Jaundice (icterus) typically causes symptoms such as yellowing of the eyes, skin and mucous membranes. The discoloration is triggered by an elevated concentration of bilirubin in the body. This can have various causes, including disease of the liver or gall bladder. Adult jaundice must be distinguished from so-called neonatal jaundice. This is not a symptom of a disease, but occurs as part of a normal developmental process. If adults suffer from jaundice, treatment depends on the underlying disease.
Causes of jaundice
If there is an increased concentration of the bile pigment bilirubin in the blood, yellowing of the eyes, skin and mucous membranes occurs. Bilirubin is a breakdown product of the red blood pigment hemoglobin. In certain diseases, its concentration in the blood increases and deposits are formed in the tissues. These deposits then cause the yellowish tinge. The yellowing occurs at a concentration of about two milligrams per deciliter of blood. Various causes can lie behind jaundice. Roughly, these can be divided into three categories:
- Disease of the blood (prehepatic jaundice).
- Disease of the liver (hepatic icterus).
- Disease of the gall bladder (posthepatic jaundice).
Diseases of the blood as a cause
If a disease of the blood is the cause of jaundice, this is called prehepatic jaundice, because the cause lies before the liver. The increased bilirubin concentration may be caused by, among other things, too many red blood cells breaking down. Since bilirubin is a breakdown product of the red blood pigment hemoglobin, this causes the bilirubin level to rise. This is the case, for example, with viral infections, poisoning, diseases such as sickle cell anemia or artificial heart valves. Problems with a blood transfusion can also be the cause. If the liver does not keep up with the breakdown of bilirubin, the dye is deposited in the tissue and causes the typical discoloration.
Diseases of the liver as a cause
If the causes of jaundice lie in the liver, it is called hepatic icterus. In most cases, inflammation of the liver is the trigger. This can be caused, for example, by taking certain medications, excessive consumption of alcohol, or infection with viruses such as the hepatitis B virus. If acute liver inflammation becomes chronic, cirrhosis of the liver or liver cancer can develop as a consequence.
Diseases of the gall bladder as a cause
In posthepatic jaundice, the causes of jaundice lie after the liver. Frequently, a bile stasis is then responsible for the symptoms that occur. This is because when the bile can no longer drain, for example due to a gallstone, the fluid backs up and some components – including bilirubin – can leak into the blood. In addition to gallstones, tumors and adhesions triggered by surgery or inflammation can also cause bile stasis.
Symptoms of jaundice
The most typical symptom of jaundice is a yellowish discoloration of the eyes, skin, and mucous membranes. In addition, however, there may be a number of other symptoms. The symptoms that occur always depend on the cause of the jaundice. Depending on the cause, symptoms such as fatigue, fever, abdominal pain or itching may become noticeable. In addition, the color of the stool and urine may change.
Neonatal jaundice
Neonatal jaundice in babies must be differentiated from morbid jaundice, which occurs in adults. This is because when the skin of infants turns yellowish, it is usually harmless. Usually, the symptom appears about two to three days after birth and disappears after one or two weeks. As long as babies are in their mother’s womb, they are supplied with oxygen through her blood. They need a lot of red blood cells for this. After birth, however, not all the blood cells are needed and some break down. This produces bilirubin, which is converted in the liver and then excreted. If there is too much bilirubin, it can cause congestion in front of the liver and, above a certain concentration, jaundice.
Correctly diagnose yellowing of the skin
Because there are many different causes of yellowing of the skin, it is not always easy to diagnose jaundice. First, there is usually a detailed interview in which the doctor asks about medications taken, alcohol consumption or recent travel, among other things. Existing pre-existing conditions, such as gallstones or cancer, should also be mentioned. Various physical examinations are then performed, including:
- A blood test
- A urine and stool examination
- A palpation examination of the liver and gallbladder
- An ultrasound examination of the upper abdomen
Depending on the results, further examinations may subsequently be necessary.
Treat jaundice
Jaundice is not a disease in itself, but a symptom of another disease. That is why jaundice is not contagious in itself, but certain underlying diseases can be. For the same reason, there is no vaccination against jaundice. However, certain causes such as hepatitis B infection can be prevented by vaccination. If you notice a yellowing of the eyes or skin, you should always consult a doctor and have him clarify the cause. Medication or home remedies will not help with jaundice. The only way to cure it is to have the underlying disease treated. The exact treatment of jaundice always depends on the underlying disease. For example, if there is a problem with the bile, such as a gallstone, the stone must be removed. If the causes of jaundice are the intake of certain medications or excessive alcohol consumption, the triggering substance should be discontinued. Also, talk to your doctor to see if there are other treatment options.
