What is Jaundice?

Understanding Jaundice Disease: Types, Symptoms and Treatment Options

Jaundice, medically termed as hyperbilirubinemia, is characterized by the yellowing of body tissues, mucous membranes, and sclera (white portion of the eyes). It occurs when the liver doesn’t function properly to process bilirubin (a yellow substance released during the breakdown of red blood cells) in the blood. This leads to the accumulation of bilirubin in the blood, causing the yellowing effect.

A bilirubin level in the blood below 1mg/dl is considered within the normal range. If it rises to 3mg/dL or above, it indicates jaundice. However, a bilirubin level of 5mg/dL or above is diagnosed as jaundice in infants, but jaundice threshold may varies by hour of life (e.g., >12mg/dL at 72h).

Keep reading to understand the types, symptoms, causes, diagnosis, treatment options, and prevention tips for jaundice.

What are the Types of Jaundice?  

Certain underlying conditions cause the overproduction of bilirubin or prevent the liver from processing it. Listed below are the types of jaundice:

• Pre-hepatic Jaundice (Before the Production of Bilirubin)  : This type of jaundice occurs due to an elevated rate of blood hemolysis. In hemolysis, the red blood cells break down easily to release bilirubin. Blood hemolysis increases due to malaria, sickle cell anemia, thalassemia, and spherocytosis. It increases the load on the liver as it can’t process higher amounts of bilirubin at once. This accumulation of bilirubin in the body leads to the development of jaundice.
• Hepatic Jaundice (During the Production of Bilirubin) : This type of jaundice occurs when the hepatic cells don’t function effectively or are damaged, causing cirrhosis. It reduces liver function, causing the accumulation of bilirubin in the blood. The primary causes of hepatic jaundice are liver cirrhosis, viral hepatitis, alcoholic hepatitis, biliary cirrhosis, and liver cancer.
• Post-hepatic Jaundice (After the Production of Bilirubin) : The liver fails to process bilirubin into the bile ducts due to a blockage caused by gallstones, bile duct cancer, pancreatic cancer, pancreatitis, and biliary atresia. Therefore, it is also known as obstructive jaundice.

What are the Symptoms of Jaundice?

The intensity of the symptoms varies depending on the underlying cause or type of jaundice. It usually doesn’t show any serious symptoms. However, the healthcare professional can diagnose jaundice while looking for other ailments.

If the root cause of jaundice is any infection, then these symptoms may appear:  

• Fever
• Chills
• Stomachache
• Discoloration of the skin
• Dark or yellow urine
• Pale clay-colored stools

If an underlying infection is not causing jaundice, then you may experience pruritus (a disorder of the skin) and unexplained weight loss.

If biliary tract or pancreatic cancer is the underlying cause of jaundice, then the stomach is the primary symptom.

If reduced liver function has caused jaundice, then you may experience these symptoms:

• Inflammation in the joints (Polyarthritis)
• Chronic Hepatitis
• Acute Hepatitis- A, B, or C
• Pyoderma Gangrenosum (Disorder of the skin)

What are the Causes of Jaundice?

The underlying causes of jaundice depend on the type and severity of the condition. Here’s a breakdown of causes according to the type of jaundice diagnosed:

1. Causes of Prehepatic Jaundice:

• When the body breaks down a large hematoma and reabsorbs it back into the bloodstream, the liver can’t process huge amounts of bilirubin, hence causing jaundice.
• If the patient has hemolytic anemia, the red blood cells break down prematurely, shortening their normal lifespan.

2. Causes of Hepatic Jaundice:

• Viral infections like hepatitis A, chronic hepatitis B and C, and Epstein-Barr infections
• Hepatitis infection that is influenced by the intake of alcohol
• Autoimmune disorders
• Various rare genetic metabolic disorders
• Intake of certain medications and steroids, like penicillin, oral contraceptives, chlorpromazine, and acetaminophen, that can lead to toxicity.

3. Causes of Posthepatic Jaundice (Obstructive Jaundice):

• Gallstones
• Inflammation of the gallbladder
• Gallbladder Cancer
• Pancreatic Tumour

How is Jaundice Diagnosed?

The diagnosis of jaundice often begins with a physical examination, where the doctor will check the abdominal area, liver, and skin. After this, they will do the following:

Prescribe certain tests to identify the underlying cause of jaundice, such as:

• Bilirubin Tests: If unconjugated bilirubin levels are higher than conjugated bilirubin levels, then hemolytic jaundice is diagnosed.
• Complete Blood Count (CBC) Test: This test measures the number of red blood cells, white blood cells, and platelets in the body.
• Hepatitis A, B, and C Tests: These are liver function tests that measure the efficiency of liver function.

If the doctors suspect it to be obstructive jaundice, then they may also ask for imaging tests like MRI, CT scans, or ultrasounds to study the structure of the liver. They may also perform an Endoscopic Retrograde Cholangiopancreatography (ERCP), a process combining endoscopy and x-ray.

If they suspect inflammation, cirrhosis, cancer, or fatty liver, then they may also perform a liver biopsy. This process includes inserting a needle into the liver to obtain a small tissue sample to be examined under the microscope.

What are the Treatment Options for Jaundice?

Treatment of jaundice involves addressing the underlying cause, which worsens the condition:

• In case of acute viral hepatitis, jaundice will go away once the liver heals itself.
• If it’s due to obstruction in the bile duct, then the doctor may perform surgery to remove the obstruction.
• Jaundice often leads to skin itching, so the doctor may also prescribe antihistamines, such as cholestyramine. It is taken orally to remove the bile acids accumulating in the body, which causes itching.
• For newborn babies, phototherapy treatment is used to break down bilirubin, which can be released from the body. It uses a fluorescent white or blue-spectrum light to carry out this process. However, it hasn’t proven to be effective in adults.

How to Prevent Jaundice?

Preventing infections that lead to the accumulation of bilirubin in the blood is an effective measure of keeping jaundice at bay. Here are some tips to stay away from infections:

• Hepatitis infection can be prevented through vaccination, maintaining personal hygiene, and using safe sex practices.
• Reduce alcohol intake as much as you can to protect your liver.
• Maintain a healthy body weight.
• Incorporate healthy lifestyle habits to manage cholesterol.
• Avoid natural and herbal supplements that can be toxic to the liver. Always consult your doctor before including any supplement in your diet.

Early detection and timely treatment can help you avoid the potentially life-threatening consequences of jaundice. Seek immediate medical attention if the symptoms worsen. In this regard, it is wise to have health insurance to safeguard your health and finances during these critical times.

At Star Health, we offer comprehensive coverage for liver diseases, diagnostic tests, and hassle-free cashless treatment at over 14,000 network hospitals across India.

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