Jaundice Condition
What is Jaundice
By Dr. Lee Ser Yee
Jaundice (Hyperbilirubinemia) is a condition where the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin.

Bilirubin, a yellowish- brown substance, is produced when the haemoglobin (red blood cells) is broken down and carried in the bloodstream to the liver where it is filtered and binds with bile. Bile is excreted into intestine and helps to digest oils and fat.

When bile or bilirubin cannot be excreted by the liver or its passage via the bile ducts to the intestines is blocked, it results in a build-up in the blood which gets deposited in the skin, excreted in the urine, leading to jaundice.

Signs of Jaundice

  • Yellowing of the skin and eyes (jaundice)
  • Itchy skin (Pruritus)
  • Tea-coloured urine and Pale stools
  • Abdominal discomfort, pain, bloatedness
  • Others- loss of appetite and weight, fatigue

Causes of Jaundice

  • Obstruction to the flow of bile (Obstructive jaundice)
  • Diseases affecting bilirubin production (Hepatic jaundice)
    • Hepatitis – A, B, C
    • Autoimmune disorders
    • Medicines – NSAIDs, certain antibiotics, paracetamol
  • Damage the liver (Hepatic jaundice)
    • Liver cirrhosis
  • Excess destruction of red blood cells (hemolysis) (Pre-hepatic jaundice)
    • more bilirubin is produced than what the liver can handle

Evaluation

  • A full medical history and clinical evaluation
  • Blood Tests which would include liver function tests and tumour markers
  • Imaging -Ultrasound, CT, and MRI scans to confirm the cause
  • Endoscopy
    • Endoscopic Retrograde Cholangiopancreatography (ERCP)
    • Endoscopic ultrasound (EUS)
    • Biopsy – if indicated

Treatments for jaundice depend on the cause identified. It is recommended to seek medical attention from a liver specialist early.

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