What is Jaundice?

What is Bilirubin?

Bilirubin is a yellow coloured substance formed after the breakdown of red blood cells. The unconjugated or indirect or albumin-bound bilirubin is produced by the breakdown of red blood cells. This indirect bilirubin is metabolized by the liver and produce conjugated or direct bilirubin. Bilirubin passes through the liver and excreted through urine or stool. The high level of bilirubin in the blood is the sign of excess hemolysis and the major sign of liver disease. The normal range of conjugated bilirubin in the body is 0-0.3 mg/dl and in case of Unconjugated bilirubin, the normal range is 0.1-1.2 mg/dl. Level of bilirubin higher than the given range is usually considered high.

Jaundice signs and symptoms

• Skin yellowing, yellowing of white part of the eyes
• Dark yellow urine and pale stools
• Excess fatigue
• Nausea and Vomiting
• Fever
• Loss of apetite
• Weight loss
• Muscle and joint pain

Types of jaundice

Jaundice happens when too much bilirubin builds in your blood, which makes the patient's skin and the white part of the eyes look yellow. Jaundice is a term given to a symptomatic condition that appears as yellow colouring of the body. At the same time, it seems like a worrying disease, a symptom of underlying ones. Treatment for jaundice is not specific, as the condition is a symptom in itself. Thus, the best way of treatment is to diagnose your condition, but you should consult your doctor firsthand. While jaundice is generally a sign of an underlying health issue like liver disease, hepatitis, or alcohol abuse, jaundice commonly also occurs in newborns due to an immature liver function. You need to get yourself checked, and if left untreated, jaundice can lead to severe health complications, including liver failure, brain damage, and even death. Therefore, you must seek medical treatment if you experience any of the signs and symptoms of jaundice, such as yellowing of the skin, abdominal pain, dark urine, or pale-coloured stools. There are different types of jaundice in both adults and kids and they are specific in character : 

• • Pre hepatic jaundice 

It is the type of jaundice that happens when the hemolysis rate increases and causes increased bilirubin production. Thus, if you suffer from itchiness, abdominal pain, sudden weight loss, chills, and fever, consult the best liver specialist immediately. 

• • Hepatitis jaundice 

It is another type of jaundice that occurs if you have inflammation in the liver, like NASH. It is an infection in the liver, which means it is damaged and cannot produce bilirubin effectively. Some common symptoms of this type of jaundice are joint or muscular pain, tiredness, itchy skin, dark urine, etc. Thus, if you notice any of these symptoms, get yourself checked immediately. 

• • Post hepatitis jaundice 

It is another type of jaundice that occurs due to a blockage in the bile duct or other digestive tract, and because of this, bilirubin cannot travel. The symptoms of this type of jaundice are pale stool or dark urine, diarrhoea, weight loss, swollen abdomen, or sickness symptoms. If you experience these, consult the best liver doctor for immediate diagnosis and treatment.

• • Neonatal jaundice 

It is a type of jaundice visible in newborns when their RBC count is not as per standard. Because of this, bilirubin processing in them is slow, and it leads to many symptoms like fever, feeding problems, and arch in the back or neck. If these synonyms are seen, contact a liver doctor for immediate treatment as if left untreated, it can lead to severe complications.

• When to seek medical advice

Jaundice in adults is caused by many medical conditions that affect the normal metabolism of excretion of bilirubin. This disruption in bilirubin can occur at various stages, and it is thus necessary to know different causes of jaundice. However, you must keep a check on symptoms of jaundice. The most well-known sign of jaundice is the yellow effect it has on the skin and the white part of the eyes. This is not the only symptom or the change you may notice. There are many other symptoms, including:

• • Abdominal swelling or pain
• • Stool with light grey or yellow colour 
• • Itching
• • Nausea
• • Dark urine

The treatment of jaundice entirely depends upon the underlying cause, and once the expert doctor diagnos it, you will be recommended with the appropriate treatment course. The main reason to seek treatment for jaundice is not because of the condition itself, but instead the cause behind it. In adults, jaundice can indicate a more severe health issue. Its causes are : 

• • Inflammation of the liver (hepatitis)
• • Bile duct obstruction
• • Pancreatic cancer
• • Congenital disorders
• • Malaria
• • Cirrhosis

To diagnose jaundice, expert doctors recommend a blood test to determine the levels of bilirubin and many other components in the blood. The treatment of jaundice depends on the severity of the condition. However, different treatment options are available and recommended by the specialist, ranging from simple lifestyle changes to hospitalisation or medication. Consulting the best gastroenterologist will help you to determine the cause of jaundice. According to the reason, the doctor will recommend suitable treatment options. Jaundice is a severe condition that can spread if left untreated; thus, it is vital to seek medical advice from a qualified Gastroenterologist to ensure proper diagnosis and treatment. You should know all about jaundice, its causes and symptoms, and how to manage it well. If you are seeking an experienced Gastroenterologist in Delhi, visit Samadhan Clinic to meet the best liver specialist doctor in Delhi. They will perform specialised as well as advanced diagnostic and therapeutic procedures of the liver to give you the best treatment. 

Causes of High bilirubin

Here are some conditions which cause a high level of bilirubin in the blood:
• Gallstones: Blockade of gall bladder leads to high level of bilirubin.
• Gilbert’s syndrome: A liver condition in which processing of the bilirubin in the liver is altered.
• Liver dysfunction: Altered liver functions is the main cause of high bilirubin and thus causes jaundice. Conditions which can affect the live functions are cirrhosis, autoimmune disorders of the liver such as hepatitis, Liver cancer etc.
• Bile duct obstruction
• Hemolytic anaemia

Jaundice in newborn

Jaundice in infants characterized by yellow discolouration of skin and sclera (the white portion of the eyes) of a newborn baby. Jaundice is the most common problem in a newborn that require early medical attention. Infants develop jaundice within one week of their birth and most of the babies are still jaundiced in 1 month of the age. This early jaundice is also called physiological jaundice and it is harmless.

Cause of jaundice in newborns:The breakdown of Red cells in blood produces bilirubin. The concentration of RBCs in infants is comparatively higher than adults and having a shorter life span. So the bilirubin level in infants is higher than the adults as the rate of RBCs breakdown is higher.
Although the early jaundice is harmless, treatment is still needed to prevent the prolongation of this condition. Phototherapy is the safe and most effective treatment of jaundice in infants, in which bilirubin is controlled by placing the newborn baby under the lamp emitting light in the blue spectrum. The bilirubin than converts into harmless and excreted in the urine.

Diagnosis

A history of any liver disease will be taken by your doctor to conduct a physical exam.
Blood test: Blood test is performed to measure the amount of bilirubin, hepatitis virus antibodies, abnormal RBCs and other substances that are involved in the functioning of the liver or to trace the presence of diseases like hepatitis.
Liver function test: Liver function tests are performed to compare the levels of liver functional proteins and enzymes. Comparison is made between when the liver is in healthy condition and when it is damaged.
Liver biopsy: Samples of the liver tissues are collected and examined under a microscope. Abdominal ultrasounds, CT scans and MRI tests are also the preferred diagnostic procedures.

Treatments

Treatment of jaundice depends on the type of liver disease present. Treatment of liver disease which is the cause of jaundice is the ultimate treatment of jaundice. Such as if the alcoholic drinks are the cause of liver cirrhosis or hepatitis, then the drinking of alcoholic beverages should be avoided. If jaundice occurs by the lack of RBCs the treatment may include a blood transfusion. When liver disease is caused by any drug toxicity then stopping the drug therapy is needed to treat jaundice. Removal of the gall bladder is required in case of jaundice occur due to gall bladder stone. Liver cancer can also lead to jaundice which can be treated by radiation and chemotherapy.

FAQ

1. How do you treat jaundice in newborns?

Jaundice in newborns is when a baby's skin and eyes turn yellow because of excessive bilirubin. Not only yellowing of the skin, but jaundice also causes the yellowing of the white part of the eyes. In newborns, a still-maturing liver may not be mature enough to process and pass bilirubin through the intestinal tract. Though visible yellow colour confirms that the baby has jaundice, some additional tests may also be needed to determine the severity. Usually, mild jaundice will resolve on its own as the baby's liver matures. Frequent feedings also help them pass bilirubin through their bodies.

In some cases, with more severe jaundice, there is a need for treatment, and phototherapy is a common and highly effective treatment method. A light is used in the treatment that breaks down bilirubin in your baby's body. During phototherapy, your baby will be placed on a special bed under blue spectrum light while wearing only diapers and special protective goggles. Also, a fibre optic blanket is placed underneath the baby. 

2. How long does jaundice last in newborns?

Jaundice in newborns is common and normal, and it usually develops on its own on the second or third day post-birth. Jaundice is more common in babies who are breastfed as compared to babies who are formula-fed. In formula-fed babies, jaundice goes away on its own within two weeks. But it may also last more than 2 to 3 weeks in breastfed babies. In most babies, jaundice will get better without treatment within one or two weeks, but you need to get your baby's bilirubin level checked as high levels can lead to severe health conditions if left untreated. If your baby's jaundice lasts over three weeks, talk to the doctor.

3. How to reduce bilirubin?

Jaundice is a condition in which a newborn baby's skin turns yellow because a high amount of bilirubin is produced, and the liver is not mature enough to get rid of it. Bilirubin is a yellow substance produced after red blood cells break down. The best way to reduce infant jaundice is to offer them adequate feeding. Breastfed infants should have eight to 12 daily feedings for the first few days of life. Formula-fed infants generally should have 1 to 2 ounces of formula every two to three hours for the first week. Breastmilk should be continued, and mild jaundice is not harmful as it disappears on its own in newborns when their bodies learn to deal with bilirubin.

In some cases, babies may need help to get their bilirubin level down in case of severe jaundice. Babies will need immediate treatment for severe jaundice, and the levels get down through phototherapy treatment given by the doctor.

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