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Also called: Icterus


Image source : Wikipedia

What is jaundice ?

         Jaundice is a yellowing of the skin and the whites of the eyes caused by an accumulation of a cellular waste production called bilirubin. The discoloration is often, but by no means always, accompanied by itching, which can be intense, as well as by nausea, vomiting, headache, fever, dark-colored urine, abdominal pain, loss of appetite, abdominal swelling, and light-colored stools.

         Jaundice is not a disease in and of itself, but a sign that the liver is having a problem handling bilirubin as it should. The liver makes bilirubin from dying red blood cells and other sources. It then converts bilirubin into bile, which has several purposes, among them the digestion of fatty acids and neutralization of stomach acid. If there is too much bilirubin for the liver to deal with, or if the liver's functioning is compromised, jaundice can result.

         The specific causes of jaundice are numerous. The major categories of problems that can lead to jaundice include conditions that results in an excessive breakdown of red blood cells; hereditary disease that impair the liver's ability to convert bilirubin into bile; liver damage from exposure to toxic chemicals, including alcohol, carbon tetrachloride, and others; liver diseases such as hepatitis, bacterial infection, parasitic infestation, or cancer; and obstructions that block the outflow of bile so that it cannot leave the liver as it is supposed to. Newborns often develop some degree of jaundice in the days after birth, as their bodies adjust to life outside the womb, but this is not usually a serious problem.

         An extensive medical workup may be required t determine the precise cause of jaundice. A detailed medical history is an important first step. Illness you may have been exposed to, medications your take or have taken, possible exposures to toxic compounds or alcohol, travel to places where food and/or water safety might be questionable, possible encounters with infected animals, a family history of blood diseases, liver problems, chromosomal abnormalities, cancer, or HIV disease - all of these are important factors that can help your physician in evaluating the cause of the problem. Laboratory tests are done to examine the levels of enzymes and other body chemicals directly involved in the health of the liver. These can help determine where along the line of processing bilirubin the problem may be. Ultrasound, computerized tomography, and magnetic resonance imaging are imaging studies that may be done to detect blocked ducts, tumors, liver enlargement, and changes in blood-vessel size that might lead to an explanation. Though the blood work and some phases of the imaging scans require the insertion of a needle in a vein, these studies are considered minimally invasive.

         If an obstruction becomes the likely explanation, one of two other tests may be performed. These are endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC). Both involve guiding a catheter to the site of interest, then injecting a dye that can be seen on an x-ray study. In ERCP, the catheter is inserted through the intestinal tract; in PTC, it is inserted through the skin.

         If no cause can be found by any other techniques, a percutaneous liver biopsy may be recommended. In this test, a needle is inserted through the skin and into the liver, sometimes with the guidance of ultrasound or a CT scan, and a sample of liver tissue is removed for microscopic examination.

Causes of Jaundice : May be the following -
  • Blood diseases
  • Genetic syndromes
  • Liver diseases, such as hepatitis or cirrhosis
  • Blockage of bile ducts
  • Infections
  • Medicines

Treatment :

          Treatment depends on the underlying cause, and may involve removal of the offending agent; administration of antibiotic, antiviral, antifungal, or antiparasitic drugs; surgery to correct blockage; the use of chemotherapy, antiflammatory, or steroid medications, dietary changes; measures to minimize symptoms; or any combination of the above. The need to limit activity depends entirely on the underlying cause of the jaundice, but in general, only serious problems require severe limitations.

© 2018 by Partha Sarathi(Director)