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
- 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
- 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.
Senior Consultant Hepatopancreatobiliary Surgeon
MBBS, MMed (Surgery), MSc, FAMS, FRCSEd
Prior to private practice, Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.
He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.
He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.