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Jaundice

(Yellowing of Skin)

Definition

Jaundice is a yellow discoloration of the skin, mucus membranes, and whites of the eyes.

Causes

Jaundice is caused by an excess of bilirubin in the blood. Bilirubin is a yellow-brown colored substance in bile. Bile is a liquid that carries waste products and bilirubin away from the liver. It also helps break down fats in the small intestine. It is formed during the body's normal process of breaking down red blood cells.

There are several reasons why too much bilirubin can build up in the blood. They include:

  • Excess breakdown of red blood cells, which can occur in:
  • A blockage in or near the liver that prevents the flow of bile such as:
  • Liver damage caused by:
  • In babies, insufficient amounts of a certain liver enzyme during the first 2 weeks of life
  • Inherited metabolic disorders, including Gilbert, Crigler-Nager, and Dubin-Johnson syndromes

Liver, Gallbladder, and Bile duct
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Risk Factors

Factors that may increase the chances of jaundice are similar to risk factors for liver and gallbladder disorders. They may include:

Symptoms

Jaundice may indicate another condition or disease. In addition to jaundice, you may experience other symptoms. Symptoms may include:

  • Fatigue
  • Itching
  • Fever or chills
  • Unexplained weight loss

Diagnosis

Your doctor will ask you questions about your symptoms and medical history. A physical exam will be done. In order to make a diagnosis on what is causing jaundice, your doctor may recommend tests. Tests may include:

Treatment

In most other types of jaundice, the specific condition causing it must be treated. There are many treatments that may be used for liver and gallbladder problems depending on the exact condition. They include:

  • Avoiding substances that cause jaundice such as alcohol or medication
  • Addressing the cause of anemia
  • Taking medication to treat infectious diseases
  • Relieving bile duct obstructions by:

Mild jaundice in newborns is common and usually clears without treatment. If bilirubin levels rise above a certain level, the baby may receive phototherapy, which is treatment with a special ultraviolet light. In Gilbert syndrome, jaundice tends to clear without treatment.

Prevention

Prevention depends on the disorder causing jaundice. You may not be able to prevent some of the disorders. However, you can take the steps below to decrease your chance of developing liver disease:

  • Drink alcohol in moderation. Moderation is no more than 2 drinks per day for men or 1 drink per day for women.
  • Be careful mixing alcohol with other medications such as acetaminophen.
  • Avoid exposure to industrial chemicals.
  • Do not use illicit drugs.
  • Do not share needles or nasal snorting equipment.
  • Practice safe sex.
  • To decrease your risk of hepatitis A, get the hepatitis A vaccine.
  • To decrease your risk of hepatitis B, get the hepatitis B vaccine.
RESOURCES:

American Gastroenterological Association
http://www.gastro.org

American Liver Foundation
https://www.liverfoundation.org

CANADIAN RESOURCES

Canadian Liver Foundation
https://www.liver.ca

Health Canada
https://www.canada.ca

REFERENCES:

Abnormal liver function tests—approach to the patient. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T316452/Abnormal-liver-function-tests-approach-to-the-patient. Updated February 19, 2018. Accessed April 4, 2018.

Bilirubin. Lab Tests Online—American Association for Clinical Chemistry website. Available at: https://labtestsonline.org/tests/bilirubin. Updated April 4, 2018. Accessed April 4, 2018.

Neonatal hyperbilirubinemia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116718/Neonatal-hyperbilirubinemia. Updated July 31, 2017. Accessed April 4, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Daus Mahnke, MD