due to accelerated rate of erythrocytes or red blood cells. Malaria, anaemia etc.

• Obstructive Jaundice: Hindrance of bilirubin from exiting the liver is the main cause for this kind of jaundice. Blockage is cleared by surgery to clear the bile duct system.

Underlying Factors Causing Jaundice

The main cause of jaundice is either due to accumulation of bilirubin or hindering the function of the liver to filter bilirubin. This results in deposition of bilirubin in tissues.

The Underlying factors are:

• Acute inflammation of Liver: This impairs the ability of liver to conjugate and secrete bilirubin, which results in accumulation of bilirubin level.

• Inflammation of Bile Duct: The inflammation occurs due to the hindrance in secretion of bile and removal of bilirubin, resulting in jaundice.

• Obstruction of Bile Duct: Disposal of bilirubin by liver occurs in this case, leading to jaundice.

• Hemolytic Anemia: Uncontrolled production of Red blood cells leads to increase in the production of bilirubin which causes hemolytic anemia.

• Gilbert’s Syndrome: An inherited condition which impairs the ability of enzymes to process the excretion of bile.

• Cholestasis: The passage of bile from the liver is interrupted in this condition. The conjugated bilirubin present in the bile remains in the liver due to the obstruction of passage instead of being excreted.

Some of the rare conditions which cause jaundice are:

• Crigler-Najjar Syndrome: This is an inherited condition which impairs the enzyme responsible for processing bilirubin.

• Dubin-Johnson Syndrome: An inherited form of chronic jaundice which inhibits the secretion of conjugated bilirubin from the cells of liver.

• Pseudojaundice:  Harmless form of jaundice which occurs due to excess levels of beta-carotene. This is caused due to high intake of carrot, pumpkin, or melon.

Diagnosis for Jaundice

The most basic method of diagnosing jaundice is by checking the levels of bilirubin. The physical check is performed by examining the abdomen, feel for tumor, and checking for the firm condition of liver.

Various tests can be done to check the condition of the liver and the level of bilirubin to diagnose jaundice.

• Bilirubin Tests: Difference in the level of unconjugated bilirubin when compared to conjugated bilirubin result in hemolytic anemia.

• Full Blood Count: This provides a complete report of the count of RBC, WBC, and Platelets.

• Hepatitis A, B, and C tests: This accounts for various kinds of liver functions.

Treatment for Jaundice

Usually there is no requirement of jaundice in adults, it is a rather severe problem in infants. The causes and complications of jaundice can be easily treated. For example, a healthcare professional can prescribe medications to treat itching. Also, if the liver has been damaged, there may be a need to transplant it. 

Prevention of Jaundice

Jaundice can be prevented by taking care of the liver and doing some lifestyle changes.

• Always try to eat balanced meals.

• Exercise regularly to maintain healthy weight.

• Limit the consumption of alcohol and avoid smoking and taking intravenous drugs. 

• Avoid taking herbal supplements without consulting your doctor.

Conclusion

Jaundice is a medical condition which is characterized by the yellow appearance of skin and eyes. This is caused by liver inflammation or an obstructed bile duct. We also learnt about types, diagnosis, treatment and prevention of jaundice.