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active  Topic # 73

29/10/2016 @ 4:37 PM
by NHS_UK

Anonymous

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Introduction 

Jaundice is a term used to describe the yellowing of the skin and the whites of the eyes.

It's caused by a build-up of a substance called bilirubin in the blood and body's tissues.

Signs of jaundice

The most common signs of jaundice are:

  • yellowing of the skin, eyes and the lining of the inside of parts of the body, such as the mouth and nose (mucus membrane)
  • pale-coloured stools
  • dark-coloured urine

When to seek medical advice

Always seek immediate medical advice if you develop the above signs of jaundice. They're a warning sign that something is wrong with the normal processes of your body.

Speak to your GP as soon as possible. If this isn't possible, telephone NHS 111 or contact your local out-of-hours service.

Types of jaundice

There are three types of jaundice depending on what's disrupting the normal removal of bilirubin from the body. They are:

  • pre-hepatic jaundice – the disruption happens before bilirubin has been transported from the blood to the liver; it's caused by conditions such as sickle cell anaemia and haemolytic anaemia
  • intra-hepatic jaundice (also known as hepatocellular jaundice) – the disruption happens inside the liver; it's caused by conditions such as Gilbert's syndromecirrhosis or other liver damage
  • post-hepatic jaundice (also known as obstructive jaundice) – the disruption prevents the bile (and the bilirubin inside it) from draining out of the gallbladder and into the digestive system; it's caused by conditions such as gallstones or tumours

Read more about the causes of jaundice.

Who's at risk

Intra-hepatic and post-hepatic jaundice are more common in middle-aged and elderly people than in the young. Pre-hepatic jaundice can affect people of all ages, including children.

Certain lifestyle changes may help prevent jaundice. For example, maintaining a healthy weight, not drinking too much alcohol, and minimising your risk of hepatitis, will all help.

Diagnosing jaundice 

If you have jaundice, you'll have a number of initial tests to find out how severe it is and determine the underlying cause. You'll probably have a urine test and liver function and blood tests. If intra-hepatic jaundice or post-hepatic jaundice is suspected, it's often possible to confirm the diagnosis using imaging tests to check for abnormalities inside the liver or bile duct systems.

Medical history and examination

It's likely your GP or hospital doctor will take a detailed medical history to try to determine why you have jaundice.

You may be asked whether:

  • you had any flu-like symptoms before jaundice (this may indicate hepatitis)
  • you're currently experiencing other symptoms, such as abdominal pain, itchy skin or weight loss
  • you've recently travelled to a country where conditions such as malaria or hepatitis A are widespread
  • you've noticed a change of colour in your urine and stools
  • you have a history of alcohol misuse
  • you're currently taking drugs or have taken them in the past
  • your occupation could have exposed you to harmful substances

It's likely you'll also have a physical examination to check for signs of an underlying condition, such as swelling of the legs, ankles and feet (a possible sign of cirrhosis), or a noticeable swelling of your liver (a possible sign of hepatitis)

Urine test

A urine test can be used to measure levels of a substance called urobilinogen. It's produced when bacteria break down bilirubin inside the digestive system.

Higher-than-expected levels of urobilinogen in your urine may suggest pre-hepatic jaundice or intra-hepatic jaundice. Lower levels could suggest post-hepatic jaundice.

Liver function and blood tests

A liver function test is a type of blood test used to help diagnose certain liver conditions including:

When the liver is damaged it releases enzymes into the blood. At the same time, levels of proteins that the liver produces to keep the body healthy begin to fall.

By measuring the levels of these enzymes and proteins, it's possible to build up a picture of how well the liver is functioning. In addition, your blood can be tested for infections known to trigger jaundice, such as malaria and hepatitis C.

Imaging tests

If intra-hepatic jaundice or post-hepatic jaundice is suspected, imaging tests can be used to check for abnormalities inside the liver or bile duct systems. These include:

Liver biopsy

A biopsy may be recommended to assess the condition of the liver tissue if it may have been damaged by a condition such as cirrhosis or liver cancer.

During a liver biopsy, your tummy is numbed with a local anaesthetic, and a fine needle is inserted so that a small sample of liver cells can be taken and sent to a laboratory for examination under a microscope.

Treating jaundice

Treatment for jaundice in adults and older children depends on what's causing it. This may involve treating the underlying condition, a blood transfusion or surgery.

Read more about treating jaundice.

Preventing jaundice

It's not possible to prevent all cases of jaundice because it can be caused by a wide range of conditions or circumstances.

However, you can take precautions to minimise your risk of developing jaundice. These include:

  • ensuring you don't exceed the recommended daily amount (RDA) for alcohol consumption
  • maintaining a healthy weight for your height and build
  • if appropriate, ensuring you're vaccinated against hepatitis A or hepatitis B if you're travelling to high-risk areas of the world
  • minimising your risk of exposure to hepatitis C because there's currently no vaccine for the condition; In England, the most effective way of preventing hepatitis C is by not injecting illegal drugs, such as heroin, or making sure that you don't share drug injecting equipment if you do

Newborn jaundice

Newborn babies are often born with jaundice. At a very young age, the various systems the body uses to remove bilirubin from the body aren't fully developed.

Newborn jaundice isn't usually a cause for concern and often resolves within two weeks without treatment.

Read more about newborn jaundice.

Web site NHS_UK
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