Jaundice Introduction Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. Jaundice is a symptom of a disease rather than a disease itself. A number of different conditions can cause jaundice. This reference summary will help you understand jaundice. It discusses the symptoms, causes, diagnosis and treatment. What is Jaundice? Jaundice comes from the French word jaune, which means yellow. When a person has jaundice, their skin looks yellow. The whites of their eyes can also turn yellow. A yellow substance called bilirubin is what makes a person with jaundice have a yellow color. It collects in the skin and the white area of a person s eyes. Bilirubin is an important part of red blood cells. Red blood cells are the oxygen carrying cells in the blood. When we breathe in, we bring oxygen into our lungs. Red blood cells pick up oxygen from the lungs. They carry the oxygen to the cells of the body. Without Jaundice With Jaundice The cells in the body release carbon dioxide as they use the oxygen. Carbon dioxide is also called CO2. The red blood cells remove the CO2 from the cells and take it to the lungs where it is breathed out. The body gets rid of old red blood cells and replaces them with new ones all the time. Old red blood cells contain bilirubin, the substance that causes jaundice. 1
Bilirubin is usually cleaned out from our body through the liver. The liver creates bile that has the bilirubin in it. The bile goes through the lower digestive tract. Finally it leaves our body in stools when we use the bathroom. Bilirubin is what gives our stools their brownish color. Jaundice happens when there is too much bilirubin in the body. The bilirubin is not being cleaned out and removed as it should be. The bilirubin that has not been cleaned from the body collects in the skin. Liver Jaundice in newborn babies is a very common condition. A newborn s liver may not have matured enough to clean out the bilirubin. Fortunately, most cases of jaundice in newborns go away on their own. Symptoms Jaundice may appear slowly. It may also begin suddenly. The most common symptom of jaundice is yellowing of the skin. The white part of the eyes may also turn yellow, as well as the inside of the mouth. Severe jaundice may turn the skin and the whites of the eyes brown. Other symptoms of jaundice include: Urine that is dark yellow or brown. Skin that is itchy. Stools that are pale or clay-colored. A person with jaundice may experience other symptoms. These symptoms depend on the cause of the jaundice. For example, if cancer is causing the jaundice, a person may also feel tired and lose weight. A person may have yellow-orange skin without having jaundice. This is more likely if the whites of the eyes are not yellow. Skin can turn yellow-orange if too much beta carotene is eaten. This is sometimes called pseudojaundice. Beta carotene is a substance found in yellow and orange fruits and vegetables. It is also found in dark green, leafy vegetables. Beta carotene gives these foods their color. Also, the body uses beta carotene to make vitamin A. 2
Causes Jaundice is a symptom of a disease rather than a disease itself. A number of different conditions can cause jaundice. Common causes of jaundice are viral hepatitis, a parasite infection of the liver, gallstones and pancreatic cancer. Hepatitis is a viral infection that causes inflammation of the liver. There are different hepatitis viruses: hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. A parasite is an animal or plant that gets nutrients by living on or in an organism of another species. Gallstones are solid materials that form in the gallbladder or common bile duct. Gallstones are made of cholesterol or other substances found in the gallbladder. Pancreatic cancer is cancer that Gallstones begins in the pancreas. The pancreas is located in the abdomen, behind the bowels and in front of the spine. Jaundice may also be caused by other illnesses that affect the body s ability to break down bilirubin. Any disease that damages the liver may also cause jaundice. For example, autoimmune hepatitis causes your body to attack the liver by mistake. Hemolytic anemia may also cause jaundice. In hemolytic anemia, the body gets rid of too many red blood cells. The liver can t handle the excess red blood cells. This causes jaundice. Jaundice may also be caused by disorders of the gallbladder and bile duct. A bile duct may become blocked or damaged due to gallstones, infection, tumor or narrowing. A blockage of the bile duct causes the bilirubin to back up into the blood. Sometimes pregnancy may cause temporary jaundice. Pregnancy causes a buildup of pressure in the belly area. This can cause bile to build up in the gallbladder. Other causes of jaundice include: Eating or drinking poisons, such as poisonous mushrooms. Using certain drugs, such as taking too much acetaminophen or Tylenol. 3
Diagnosis To diagnose jaundice, your health care provider will ask you about your symptoms and do a physical exam. If you have jaundice, your health care provider may also order other blood tests to try and determine what is causing the jaundice. An ultrasound may be done to diagnose the cause of jaundice. An ultrasound can look at the gallbladder, liver and other organs in the abdomen by using sound waves. These sound waves create pictures of the inside of the body. A CT scan may also be used to look at the organs in the abdomen. A CT scan is an x-ray machine linked to a computer. It takes a series of detailed pictures of your organs. To look at the bile and pancreatic ducts, an ERCP may be performed. It is a procedure in which a thin tube, called an endoscope, is passed through the mouth to the beginning of the small intestine. A dye is injected into the ducts and x-rays are taken. ERCP stands for Endoscopic Retrograde Cholangiopancreatography. It is usually performed by a gastroenterologist or radiologist. A liver biopsy may also be done. A biopsy is a removal of cells or tissue for examination under a microscope. This may help determine the cause of jaundice. ERCP Treatment The treatment for jaundice depends on the underlying cause of jaundice. Treating the condition that is causing jaundice is the first step in getting rid of jaundice. If a disease of the liver caused the jaundice, it will usually improve on its own as the liver improves. Liver biopsy If jaundice is caused by a blocked bile duct, surgery is usually needed to unblock the duct. Pregnancy may cause temporary jaundice. This will usually go away after the baby is delivered. In more severe cases of jaundice, a liver transplant may be needed. 4
Jaundice is a symptom of a disease rather than a disease itself. A number of different conditions can cause jaundice. Talk to your health care provider about the possible treatment options for jaundice. These will depend on what is causing the jaundice. Summary Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. Jaundice may appear slowly. It may also begin suddenly. The most common symptom of jaundice is yellowing of the skin. The white part of the eyes may also turn yellow, as well as the inside of the mouth. Jaundice is a symptom of a disease rather than a disease itself. A number of different conditions can cause jaundice. The most common causes of jaundice are viral hepatitis, a parasite infection of the liver, gallstones and pancreatic cancer. The treatment for jaundice depends on the underlying cause. Talk to your health care provider about the treatment options for jaundice. Often jaundice will go away over time if the underlying cause is treated. 5