Jaundice – Causes and Treatment

Jaundice is the name for yellow discoloration of the skin and the whites of the eyes. It is a symptom of many disorders of the liver, gallbladder and pancreas, and may also be caused by some blood disorders.

Jaundice results from excessively high blood levels of the pigment bilirubin, a breakdown product of red blood cells. Bilirubin is processed by the liver and then excreted as a component of bile. In liver disease the liver cannot process bilirubin, so levels gradually rise in the blood, leading to jaundice. If for some reason, many millions of red blood cells are being broken down, bilirubin levels rise because even healthy livers become overloaded. A few days after birth, many babies develop a form of jaundice that is usually harmless and disappears quickly Jaundice always requires investigation because the underlying disorder may be serious.

If the underlying cause of jaundice can be treated, jaundice will disappear. If the cause is not curable, as in the case of pancreatic cancer, treatment may be given to relieve symptoms associated with jaundice, such as itching.

Causes of Jaundice

Levels of bilirubin in the blood can increase if the amount of bilirubin produced is too great for the liver to process. Damaged liver cells or obstruction of the bile ducts, which carry bile from the liver to the gallbladder and thence to the small intestine, can also lead to high levels of bilirubin in the blood.

The following are Possible cause of this

• Excess red cell breakdown. In a healthy person, red blood cells have a lifespan of about 120 days, after which they are removed from the blood and broken down by the spleen to produce bilirubin. The bilirubin then passes to the liver. If the number of red blood cells being broken down is above normal (haemolysis), the liver cannot process the large amounts of bilirubin produced. This is known as haemolytic jaundice.
• Liver cell damage. If the liver is damaged, its ability to process bilirubin is reduced. Liver cell damage may occur for a variety of reasons, including viral infection, alcohol abuse and an adverse reaction to some drugs. Jaundice due to liver cell damage is sometimes accompanied by nausea, vomiting, pain in the abdomen and a swollen abdomen.
• Bile duct obstruction. An obstruction in the bile ducts, the channels through which bile leaves the liver, may result in jaundice. Obstruction may be due to disorders such as pancreatic cancer or gallstones. If the bile ducts are blocked, bile builds up in the liver, and bilirubin is forced back into the blood. This type of jaundice may be accompanied by itching of the skin, dark-coloured urine and lighter than normal stools.

Treatment of Jaundice

• Your doctor may arrange for blood tests to assess liver function and to look for evidence of excess red blood cell destruction, viral hepatitis or other disorders affecting the liver.
• To look for signs of inflammation or obstruction, your doctor may use imaging techniques such as computerized tomography (CT) scanning, magnetic resonance imaging (MRI), endoscopy of the pancreas (ERCP) or ultrasound scanning using an endoscope.
• A sample of liver tissue may be taken – liver biopsy – for microscopic examination to look for underlying liver disease.