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jaundice

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Biliary System

Alternative Names
icterus

Definition
Jaundice is a yellowish discolouration of the eyes and skin.

What is going on in the body?
Jaundice is a condition caused by too much bilirubin in the blood. Bilirubin is a yellowish-orange breakdown product of red blood cells. It is removed from the blood by the liver. Bilirubin is then processed by the liver, passed into the bile, and excreted into the stool. If it is not excreted, it builds up in the blood. Eventually, the bilirubin can get deposited into the surface of the body. This can cause a yellowish tint to the skin, eyes and lining inside the mouth.

What are the signs and symptoms of the condition?
Jaundice is considered a sign of disease that has affected the level of bilirubin in the body. Those with jaundice may have no other symptoms. Other symptoms may occur, depending on the cause, including:
  • nausea and decreased appetite
  • vomiting
  • fever
  • weight loss
  • itching
  • dark urine
  • clay-coloured stool
  • abdominal pain
What are the causes and risks of the condition?
Jaundice can be caused by:
  • immaturity of the liver, which happens in a large number of newborn infants. This is usually normal, goes away on its own, and results in no problems. It is more common when babies are born early, or premature.
  • liver disease, such as liver infection, damage from alcohol or other toxins or drugs, or cancer.
  • obstruction of bile flow, which may be caused by certain drugs, gallstones, or cancer.
  • destruction of a large number of red blood cells, which may occur due to inherited defects in red blood cells, medications, or infections.
  • inherited disorders that affect metabolism.
What can be done to prevent the condition?
In adults, two of the most common causes of jaundice are viral liver infection known as hepatitis, and alcohol. Alcohol does not cause this condition unless it is abused. Vaccines for hepatitis A and B are available and can prevent some cases of viral hepatitis. Many cases of jaundice cannot be prevented.

How is the condition diagnosed?
The affected person as well as the doctor usually notice jaundice. Further tests are usually done to determine the cause of the jaundice. These commonly include urine, blood, and x-ray tests.

What are the long-term effects of the condition?
Jaundice itself doesn't have any long-term effects. It is a description of the yellowish tint that occurs. However, the underlying cause of the jaundice may have severe long-term effects, including liver failure and death. Babies with jaundice may rarely develop brain damage if the level of bilirubin gets too high.

What are the risks to others?
Jaundice itself is not contagious and poses no risks to others. If viral hepatitis is the cause of the jaundice, it may or may not be contagious. The forms of hepatitis that are contagious are usually spread by sexual contact or sharing of needles, such as by intravenous drug users or by poor hygiene.

What are the treatments for the condition?
Most cases of jaundice in a newborn do not need treatment. If newborn babies develop severe jaundice, they may be put under special lights that cause a chemical change in bilirubin. This change allows the bilirubin to be excreted by the body. For extremely high levels of bilirubin, babies may need special blood transfusions that trade normal blood for their high-bilirubin blood. Treatment for other types of jaundice depends on the cause. Medications, such as antibiotics, or surgery may be needed in some cases.

What are the side effects of the treatments?
The lights used to treat babies with jaundice may cause diarrhoea, rash, overheating, and dehydration. If a transfusion is needed, infection may occur. All medications have potential side effects. These may include allergic reactions, stomach upset, and others. Specific side effects depend on the drugs used. Surgery carries a risk of bleeding, infection, and reactions to the pain medications used.

What happens after treatment for the condition?
This depends on the underlying cause. The underlying cause may be treated or resolve on its own, causing the jaundice to go away. In this setting, no further treatment may be required and people can usually return to normal activities. In other cases, the underlying condition cannot be fixed. This is common with severe, permanent liver damage or cancer. In this case, treatment does not usually end.

How is the condition monitored?
This also depends on the underlying cause. Both the affected person and the doctor can monitor the jaundice itself. Repeated blood tests can monitor the bilirubin level, liver function, and other factors. More specific monitoring depends on the underlying cause.

Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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