Jaundice

Jaundice is a yellowing of the skin and the whites of the eyes caused by a buildup of a substance called bilirubin in the blood. Bilirubin is a yellow pigment that is created when the body breaks down old red blood cells. Normally, the liver processes bilirubin and removes it from the body. Jaundice is not a disease itself but a symptom of an underlying condition affecting the liver, gallbladder, or pancreas. 

Signs and symptoms

The most prominent sign of jaundice is the yellow discoloration of the skin and the whites of the eyes (sclera). In severe cases, the skin can appear brownish-yellow. Other symptoms depend on the underlying cause and can include: 

  • Dark-colored urine: As the body tries to get rid of excess bilirubin, it can lead to dark-colored urine.

  • Pale or clay-colored stools: This occurs when bilirubin cannot reach the digestive tract, where it would normally be expelled.

  • Itchy skin (pruritus): The buildup of bile salts in the skin can cause intense itching.

  • Flu-like symptoms: Fever, chills, and fatigue may accompany jaundice, especially if caused by an infection like hepatitis.

  • Abdominal pain: Pain in the belly area can be a symptom, particularly if the cause is a blocked bile duct or gallstones.

  • Weight loss: Unexplained weight loss can occur with more serious underlying conditions, such as cancer. 

Diagnosis

To diagnose jaundice and find its cause, a doctor will perform several tests: 

  • Physical exam: The doctor will check for the yellow tint in your skin and eyes, and may examine your abdomen for signs of an enlarged liver or other issues.

  • Blood tests: Blood tests are used to measure the level of bilirubin in your blood. They can also measure liver enzyme levels to see how well your liver is functioning. Additional blood tests can help identify issues like infections or blood disorders.

  • Imaging tests: Your doctor may order an ultrasound, CT scan, or MRI to get detailed images of your liver, gallbladder, and bile ducts. This can help detect blockages, tumors, or other abnormalities.

  • Liver biopsy: In some cases, a small sample of liver tissue may be taken for further examination. 

Treatment

The treatment for jaundice depends entirely on the underlying cause, and addressing that condition will resolve the jaundice. 

  • For infections: If a viral infection like hepatitis is the cause, the jaundice may clear up on its own as the infection resolves.

  • For blockages: If the bile ducts are blocked, a procedure may be done to clear the blockage. This is often done during an endoscopic procedure (ERCP), where instruments are used to remove gallstones or place a stent.

  • For other conditions: If a blood disorder, liver disease (like cirrhosis), or cancer is the cause, treatment will focus on managing that specific condition.

  • Symptom management: Some treatments can help with the symptoms of jaundice, such as medication for severe itching. 

Special note on newborn jaundice

Newborn jaundice is very common, especially in premature babies, and typically resolves on its own. This is because a newborn's liver is not yet fully developed. For more severe cases, treatment may involve: 

  • Phototherapy: Placing the baby under special blue lights, which helps break down the bilirubin so it can be passed more easily.

  • Increased feedings: Frequent feedings help move bilirubin out of the baby's body more quickly.

  • Exchange transfusion: This is a rare procedure for very severe jaundice where a portion of the baby's blood is replaced with donor blood. 

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