What is Jaundice?

Jaundice is a condition characterized by yellowing of the skin and the sclera (white portion of the eyes). Yellowing of the skin is caused by a yellow substance present in the blood called Bilirubin. When the body can't properly process the bilirubin, jaundice occurs. The break down of blood cells is the body’s natural process to build new cells. These broken RBCs replaced with the new cells and processed by the liver after breakdown. When the liver is unable to process or can't get rid of the blood cells when they break down, jaundice occurs. Jaundice is the most common health problem in babies.

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What is Bilirubin?

Bilirubin is a yellow coloured substance formed after the breakdown of red blood cells. The unconjugated or indirect or albumin-bound bilirubin is produced by the breakdown of red blood cells. This indirect bilirubin is metabolized by the liver and produce conjugated or direct bilirubin. Bilirubin passes through the liver and excreted through urine or stool. The high level of bilirubin in the blood is the sign of excess hemolysis and the major sign of liver disease. The normal range of conjugated bilirubin in the body is 0-0.3 mg/dl and in case of Unconjugated bilirubin, the normal range is 0.1-1.2 mg/dl. Level of bilirubin higher than the given range is usually considered high.


Jaundice signs and symptoms

• Skin yellowing, yellowing of white part of the eyes
• Dark yellow urine and pale stools
• Excess fatigue
• Nausea and Vomiting
• Fever
• Loss of apetite
• Weight loss
• Muscle and joint pain


Causes of High bilirubin

Here are some conditions which cause a high level of bilirubin in the blood:
Gallstones: Blockade of gall bladder leads to high level of bilirubin.
Gilbert’s syndrome: A liver condition in which processing of the bilirubin in the liver is altered.
Liver dysfunction: Altered liver functions is the main cause of high bilirubin and thus causes jaundice. Conditions which can affect the live functions are cirrhosis, autoimmune disorders of the liver such as hepatitis, Liver cancer etc.
Bile duct obstruction
Hemolytic anaemia


Jaundice in newborn

Jaundice in infants characterized by yellow discolouration of skin and sclera (the white portion of the eyes) of a newborn baby. Jaundice is the most common problem in a newborn that require early medical attention. Infants develop jaundice within one week of their birth and most of the babies are still jaundiced in 1 month of the age. This early jaundice is also called physiological jaundice and it is harmless.

Cause of jaundice in newborns:The breakdown of Red cells in blood produces bilirubin. The concentration of RBCs in infants is comparatively higher than adults and having a shorter life span. So the bilirubin level in infants is higher than the adults as the rate of RBCs breakdown is higher.
Although the early jaundice is harmless, treatment is still needed to prevent the prolongation of this condition. Phototherapy is the safe and most effective treatment of jaundice in infants, in which bilirubin is controlled by placing the newborn baby under the lamp emitting light in the blue spectrum. The bilirubin than converts into harmless and excreted in the urine.


Diagnosis

A history of any liver disease will be taken by your doctor to conduct a physical exam.
Blood test: Blood test is performed to measure the amount of bilirubin, hepatitis virus antibodies, abnormal RBCs and other substances that are involved in the functioning of the liver or to trace the presence of diseases like hepatitis.
Liver function test: Liver function tests are performed to compare the levels of liver functional proteins and enzymes. Comparison is made between when the liver is in healthy condition and when it is damaged.
Liver biopsy: Samples of the liver tissues are collected and examined under a microscope. Abdominal ultrasounds, CT scans and MRI tests are also the preferred diagnostic procedures.

Treatments

Treatment of jaundice depends on the type of liver disease present. Treatment of liver disease which is the cause of jaundice is the ultimate treatment of jaundice. Such as if the alcoholic drinks are the cause of liver cirrhosis or hepatitis, then the drinking of alcoholic beverages should be avoided. If jaundice occurs by the lack of RBCs the treatment may include a blood transfusion. When liver disease is caused by any drug toxicity then stopping the drug therapy is needed to treat jaundice. Removal of the gall bladder is required in case of jaundice occur due to gall bladder stone. Liver cancer can also lead to jaundice which can be treated by radiation and chemotherapy.


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