Jaundice

neonatal jaundice

Last Updated December 20th, 2021

Overview of jaundice

Environmental pollution, combined with lack of hygiene, predispose an individual to different diseases. Liver diseases are becoming very common in low and middle-income countries where awareness related to the importance of hygiene is lacking. Among innumerable liver disorders, jaundice is the leading cause of illness in infants and adults. It is a very common occurrence in newborns. Nearly 60% new-borns around the world acquire the disease annually. This has triggered American Liver Foundation to organize health campaigns to educate the mass about relevant vaccinations which can prevent future risks of hepatic diseases.

What is jaundice?

Jaundice is the yellowish discoloration of the skin, sclera (white membrane covering the eye-ball) and mucous membranes. Abnormalities in bilirubin secretion by the liver or obstruction of bile duct are the prime factors behind the disease. Bilirubin is a yellowish pigment present in hemoglobin (responsible for carrying oxygen in Red Blood Cells). An increase in the concentration of bilirubin above 3 mg per dL of blood leads to hepatic diseases.

What causes jaundice?

jaundice symptomsHepatic diseases are caused by an elevation in the level of bilirubin in the blood, which is clinically termed as “hyperbilirubinemia”. This condition results due to three distinct phases of bilirubin metabolism namely – Prehepatic Phase, Intrahepatic Phase, and Posthepatic phase. The contributions of these phases are as follows-

    • Pre-hepatic causes: In the prehepatic phase, excessive heme (non-protein, an insoluble element of hemoglobin) metabolism can lead to increased level of bilirubin in the blood. This condition can arise due to hemolytic anemia in which membrane abnormalities of RBC membrane or enzyme functions occur, causing a rise in bilirubin content to about 5 mg per dL of blood.
    • Intrahepatic causes: Aberrations in enzyme metabolism in the Intrahepatic phase causes excessive bilirubin in the bloodstream. These enzyme metabolism abnormalities may result from Gilbert syndrome or Autoimmune hepatitis.
  • Posthepatic causes: The disease can occur in the post-hepatic phase due to the obstruction of the bile duct due to internal or external agents. This condition might arise due to Cholelithiasis (gallstones), Cholecystitis (gallbladder inflammation) or biliary tract tumors.

Here is a list of the more general causes of hepatic diseases-

  • Viral hepatitis (pathogens: Hepatitis A, B, C, D or E virus)
  • Infections of gallbladder, liver or pancreas (pancreatitis) which interferes with the body’s capacity to break down bilirubin
  • Accidental consumption of poison, for example, poisonous mushrooms or expired milk
  • Certain medications such as Acetaminophen or Tylenol
  • Hormonal changes during pregnancy can cause jaundice in women
  • Excess consumption of tobacco or alcohol
  • Past occurrence of jaundice

What are the warning signs?

The signs and symptoms of hepatic diseases are not so prominent in the initial stages. With the slow progress of the disease, a few distinct symptoms appear-

  • Yellowish discoloration of skin
  • Sclera, conjunctiva, and mucosa turns pale yellow (in advanced stages)
  • Dark yellow or brownish discoloration of urine
  • Dark stool
  • Irritation of skin
  • Severe loss of appetite
  • Abnormal weight loss in advanced stages
  • Extreme fatigue
  • Occasional pain in the upper right portion of stomach
  • Nausea and vomiting
  • Occasional headaches
  • Fever (occasional)

 Types of jaundice

Jaundice, clinically termed as “icterus” may be classified into different categories based on the etiology and the degree of infection. The main categories are listed below-

  • Physiological jaundice: It is caused by excessive destruction of Red Blood Cells, especially in infants. It is often characterized by severe infarction of lungs and tissues. It usually occurs as mild infection and disappears after a few days.
  • Obstructive jaundice: Obstruction of the biliary ducts due to tumor formation (intrinsic or extrinsic carcinoma), clustered tissues or stone formation causes abnormalities in the normal mechanism of bile flow. This leads to hepatic syndromes. This is accompanied by the enlarged liver with metastatic nodules.
  • Toxic/infective jaundice: In this condition, acute viral infection of liver cells occurs, leading to inflammation and abnormal functioning of the liver. Yellow atrophy and enlargement of the liver occur. Infective jaundice may also occur during other infectious diseases like Weil’s disease, Glandular fever, Pneumonia or Yellow fever. In these conditions, the urine contains bile pigments, bile salts and a trace amount of urobilinogen.
  • Haemolytic jaundice: This occurs due to excessive destruction of hemoglobin due to intrinsic (congenital infections) or extrinsic (incompatible blood transfusion) Haemolytic jaundice is usually accompanied by elevated body temperature and abnormally enlarged spleen. It is normally accompanied by Reticulocytosis (abnormal increase in the count of immature RBCs).

Congenital jaundice

congenital jaundiceIn many cases, infants are born with hepatic diseases. This is called neonatal jaundice and is usually of the following types-

  • Physiological jaundice: It reaches its peak within 4-5 days of birth and is characterized by shortening of RBC life span (70-90 days instead of the usual 120 days).
  • Pathological jaundice: It appears within 24 hours of birth and bilirubin level rises above 5 mg per dL of blood. It usually stays even after 14 days and is characterized by dark-colored stool and brownish urine.
  • Breast-milk jaundice: Breast milk might contain a bilirubin conjugation inhibitor or bilirubin recirculation enhancer (beta-glucuronidase) which when passed on to the infant can cause neonatal jaundice.

Diagnosis

The first step to the diagnosis of hepatic diseases involves an ultrasonography of gallbladder and liver to determine the exact cause of jaundice. A CT scan of the organs of the abdomen and an Endoscopic Retrograde Cholangiopancreatography (ERCP) to study the bile and pancreatic ducts is very essential. A liver biopsy can be carried out in few extreme cases.Blood tests to measure bilirubin levels are also precribed.

Treatment & Prevention

Since there can be many reasons for the onset of jaundice, the treatment methodology depends upon the actual cause. Jaundice caused by anemia can be treated by consuming iron-rich foods and taking additional iron supplements. Hepatitis-induced jaundice is treated with the help of antiviral or steroidal drugs. The most effective way to prevent jaundice is vaccination. One must completely cut down on alcohol and use of illicit drugs, in order to keep the liver healthy.  Stress and high BMI are also responsible in weakening the liver. Easy to digest food should be consumed that put negligible strain on the liver. Foods such as boiled rice, yogurt, turmeric, ginger, fresh fruit juice, and almonds are help greatly in recuperation from the disease. It is important to maintain adequate sanitation and stay away from contaminated food and water. Removing excess cholesterol from body can also reduce your chances of acquiring jaundice.

Center for Disease Control and Prevention (CDC) has estimated that nearly 200 million people worldwide are suffering from jaundice at present. Majority of these cases are observed in the undeveloped countries. Health Organizations all around the world are recommending a hygienic lifestyle, combined with healthy food habits to prevent the occurrence of the disease. These organizations are also spreading awareness related to hepatic diseases in new-born children to reduce the mortality rates on a global scale.

Facts

  • Excess build-up of bilirubin, when left untreated can cause brain damage. This condition, known as kernicterus could lead to cerebral palsy and hearing impairment in babies.
  • Premature babies, dark-skinned babies, and babies with Asian/Mediterranean descent have a higher risk of acquiring this illness.

Facts

  • Jaundice is widely prevalent in new-born babies. 60% full term and 80% pre-term babies fall a victim to this condition.
  • Bilirubin is a part of hemoglobin. It is produced primarily in the bone marrow.

Facts

  • Medications for auto-immune diseases can cause increased destruction of red blood cells and result in pre-hepatic jaundice.
  • While in infants, jaundice symptoms mostly disappear by themselves; in adults, it requires proper treatment and medication.

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Dos and Don'ts

Dos
  • Opt for more fruits, nuts, black soybeans, lemons, bitter-gourd, and tomatoes in the diet.
  • Basil leaf decoction/paste, when taken with radish juice, is an excellent home remedy for jaundice.
  • Jaundice causes a severe deficiency of calories and sudden weight-loss. To make up for the loss, add healthy and easily digestible carbs such as soft bread and rice.
Don'ts
  • Consume pulses, legumes, and peas as they are complex sources of proteins and difficult to digest.
  • Consume meat, eggs, and poultry for at least a month.
  • Have a salty diet since it contains minerals which are difficult to digest.

 

 

 

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Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
CBC blood test
CBC (Hemogram 6-part diff) blood test CBC (Hemogram 6-part diff) blood test refers to the test that measures the number of RBCs, WBCs, etc…
BoneMarrow-Biopsy
Bone Marrow Biopsy Bone marrow biopsy is a diagnostic procedure where a small amount of bone marrow is extracted from hip…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
lipoprotein A
Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
piles,fistula,fissures
Difference between piles, fissures, and fistula Click to know the difference between piles, fistula and fissure and the best ways to get effective treatment…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
GERD heartburn
Heartburn: What are the exact symptoms and the best home remedies? There are easy home remedies for heartburn, which not only acts as a first aid when you experience…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…