What Is Jaundice?
Jaundice occurs when your skin, mucous membranes or eyes take on a yellow color due to the buildup of bilirubin in your system. Bilirubin is produced when your body breaks down red blood cells. Normally, the liver processes bilirubin and then your body eliminates it in your stool.
When the liver cannot process bilirubin properly, the excess builds up and causes the signature yellowing of the skin and eyes. Any condition or health issue that causes this yellow skin is considered a jaundice-associated condition.
Jaundice is common in newborns, especially those who are premature. It does not always require treatment.
In older children and adults, jaundice is usually the result of an underlying infection or illness, which can include liver damage or disease. In order to treat jaundice, your doctor must first determine the cause.
What Causes Jaundice?
Your body breaks down red blood cells every day. This process results in a yellowish substance called bilirubin. Normally, bilirubin is processed in the liver and then eliminated from your body in your stool. A buildup of bilirubin occurs when there are too many red blood cells, or when your liver is not functioning properly. This gives the skin and eyes a yellow appearance.
Types of Jaundice-Associated Conditions
Jaundice is fairly common among newborns and not always a sign of an underlying illness. Physiologic jaundice can occur when an infant has trouble with handling bilirubin. This form usually lasts only a few days.
Breast milk jaundice develops in an infant during the first few weeks of breast-feeding. It is likely caused by something in breast milk that blocks certain proteins in the liver that help break down bilirubin. Breast milk jaundice sometimes runs in families and affects up to 2.4 percent of newborn babies.
If a baby is unable to nurse well, it may lead to dehydration. The decreased urine production can cause bilirubin to build up, resulting in breast-feeding failure jaundice. This is more likely to happen if the infant is premature and has not developed the strength or coordination needed to start breast-feeding.
Transient familial hyperbilirubinemia is a hereditary metabolic condition in which the body cannot break down bilirubin correctly. Infants with this type of hyperbilirubinemia are born severely jaundiced. Complications may include seizures or brain and nervous system problems. However, prompt treatment usually gives a positive outcome.
Other conditions that may cause infant jaundice include:
- internal bleeding
- enzyme deficiency
- red blood cell abnormalities
- poor liver function due to infection or other conditions
- hemolysis—a type of jaundice that happens when an infant has too many red blood cells, or bleeding because of hemolytic disease (Rh disease)
Older children and adults may develop jaundice due to a variety of conditions, including:
- gallbladder and other bile duct disorders—such as primary biliary cirrhosis, gallstones, blocked bile ducts
- liver disorders such as hemolytic anemia or cancers of the liver or pancreas
- liver damage from overuse of medications such as acetaminophen, parasitic infections of the liver, poisoning from mushrooms or other substances
- pregnancy-related jaundice due to pressure in the abdomen that causes bile buildup
In very rare cases, mild jaundice may be an early symptom of heart disease (JR Soc Med).
Signs and Symptoms of Jaundice
Jaundice can come on suddenly, but it often develops over a period of weeks. Symptoms of jaundice include:
- skin that is turning yellow
- yellow in the whites of your eyes
- a yellow tint inside your mouth
- dark urine
- pale stools
It is important to note that yellow skin is not always a result of jaundice. Your skin may appear yellow if you consume a lot of foods that are rich in beta-carotene, such as squash or carrots. Yellowing skin that is due to your diet is different from jaundice because your eyes will not turn yellow.
You should call your doctor if you or your baby shows symptoms of jaundice. The underlying condition—such as liver disease—may require prompt treatment.
Jaundice is usually easy to diagnose based on a physical exam, but your doctor must determine the cause before beginning a treatment plan. You should be prepared to give a complete medical history, including any previously diagnosed conditions, and to list all your prescription drugs, over-the-counter medications and supplements. Any additional symptoms you have will help the doctor decide what other tests are required.
Diagnostic testing may include:
- blood tests to determine bilirubin levels
- complete blood count
- cholesterol levels
- trothrombin time—a blood test that measures clotting time
- hepatitis panel
- liver function testing
- abdominal imaging tests such as a CT scan or ultrasound
- liver biopsy
The treatment and long-term outlook for jaundice patients depends on the cause. Jaundice in a newborn often clears up within a few weeks without treatment.