Jaundice
Ashley Hahn, Amanda Kishazy
Description
Jaundice, also known as icterus, is a yellowish tinge to the skin and sclerae (the white part of the eye) that is caused by hyperbilirubinemia (an excess of bilirubin in the blood). Body fluids may also be yellow. The color of the skin and sclerae varies depending on levels of bilirubin; mildly elevated levels display yellow skin and sclerae, while highly elevated levels display brown.
Signs/Symptoms
- As well as the classic yellow tinge to the skin and whites of the eyes, someone with jaundice may also have yellowing of mucous membranes in the mouth and nose.
- Stools can be pale in color and urine dark in color.
- Some underlying conditions, which lead to jaundice, may feel like flu, and may also result in fever, chills, stomach pain, itching or weight-loss or be without an explanation such as a diet.
APA Sources
Jaundice: Causes, symptoms, diagnosis, treatment, prevention. (n.d.). Retrieved December 12, 2014, from http://www.webmd.boots.com/a-to-z-guides/jaundice
Jaundice (Adults) Symptoms, Causes, Treatment - What is the treatment for jaundice in adults? - MedicineNet. (n.d.). Retrieved December 12, 2014, from http://www.medicinenet.com/jaundice_in_adults/page6.htm#what_is_the_treatment_for_jaundice_in_adults
Causes of Jaundice
- When red blood cells break down naturally in a 120-day cycle, bilirubin is produced as a waste by-product.
- The journey bilirubin takes out of the body's waste disposal systems takes it carried by blood to the liver. There is it combined with bile (digestive fluid) from the gallbladder.
- This mixture exits the body through poop and urine. If everything is working well, poop should be brown and urine light yellow.
- Infections or damage can disrupt this process, leading to jaundice.
Diagnosis
- The yellowing of skin and eyes are likely to be the main clues a doctor will use before confirming a jaundice diagnosis.
- A person will be asked about other symptoms and risks, such as foreign travel or illegal drug use.
- A physical examination will be carried out to look for signs of swelling of the liver and legs, ankles or feet which might indicate cirrhosis of the liver.
- Urine can be tested for urobilinogen, which is produced when bilirubin is broken down. Finding high or low levels can help pinpoint the type of jaundice.
- Blood tests may be used to check for conditions like malaria or hepatitis.
- A liver function blood test may indicate hepatitis, cirrhosis or alcoholic liver disease. Sometimes a liver biopsy - removal of small tissue sample - is needed to confirm or rule out conditions such as cirrhosis or liver cancer.
- Doctors may also need to look inside the body for problems with the liver or bile duct using ultrasound, X-ray with contrast, MRI or CT scans.
Treatment
- In certain individuals with jaundice, the treatment will consist of supportive care and can be managed at home. For example, most cases of mild viral hepatitis can be managed at home with watchful waiting and close monitoring by your doctor (expectant management).
- Alcohol cessation is necessary in patients with cirrhosis, alcoholic hepatitis, or acute pancreatitis secondary to alcohol use.
- Jaundice caused by drugs/medications/toxins requires discontinuation of the offending agent. In cases of intentional or unintentional acetaminophen overdose, the antidote N-acetylcysteine (Mucomyst) may be required. acetaminophen overdose,
- Various medications may be used to treat the conditions leading to jaundice, such as steroids in the treatment of some autoimmune disorders. Certain patients with cirrhosis, for example, may require treatment with diuretics and lactulose.
- Antibiotics may be required for infectious causes of jaundice, or for the complications associated with certain conditions leading to jaundice (for example, cholangitis)
Prognosis
Outcome depends on the cause. As the underlying condition improves, the jaundice will usually disappear. Individuals with jaundice secondary to cirrhosis may develop kidney or liver failure. Individuals with jaundice secondary to acute viral hepatitis may develop chronic active hepatitis.
ERCP is usually successful in removing stones that are often the source of obstructive jaundice. Therefore, once the obstruction is relieved, the jaundice clears. Complications that may arise from ERCP, however, include pancreatitis and, less commonly, inflammation of the bile duct (cholangitis) and bleeding or duodenal perforation.
ERCP is usually successful in removing stones that are often the source of obstructive jaundice. Therefore, once the obstruction is relieved, the jaundice clears. Complications that may arise from ERCP, however, include pancreatitis and, less commonly, inflammation of the bile duct (cholangitis) and bleeding or duodenal perforation.