Causes and Symptoms of Jaundice

Causes of Jaundice

Jaundice can be caused by excessive break down of red blood cells or, by the liver being overloaded or damaged, or by the inability to move processed bilirubin from the liver through the biliary tract to the gut. Some of the common causes in adults are : 

Viral Hepatitis ( Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E). 
Blocked bile ducts ( by infection, tumour or gallstones) - blockage of the bile ducts decrease the flow of bile and bilirubin from the liver into the intestines. 
Drug-induced cholestasis ( bile pools in the gall bladder because of the effects of drugs)
Drug-induced Hepatitis ( Hepatitis triggered by erythromycin sulfa drugs, antidepressants, anti-cancer drugs, aldomet, rifampin, steroids, chlorpropamide, tolbutamide, oral contraceptives, testosterone, propyl-thiouracil).
Alcoholic liver disease ( alcoholic Hepatitis). 
Cancer of the pancreas.
Primary biliary cirrhosis. 
Pregnancy - bile pools in the gall bladder because of the pressure inside the abdomen. 
Haemolytic anaemia - patients with haemolytic anaemia have an abnormally rapid rate of destruction of red blood cells that releases large amounts of bilirubin into the blood. 
Disorders present since birth that cause problems processing bilirubin ( Gilbert's Syndrome, Dubin-Johnson Syndrome, Rotor's Syndrome, or Crigler-Najjar Syndrome) - a defect in the liver that prevents bilirubin from being removed from the blood, or secreted in bile. 
Chronic active Hepatitis. 

The most common causes of jaundice are viruses and alcohol, Hepatitis A and B are the commonest viruses causing jaundice. Chronic alcohol use may result in fatty liver ( steatosis), Hepatitis, and cirrhosis, with varying levels of jaundice. Hepatitis secondary to alcohol use typically presents with acute onset of jaundice and severe symptoms. Presence of gallstones in the gall bladder is a relatively common finding in adult patients with or without jaundice. Gall bladder cancer classically presents with jaundice, enlargement of liver and a mass in the right upper side of the abdomen. Jaundice also may arise secondary to pancreatitis. The most common causes of pancreatitis are gallstones and alcohol use. 

Symptoms of Jaundice

In medical terminology the term jaundice denotes serum bilirubin level greater than 1.5 mg dL in conjunction with a clinical picture of yellow skin and sclera. 

• Patients with jaundice may present with no symptoms at all ( the condition is found accidentally).

• Patients presenting with acute viral infection ( viral Hepatitis) may seek medical care because of fever, chills, abdominal pain, and flu-like symptoms. Depression can also occur in patients with chronic infectious Hepatitis and in those with jaundice due to alcoholism. 

• Patients with non-infectious jaundice may complain of weight loss or pruritus. 

• Abdominal pain is the most common presenting symptom in patients with cancer of the pancreas or biliary tract. 

Jaundice by itself causes a few problems. It can turn the skin and sclerae yellow . The stool becomes light in colour, even clay-coloured because of the absence of bilirubin that normally gives stool its brown colour. The urine turns dark yellow or brownish. When the bilirubin levels become very high itching starts in the body. 

It is the disease causing the jaundice that causes most problems associated with jaundice. Specifically, if the jaundice is due to a live disease, the patient may have symptoms or signs of liver disease or cirrhosis ( advanced liver disease), which include fatigue, swelling of the ankles, muscle wasting, ascites ( fluid accumulation in the abdominal cavity), mental confusion or coma, and bleeding into the intestines 

If the jaundice is caused by blockage of the bile ducts, no bile enters the intestine. Bile is necessary for digesting fat in the intestine and releasing vitamins from within it so that the vitamins can be absorbed into the body. Therefore, blockage of the flow of bile can lead to deficiencies of certain vitamins . For example, there may be a deficiency of Vitamin K that prevents proteins that are needed for normal clotting of blood to be made by the liver, and, as a result, uncontrolled bleeding may occur. 

Diagnosis of Jaundice

Patients history can suggest possible reasons for the jaundice. For example, heavy use of alcohol suggests alcoholic liver disease, whereas use of illegal, injectable drugs suggests viral Hepatitis. Recent initiation of a new drug suggests drug-induced jaundice. Episodes of abdominal pain associated with jaundice suggests blockage of the bile ducts usually by gallstones. 

Jaundice
Causes and Symptoms of Jaundice
Urine Analysis and Blood Testing for Jaundice