Jaundice is known as yellowing of the skin, mucous membranes or eyes due to a high concentration of bilirubin in the blood. Thus, normal numbers of bilirubin are 0.3-1 mgr / dl, while jaundice is detected when serum levels are greater than 2 mgr / dl. In this article, we will try to give you best jaundi
Bilirubin is the product that is obtained from the disintegration of the red blood cells of hemoglobin and may increase because of various diseases of the liver, gallbladder, pancreas or blood. Bilirubin sits in the tissue and causes the skin, mucous membranes and membrane of the eye (sclera) to turn yellow. It is easy to recognize if general concentration of bilirubin in the blood is greater than two milligrams per deciliter (mg / dl).
This can occur when liver is damaged by a virus (different hepatitis), gallstones, blood disorders, pancreatic cancer, accumulation of bile in the gallbladder, for example during pregnancy (jaundice of pregnancy). Of all the pathological causes of jaundice, the most frequent one for the organism is yellowing coloration in the babies. This is called jaundice of the newborn.
Thus, newborns tend to have higher levels of bilirubin after birth (physiological jaundice). The baby’s liver is responsible for eliminating this bilirubin, but may take some time, usually two weeks. During lactation, this problem (jaundice due to lactation) may also occur when newborn does not feed well or the mother’s milk comes out very slowly, usually in the first week.
Severe jaundice of the newborn can occur if the baby has a condition that increases number of red blood cells due to infection, lack of some proteins, sickle cell anemia, etc.
Jaundice can cause other symptoms besides the typical coloration of the skin. These symptoms are as follows:
- Stomach ache
- Change in stool color (depending on the cause of hepatitis, it will be darker or lighter)
- Changes in urine color (dark brown)
- Itching (pruritus)
- There are other causes that can cause yellowing of the skin such as uremia, increased consumption of carotene, or consumption of quinacrine, a medicine that stains yellow skin.
What Causes Jaundice?
Causes of jaundice are found in high levels of bilirubin in the blood, indicating an alteration in bilirubin metabolism. The liver performs primary function in the metabolism of bilirubin. For this reason, the causes of jaundice can be classified according to the location in the liver where the alteration occurs. In this way, we can identify prehepatic, hepatic or posthepatic jaundice.
- Prehepatic jaundice: The causes of prehepatic jaundice mainly target diseases in the blood associated with an increase in the disintegration of red blood cells or erythrocytes (haemolysis). In this case, excess bilirubin, a product of hemoglobin disintegration is released. Prehepatic jaundice may also appear in complications in a blood transfusion. Prehepatic jaundice is also called non-hepatic jaundice, since the causes of the pathological process are not found in the liver but in the blood.
- Hepatic jaundice: The most common causes of hepatic jaundice are inflammation of the liver (hepatitis). Among many other causes, viruses, for example the hepatitis B virus. Drugs or alcohol (up to liver cirrhosis) can cause inflammation in the liver. A dysfunction in metabolism that can lead to jaundice is called familial hyperbilirubinemia.
- Post-hepatic jaundice: The most common causes of posthepatic jaundice are gallbladder and bile disorders. Bile forms in the liver and goes through bile ducts to the gall bladder and posterior to the intestine, where it performs digestion. In bile, there is a large amount of bilirubin. If bile ducts are blocked, bile flow (cholestasis) is blocked and both bilirubin and other components of bile flow into the blood. Post-hepatic jaundice is also known as occlusive jaundice or obstructive jaundice.
Stones in the gallbladder or biliary tract, some tumors (gallbladder cancer, liver cancer or pancreatic cancer), adhesions after inflammation or surgery may occlude the bile ducts and thereby cause jaundice.
How is Jaundice Diagnosed?
It is important to determine the exact causes of jaundice to make a correct diagnosis. First, physician must perform detailed clinical interview (anamnesis) to delineate the causes. You can be asked questions about when jaundice appeared, whether you have or had other diseases (such as hepatitis, gallstones or cancer), if you notice any other discomfort (such as itching, weight loss, etc.), if you take medicines, if you drink alcohol and if you have recently traveled.
Then, your doctor will perform a complete physical examination in which doctor will palpate your liver under the right costal arch. In order to continue assessing the possible causes of jaundice, a blood test is necessary to know the values of bilirubin, hemoglobin, red blood cells (erythrocytes), specific gallbladder and liver values (eg gamma GT, alkaline phosphatase , GOT, GPT) as well as inflammation values. Occasionally, bilirubin can also be localized in the urine and in the stools, so a urine and bowel analysis would help establish the correct diagnosis.
If it is necessary, an ultrasound scan of the upper abdomen can be performed. Other analyzes, such as endosonography (esophagus ultrasonography), ERCP (endoscopic retrograde cholangiopancreatogram), computed tomography or nuclear magnetic resonance (MRI) or liver biopsy (tissue sample from the Liver) would be necessary depending on the result.
How is Jaundice Treated?
There is no treatment for jaundice. Because, jaundice is not a disease itself but it is a symptom of another disease. For this reason, treatment is directed towards to causes that have triggered this increase of blood bilirubin. Thus, for example, an obstruction of the bile ducts by a stone in the gallbladder should be eliminated immediately, so that the bile can flow again and yellowish coloration of the skin disappears. To resolve this pathology that produces jaundice are effective treatments such as endoscopy or surgery.
If alcohol, drugs or other toxic are responsible of jaundice, you should stop consuming them and consult with the doctor which treatment is the most appropriate. Similarly, hepatitis should be treated appropriately, so that the level of bilirubin in the blood decreases and the skin and mucous membranes recover to their natural color.
Treatment for lactation jaundice will depend on the baby’s bilirubin level, blood group and the times which symptom occurs. When the bilirubin level is greater than 20 mg / dl, it is recommended to stop breastfeeding baby for a day or two days to lower this level. In some cases the baby must be admitted to the hospital for a more complete treatment and lower these levels. In addition, it is important to maintain a good hydration orally at all times. If it is insufficient, it will have to be administered intravenously.
Also, if the baby’s blood group is different from baby’s mother, it can lead to jaundice, because the mother produces antibodies against her child’s red blood cells and destroys them by secreting more bilirubin.
It is important that baby must be treated on time and receive appropriate treatment to lower bilirubin levels because it can cause damage to the brain or other organs.