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Jaundice is a disease that leads to yellowish discolouration of the skin, white part of the eye, and other mucous membranes. It can also cause the bodily fluids to turn yellow.
- When red blood cells break down, they generate a waste product known as bilirubin.
- The cause of jaundice is a build-up of bilirubin in the blood and the tissues.
- It combines with bile in the liver and is then discharged through the stool and urine.
- However, if bilirubin is unable to pass through the liver, it accumulates in the blood, resulting in Jaundice.
- Jaundice in newborn babies is quite common as their liver is not fully developed, hence ineffective in processing bilirubin.
- Therefore, it is known as neonatal jaundice.
- Jaundice can lead to the following conditions – yellow skin, icterus (eyes) and membranes.
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Key Terms: Jaundice, Bile, Liver, Bilirubin, Membranes, Icterus, Neonatal Jaundice
What is Jaundice?
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Jaundice is a medical disorder that causes the skin and the whites of the eyes to turn yellow.
- This is caused by an increase in bilirubin levels in the blood.
- Bilirubin is a yellow-orange pigment that forms in the bloodstream.
- Jaundice is caused by liver inflammation or a clogged bile duct.
- It's called icterus in the medical terminology.
- Jaundice occurs when there is a disruption in the normal processing of bilirubin, leading to its accumulation in the body.
Jaundice
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Causes of Jaundice
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Jaundice in humans can be caused as a result of multiple factors such as –
- Jaundice can result from an excess of bilirubin production.
- Overloading or damage to the liver can hinder the breakdown of bilirubin, contributing to jaundice.
- Jaundice may occur if bilirubin faces obstacles moving from the liver to the digestive tract.
- Commonly, viral infections can trigger jaundice by affecting liver function.
- Certain drugs may contribute to jaundice as a side effect.
- Liver, bile duct, or pancreatic cancers can cause jaundice.
- Conditions like hemolytic anaemia, gallstones, and birth defects may lead to excessive bilirubin and jaundice.
- A genetic disorder, Gilbert's Syndrome, can disrupt bilirubin processing, resulting in jaundice.
- Immature livers in newborns may temporarily struggle to process bilirubin, causing mild jaundice.
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Types of Jaundice
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There are three different types of jaundice. The underlying cause of jaundice determines how to treat it. Treatments, in other words, focus on the symptoms rather than the disease itself.
- Hepatocellular Jaundice
- Caused by liver damage from factors like infections or excessive alcohol consumption.
- Treatment involves a liver transplant or repairing the liver to prevent further harm.
- Hemolytic Jaundice
- Results from rapid breakdown of red blood cells due to infections like malaria or anaemia.
- Treatment focuses on addressing the specific cause of the condition.
- Obstructive Jaundice
- Occurs when bilirubin is blocked and cannot be expelled from the liver.
- Surgical treatment involves clearing the bile duct system, potentially removing the gallbladder or a portion of the bile duct system.
Symptoms of Jaundice
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The following are the most common signs of jaundice:
- Skin and sclerae turn yellow, and the whites of the eyes may look brown in severe cases.
- The colour of the urine also turns to yellow.
- Experiencing excessive itchiness on the skin.
In the early stages of jaundice, the following signs may be observed:
Symptoms of Jaundice
- Jaundice may appear suddenly or develop gradually.
- Other common symptoms include dark urine, pale stools, yellow color inside the mouth, and itching (pruritus).
- Specific disorders causing jaundice may have additional symptoms such as fatigue, weight loss, nausea, or no symptoms in the case of certain cancers.
Note: Yellow skin doesn't necessarily indicate jaundice; consuming a lot of beta-carotene can turn the skin yellow-orange.
Symptoms of Jaundice in Infants
Jaundice is a prevalent health concern affecting approximately 60% of newborns. It is often linked to premature births before 37 weeks of pregnancy. Symptoms typically emerge within 72 hours after delivery.
- The primary indicator is yellowing of the skin and whites of the eyes, visible through a physical examination.
- Darkening of urine and pale or chalky stools are common signs.
- Infants may experience lethargy and difficulty feeding.
- High-pitched crying and arching of the body might be observed.
- Jaundiced infants may exhibit poor weight gain due to feeding challenges.
Symptoms of Jaundice in Infants
Diagnosing jaundice in infants is challenging due to early phases of development. A physical examination, including gently pressing on the chin, is commonly used to check for jaundice. Typically, jaundice symptoms resolve within two weeks without medication. However, persistent cases may require medical intervention.
- In some instances, abnormal bilirubin levels are managed through treatments like blood transfusions or phototherapy.
- It's crucial to note the risk of kernicterus, a rare but severe brain injury associated with prolonged jaundice in babies.
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Rare Conditions That Cause Jaundice
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Crigler-Najjar Syndrome is a hereditary disorder in which the enzyme responsible for bilirubin processing is impaired.
Dubin-Johnson Syndrome is an inherited form of persistent jaundice that prevents conjugated bilirubin from being secreted by liver cells.
Pseudojaundice is a harmless form of jaundice caused by high beta-carotene levels. This is caused by consuming too much carrot, pumpkin, or melon.
Jaundice Diagnosis
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The most basic technique for detecting jaundice is to measure bilirubin levels.
- Measuring bilirubin levels is typically done through a blood test. A higher concentration of bilirubin indicates jaundice.
- A comprehensive physical examination is conducted, involving abdomen palpation, tumour assessment, and liver firmness evaluation.
- To detect jaundice, a variety of tests can be performed to assess the state of the liver and the quantity of bilirubin.
- A complete blood count provides detailed information on red blood cell (RBC), white blood cell (WBC), and platelet counts.
- Hemolytic anaemia is caused by a difference in the levels of unconjugated bilirubin relative to conjugated bilirubin.
- A liver biopsy may be recommended to obtain a tissue sample for a more detailed analysis.
- A number of tests are performed to assess various liver functions, including tests for hepatitis A, B, and C.
Jaundice Treatment Approaches
Treatment for Jaundice is personalized to address the underlying cause of jaundice.
- For newborns with jaundice, phototherapy is a common treatment.
- Exposure to special lights helps break down bilirubin in the skin.
- Severe cases may require blood transfusions to replace damaged red blood cells and manage anemia.
- In cases of viral hepatitis (A, B, or C), antiviral medications may be prescribed.
- Medications to support liver function and manage symptoms may be prescribed.
- Adopting a healthy lifestyle, including dietary modifications and avoiding alcohol, may be recommended to support overall liver health.
- Regular monitoring and follow-up tests are crucial to track progress, adjust treatment plans, and ensure optimal liver function
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Things to Remember
- Jaundice is a medical condition diagnosed by measuring bilirubin levels in the blood.
- It leads to yellowing of the skin, mucous membranes, and eyes.
- Jaundice can result from various conditions, including liver diseases (like hepatitis or cirrhosis), hemolytic disorders, bile duct obstruction, or certain medications
- Bilirubin, a product of red blood cell breakdown, builds up in the bloodstream when the liver cannot process it effectively, leading to jaundice.
- If left untreated, jaundice can lead to complications such as liver damage, and organ failure, and in severe cases, it can be life-threatening.
Sample Questions
Ques. What is the severity of jaundice in adults? (2 Marks)
Ans. Increased levels of bilirubin, a chemical created when bile is broken down, induce jaundice, which causes itching all over the body. In adults, there are only a few minor differences in symptoms. Jaundice is more common in persons with serious liver illness. Enlarged breasts, reduced testes, and pubic hair are common in men. Apart from jaundice, liver illness can be caused by a variety of different reasons.
Ques. Jaundice is a condition in which accumulation of ____ occurs in blood. Fill in the blank. (2 Marks)
Ans. Jaundice is a condition in which the accumulation of bilirubin occurs in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells, and its elevated levels lead to the characteristic yellowing of the skin, eyes, and mucous membranes associated with jaundice.
Ques. What should you avoid if you have jaundice? (2 Marks)
Ans. Some meals and drinks to avoid if you have jaundice are listed below:
- Alcohol
- Fatty and Fried Foods
- Refined sugars and Carbohydrates
- Seafood
- Red meat
- Canned foods
- Salt and excessive iron
Ques. What are the different types of Jaundice? (3 Marks)
Ans. There are three different types of jaundice.
- Hepatocellular Jaundice occurs when the liver is damaged or injured. It can be caused by infections, excessive alcohol consumption and parasitic infection.
- Hemolytic Jaundice is caused by the rapid breakdown of erythrocytes, or red blood cells, resulting in the accumulation of excess bilirubin. It can be caused by infectious disorders such as malaria, anaemia, etc.
- Obstructive Jaundice is caused when bilirubin clogs the system and cannot be expelled by the liver. It can be treated through clearing the bile duct system (removing the gallbladder).
Ques. Name any five factors that cause Jaundice. (3 Marks)
Ans. Any of the given factors can cause jaundice:
- Acute liver inflammation affects the liver's capacity to conjugate and secrete bilirubin, resulting in an increase in bilirubin levels.
- Bile Duct Inflammation: Caused by a blockage in the secretion of bile and elimination of bilirubin, resulting in jaundice.
- Obstruction of the Bile Duct: In this scenario, the liver is unable to dispose of bilirubin, resulting in jaundice.
- Hemolytic Anemia is caused by an increase in the production of bilirubin as a result of uncontrolled red blood cell formation.
- Gilbert's Syndrome is a hereditary disorder in which enzymes are unable to handle bile excretion.
- Cholestasis is a disorder in which the flow of bile from the liver is disrupted. Due to the restriction of transit, the conjugated bilirubin in the bile lingers in the liver rather than being expelled.
Ques. What is bilirubin? (5 Marks)
Ans. Bilirubin is a yellowish pigment that forms during the normal breakdown of red blood cells. It's produced in the liver and is a byproduct of the heme component of haemoglobin, which is the oxygen-carrying molecule in red blood cells. When old or damaged red blood cells are broken down, heme is converted into bilirubin.
- When red blood cells reach the end of their life cycle (about 120 days), they are broken down, and haemoglobin is released.
- Heme, a component of haemoglobin, is broken down into biliverdin, releasing iron in the process.
- Biliverdin is then converted into bilirubin.
- Bilirubin is transported in the blood to the liver, where it is conjugated (modified) to make it water-soluble.
- The water-soluble bilirubin is then excreted from the liver into the bile, which is stored in the gallbladder. From there, it is released into the small intestine
- In the intestines, bilirubin is further modified by bacteria and broken down into urobilinogen.
- Some urobilinogen is reabsorbed into the bloodstream and excreted by the kidneys as a component of urine.
- The rest is eliminated in the faeces, giving faeces its brown colour.
When there's an imbalance in the production, conjugation, or elimination of bilirubin, it can lead to conditions such as jaundice, where the skin and eyes may appear yellow due to the accumulation of bilirubin in the body.
Ques. What type of diet is prescribed for jaundice patients? (3 marks)
Ans. Some general dietary guidelines often recommended for jaundice patients are:
- Ensure adequate hydration by drinking plenty of water.
- Emphasize foods that are rich in complex carbohydrates, such as whole grains, fruits, and vegetables.
- Include moderate amounts of high-quality protein sources, such as lean meats, poultry, fish, eggs, and plant-based proteins like legumes.
- Opt for a low-fat diet to reduce the workload on the liver.
- Completely avoid alcohol.
- Consume small, frequent meals throughout the day rather than large meals.
Ques. Jaundice is a disorder of? (3 marks)
Ans. Jaundice is a disorder primarily associated with the digestive system.
- This is because any disruption in the normal process of moving bilirubin from the blood to the liver and expelling it from the body can lead to jaundice.
- Bilirubin, a byproduct of the breakdown of red blood cells, is transported to the liver in the bloodstream, where it combines with bile—a digestive fluid.
- The final elimination of bilirubin occurs through urine or stools.
- Hence, the occurrence of jaundice is closely linked to the digestive system.
- The yellow color in stools is a result of this bilirubin excretion process.
Ques. What is another name for jaundice? (2 marks)
Ans. Jaundice is commonly referred to as "icterus." The term "icterus" is derived from the Greek word "ikteros," which means jaundice. Both terms are used interchangeably in medical contexts to describe the yellowing of the skin, mucous membranes, and eyes due to elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. When the liver is unable to effectively process and excrete bilirubin, it accumulates in the body, resulting in the characteristic yellow discoloration associated with jaundice or icterus.
Ques. Write down the functions of liver. (3 marks)
Ans. The functions of liver include –
- It regulates storage and utilization of nutrients, including carbohydrates, proteins, and fats.
- Liver filters blood, removing toxins and converting them into excretable forms.
- It produces bile for digestion, aiding in the breakdown and absorption of fats.
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