Jaundice

Jaundice refers to bilirubin levels rising too high in the blood, and to the yellowing of the skin and whites of the eyes that occurs as a result. This discoloration provides the outward sign of the abnormality. The discoloring of the skin and eyes can become brownish when levels of bilirubin are very high.

Bilirubin comes from the previously iron-containing chemical in red bloods cells that carries oxygen. This chemical is released when the cells grow old and disintegrate. The chemical becomes a pigment that is primarily excreted in bile.

The underlying conditions that cause jaundice are the primary concern. The symptom usually is a sign of a disorder of the liver or the blood system.

Causes/risk factors

It is the job of the liver to remove bilirubin from the blood and secrete it into the digestive tract in a form in which it can be disposed (processed into and eliminated in the feces by the intestines). Jaundice can result from several causes:

• a rate of red-blood-cell destruction that is too high for the liver to process the resulting bilirubin;
• a defect in the liver’s ability to process bilirubin, which is sometimes due to conditions such as cirrhosis or hepatitis;
• or obstruction of the bile ducts, so that bile fluid cannot be released into the intestines (due to cancer, gallstones, sclerosing cholangitis, or other conditions).

Jaundice can also be due to an adverse drug reaction or as well as to genetic or congenital disorders, and to certain conditions of pregnancy. A temporary jaundice is also normal in newborns, as liver function catches up with red-cell breakdown.

Signs & symptoms

In addition to yellowing of the skin and eyes, jaundice can cause discolored feces. Bilirubin accounts for the brown color of feces; without its proper release, fecal matter becomes lighter in color.

Meanwhile, as the kidneys begin to excrete some of the additional bilirubin, urine may become darker. Jaundice can also cause itching, sometimes very severely.

Beyond these manifestations of jaundice, accompanying symptoms are those of the underlying cause. Thus, symptoms of cirrhosis, hepatitis, gallstones, cancer, or other causative condition are often present.