JAUNDICE

Disease:

Jaundice

Description:

Yellowish or greenish pigmentation of the skin and whites of the eyes

Symptoms

  • Yellow-tinted skin and eyes
  • Dark urine and pale stools. 
  • Excessive fatigue and vomiting (in case of viral hepatitis)
  • Pruritis (itchiness)
  • Fever, Headache
  • Abdominal pain – typically indicates a blockage of the bile duct.
  • Weight loss, Swelling of the legs
  • Vomiting
  • Fever, Weakness
  • Dark Urine & paler than usual stools
  • Loss of apetite
  • Swelling and distension of the abdomen due to the accumulation of fluid

Causes:

Pre hepatic Causes :

  • Excessive destruction (hemolysis) of RBCs.
  • Increase in the amount of unconjugated bilirubin
  • Caused due to Malaria, Thalassemia, Sickle cell disease, G6PD deficiency,

Hepatic Causes:

  • Abnormalities in the metabolism and/or excretion of bilirubin
  • Leads to Acute or chronic hepatitis, Autoimmune disorders, Liver cancer.

Post Hepatic Causes:

  • excretion of conjugated bilirubin in the form of bile
  • Caused due to Gall stones, Cancer, Pancreatitis, Parasites (Liver Flukes)

Other Causes:

  • hepatitis, cirrhosis,Catarrhal jaundice (Caused due to Viral Infection)
  • Gilbert’s syndrome
  • Pseudojaundice (Yellowing of skin due to excess of beta carotene)

Risk Factors

  • Hereditary conditions
  • Liver diseases and liver cancer
  • Alchoholic Hepatitis (leading to development of jaundice)
  • Viral Hepatitis (leading to development of jaundice)

Diagnostic Tests

  • Liver function tests
  • Complete blood count
  • Imaging studies (MRI)
  • Abdominal ultrasonography (Identification of gall stones)
  • CT scan
  • Endoscopic retrograde cholangiopancreatography (ERCP) or a liver biopsy.

Differential Diagnosis

  • Yellow fever
  • Weil’s disease
  • Change in the state of liver (enlarged or tender)
  • Increased Body temparature
  • Elevated serum cholesterol
  • Severe itching (due top deposition of bile salts)

Treatments

  • Having iron rich food (Anemia induced jaundice)
  • Anti-viral or steroid medications. (For hepatitis induced jaundice)
  • Surgery to remove the obstruction
  • Alcohol cessation
  • Surgeries (Liver Transplant) in cases of liver failure or cirrhosis
  • Phototherapy (to remove excess bilirubin)
  • Blood Transfusions (for Severe cases)

Medications

  • Antibiotics (for infectious causes)
  • Treat the underlying infection (malaria)
  • Replacement of RBCS (for sickle cell anemia, thalassaemia)
  • Blood Transfusions
  • Anti-viral or steroid medications ( for hepatitis induced jaundice)

Lifestyle Management

  • Balanced diet
  • Exercising regularly
  • Low alcohol consumption
  • Avoiding unprotected intercourse or intravenous drug use
  • Vaccination against hepatitis A and hepatitis B
  • Avoiding contaminated food products or unsanitary water