Introduction
Jaundice is a medical condition characterized by the yellowing of the skin, eyes, and mucous membranes due to increased levels of bilirubin in the blood. Bilirubin is a yellow pigment formed from the normal breakdown of red blood cells. When the liver cannot process bilirubin properly, it accumulates in the body, leading to jaundice.Jaundice Causes Symptoms Diagnosis Treatment and Prevention
Jaundice is not a disease itself but a sign of an underlying medical condition, usually related to the liver, gallbladder, or pancreas. It can affect people of all ages—from newborns to the elderly. Understanding jaundice is important for early detection, treatment, and prevention of serious complications.
What is Jaundice?
Jaundice is a condition in which the skin, sclera (white part of the eyes), and body fluids turn yellow. The yellow discoloration is due to the build-up of bilirubin, a substance produced when old or damaged red blood cells are broken down by the body.
Normally, bilirubin passes through the liver, is mixed with bile, and is eliminated from the body via stool. But when the liver is damaged, or when bile ducts are blocked, bilirubin accumulates in the bloodstream, resulting in jaundice.
Causes of Jaundice
The main causes of jaundice include:
1 – Liver Diseases
- Hepatitis (A, B, C, D, E)
- Liver cirrhosis due to alcohol abuse or chronic infections
- Fatty liver disease
- Liver cancer
2 – Blood Disorders
- Hemolytic anemia
- Sickle cell anemia
- Malaria
- Thalassemia
3 – Obstruction of Bile Flow
- Gallstones
- Tumors in the bile duct or pancreas
- Strictures of the bile duct
4 – Newborn Causes
- Immature liver function
- Breastfeeding jaundice
- Blood group incompatibility (Rh factor)
Symptoms of Jaundice
The most noticeable sign of jaundice is yellowing of the skin and eyes, but other symptoms may also appear:
- Pale or clay-colored stools
- Dark urine (tea-colored)
- Itching of the skin (pruritus)
- Fatigue and weakness
- Nausea and vomiting
- Loss of appetite
- Abdominal pain or swelling
- Fever and chills (in cases of infection)
Types of Jaundice
1 – Pre-hepatic (Hemolytic) Jaundice
Cause: Excessive destruction (hemolysis) of red blood cells, leading to the release of a large amount of unconjugated bilirubin that the liver cannot process fully.
Mechanism:
- Increased breakdown of RBCs → Excess production of bilirubin → Liver unable to conjugate all of it → Raised unconjugated (indirect) bilirubin in blood.
Features:
- Increased unconjugated bilirubin.
- Dark-colored stools and urine are absent (urine remains normal because unconjugated bilirubin is not water-soluble).
- Mild anemia may be present.
Examples of Causes:
- Hemolytic anemia
- Sickle cell anemia
- Malaria
- Autoimmune hemolysis
- Mismatched blood transfusion
2 – Hepatic (Hepatocellular) Jaundice
Cause: Damage to the liver cells (hepatocytes), reducing their ability to take up, conjugate, or excrete bilirubin.
Mechanism:
- Liver cell injury → Impaired uptake, conjugation, and excretion → Both unconjugated and conjugated bilirubin levels rise.
Features:
- Mixed hyperbilirubinemia (both conjugated and unconjugated).
- Urine is dark (due to conjugated bilirubin).
- Stool color may be normal or pale depending on severity.
- Liver function tests (LFTs) show raised ALT, AST.
Examples of Causes:
- Viral hepatitis (Hepatitis A, B, C, etc.)
- Alcoholic liver disease
- Drug-induced liver injury
- Cirrhosis
- Liver cancer
3 – Post-hepatic (Obstructive/Cholestatic) Jaundice
Cause: Obstruction in bile ducts preventing excretion of conjugated bilirubin into the intestine.
Mechanism:
- Liver conjugates bilirubin normally → But obstruction blocks bile flow → Conjugated bilirubin refluxes into the blood.
Features:
- Predominantly conjugated bilirubin is raised.
- Clay-colored (pale) stools due to lack of bile pigments in the intestine.
- Dark urine due to excretion of conjugated bilirubin by kidneys.
- Severe itching (pruritus) due to bile salt accumulation.
Examples of Causes:
- Gallstones in common bile duct
- Carcinoma of pancreas
- Biliary atresia
- Strictures of bile duct
4 – Physiological Jaundice (Common in Newborns)
Cause: Immaturity of liver enzymes in newborn babies → decreased ability to conjugate bilirubin.
Mechanism:
- Increased bilirubin production (due to shorter RBC life in infants) + immature conjugation process → accumulation of unconjugated bilirubin.
Features:
Appears in 2–3 days after birth, peaks at 4–5 days, and disappears within 1–2 weeks.
Usually mild and self-limiting.
Risk: If bilirubin levels rise excessively, it may cause kernicterus (brain damage due to bilirubin deposition in brain tissue).
Management: Phototherapy or exchange transfusion in severe cases.
5 – Neonatal Pathological Jaundice
(Unlike normal physiological jaundice, this occurs due to disease in newborns.)
Causes:
- Hemolytic disease of the newborn (Rh or ABO incompatibility)
- Neonatal infections (sepsis, TORCH infections)
- Genetic enzyme deficiencies (Crigler-Najjar syndrome, Gilbert’s syndrome)
Features:
- Appears within the first 24 hours of birth.
- Bilirubin levels rise rapidly and may become dangerous.
- Requires urgent medical management.
6 – Other Special Types
- Gilbert’s Syndrome Jaundice: Mild, hereditary condition with reduced bilirubin conjugation; usually harmless.
- Crigler–Najjar Syndrome: Rare genetic defect in bilirubin conjugation enzyme; leads to severe unconjugated hyperbilirubinemia.
- Dubin–Johnson Syndrome / Rotor Syndrome: Genetic disorders causing impaired excretion of conjugated bilirubin.
Diagnosis of Jaundice
To confirm jaundice and its cause, doctors may recommend:
1 – Physical Examination
- Checking for yellow discoloration of skin and eyes.
- Palpation of liver and spleen.
2 – Blood Tests
- Bilirubin test (total, direct, indirect).
- Liver function tests (LFTs) to check enzyme levels.
- Complete blood count (CBC) for blood disorders.
- Viral markers (Hepatitis A, B, C tests).
3 – Imaging Tests
- Ultrasound of the abdomen (to detect gallstones, liver disease, or blockages).
- CT scan or MRI for detailed imaging.
4 – Liver Biopsy
- In some cases, a small tissue sample from the liver is examined to identify the cause.
Treatment of Jaundice
Treatment depends on the underlying cause of jaundice.
1 – For Liver Diseases
- Antiviral drugs for hepatitis.
- Avoiding alcohol and harmful medications.
- Medications to reduce liver inflammation.
- Liver transplant in severe cases.
2 – For Blood Disorders
- Treating malaria with anti-malarial drugs.
- Blood transfusion in severe anemia.
- Medications for hemolytic anemia.
3 – For Obstructive Jaundice
- Surgery to remove gallstones.
- Stent placement in bile ducts.
- Treatment of pancreatic or bile duct cancer.
4 – For Neonatal Jaundice
- Phototherapy (exposing baby to special blue light).
- Exchange blood transfusion in severe cases.
- Frequent breastfeeding to flush bilirubin.
Home Remedies and Lifestyle Management
- Although medical treatment is essential, certain lifestyle changes can help manage jaundice:
- Eat a balanced diet with fruits, vegetables, and whole grains.
- Avoid alcohol completely.
- Drink plenty of water and fluids.
- Take adequate rest to support liver recovery.
- Avoid oily, spicy, and junk foods.
- Include herbal remedies like turmeric, aloe vera, and sugarcane juice (only after consulting a doctor).
Complications of Untreated Jaundice
- If left untreated, jaundice can lead to serious health problems:
- Liver failure
- Chronic liver disease (cirrhosis)
- Brain damage in newborns (kernicterus)
- Severe anemia
- Sepsis and multi-organ failure
Prevention of Jaundice
- Preventing jaundice involves maintaining liver and overall health.
- Get vaccinated against Hepatitis A and B.
- Practice safe food and water hygiene to avoid infections.
- Avoid excessive alcohol consumption.
- Maintain a healthy body weight.
- Use safe sexual practices to prevent hepatitis transmission.
- Get regular health checkups if you have liver disease.
Jaundice in Newborns: Special Attention
- Common in the first week of life due to immature liver.
- Most cases resolve within 1–2 weeks.
- Parents should monitor their baby for yellow skin, poor feeding, or drowsiness.
- Phototherapy is the standard treatment.
- Severe jaundice requires immediate medical care to prevent brain damage.
Frequently Asked Questions (FAQs)
Q1. Is jaundice dangerous?
Jaundice itself is not always dangerous, but it can be a sign of a serious underlying disease. Early diagnosis is important.
Q2. Can adults get jaundce?
Yes, jaundice can occur in both adults and children due to liver disease, gallstones, or blood disorders.
Q3. What foods are good for jaundce?
Fresh fruits, green leafy vegetables, whole grains, sugarcane juice, coconut water, and light home-cooked meals are beneficial.
Q4. Can jaundce be cured permanently?
Yes, if the underlying cause is treated, jaundice can be cured. For example, gallstone removal or hepatitis treatment can resolve it.
Q5. Is jaundce contagious?
Jaundice itself is not contagious, but some causes like hepatitis A, B, and C are infectious.