Jaundice: MedlinePlus Medical Encyclopedia Too many red blood cells are dying or breaking down and going to the liver The liver is overloaded or damaged The bilirubin from the liver is unable to properly move into the digestive tract Jaundice is often a sign of a problem with the liver, gallbladder, or pancreas. Things that can cause jaundice include: Infections Use of certain drugs Cancer Blood disorders, gallstones, birth defects and a number of other medical conditions can lead to jaundice. For more information on the causes of jaundice see: Jaundice causes Symptoms Jaundice may appear suddenly or develop slowly over time. Symptoms of jaundice commonly include: Yellow skin and the white part of the eyes (sclera) -- when jaundice is more severe, these areas may look brown Yellow color inside the mouth Dark or brown-colored urine Pale or clay-colored stools Note: If the whites of your eyes are not yellow, you may not have jaundice. Your skin can turn a yellow-to-orange color if you eat a lot of beta carotene, the orange pigment in carrots.

Other symptoms depend on the disorder causing the jaundice: Cancers may produce no symptoms, or there may be fatigue, weight loss, or other symptoms Hepatitis may produce nausea, vomiting, fatigue, or other symptoms Exams and Tests The health care provider will perform a physical exam. This may show liver swelling. A bilirubin blood test will be done. Other tests may include: Hepatitis virus panel to look for infection of the liver Liver function tests to determine how well the liver is working Complete blood count to check for low blood count or anemia Jaundice What Is Jaundice Symptoms Of Jaundice Jaundice Treatment Causes Of Jaundice What Causes Jaundice Ictorus What is Jaundice? Also called: Icterus Jaundice is a yellow color in the skin, the mucous membranes, or the eyes. The yellow pigment is from bilirubin, a byproduct of old red blood cells. Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells.

As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow. Many healthy babies have some jaundice during the first week of life. It usually goes away. However, jaundice can happen at any age and may be a sign of a problem. Jaundice can happen for many reasons, such as: Blood diseases Jaundice Considerations If youve ever had a bruise, you may have noticed that the skin went through a series of color changes as it healed. When you saw yellow in the bruise, you were seeing bilirubin. Normally, about 1% of our red blood cells retire every day, to be replaced by fresh red blood cells. The old ones are processed in the liver and disposed of. Much of the resulting bilirubin leaves the body in the stool. If there are too many red blood cells retiring for the liver to handle, yellow pigment builds up in the body. When there is enough to be visible, jaundice results.

Jaundice can be caused by too many red blood cells retiring, by the liver being overloaded or damaged, or by the inability to move processed bilirubin from the liver through the biliary tract to the gut. Most babies have some jaundice during the first week of life. The ordeal of birth can send many red blood cells to an early retirement (especially if a vacuum is used!), and babies livers are often unprepared for the load. Before moms milk comes in and stooling begins in earnest, bilirubin accumulates more easily. Jaundice is even more common in premature babies. Physiologic jaundice is the name for normal jaundice commonly seen in healthy babies. [ Top ] Pathologic jaundice is the name given when jaundice presents a health risk, either because of its degree or its cause. Pathologic jaundice can occur in children or adults. It arises for many reasons, including blood incompatibilities, blood diseases, genetic syndromes, hepatitis, cirrhosis, bile duct blockage, other liver diseases, infections, or medications. The term also applies to physiologic jaundice exaggerated by dehydration, prematurity, difficult delivery, or other reason.

Another condition called Gilbert syndrome is a benign, hereditary condition in which mild jaundice develops. It is caused by low levels of some bilirubin-processing enzymes in the liver. This condition, once recognized, requires no further treatment or evaluation. There are other more rare hereditary causes of elevated bilirubin levels. A yellow-to-orange color may be imparted to the skin by consuming too much beta carotene, the orange pigment seen in carrots. In this condition, the whites of the eyes remain white, while people with true jaundice often have a yellowish tinge to the eyes. This condition is called hypercarotenemia or just carotenemia. Viral hepatitis ( hepatitis A , hepatitis B , hepatitis C , hepatitis D , and hepatitis E) Breastfeeding jaundice may occur in the first week of life in more than 1 in 10 breastfed infants. The cause is thought to be inadequate milk intake, leading to dehydration or low caloric intake. It is a type of physiologic or exaggerated physiologic jaundice. Breast milk jaundice is far less common and occurs in about 1 in 200 babies.

Here the jaundice isnt usually visible until the baby is a week old. It often reaches its peak during the second or third week. Breast milk jaundice can be caused by substances in mom's milk that decrease the infants livers ability to deal with bilirubin. Breast milk jaundice rarely causes any problems, whether it is treated or not. It is usually not a reason to stop nursing. Jaundice | definition of jaundice by Medical dictionary Jaundice | definition of jaundice by Medical dictionary Definition Jaundice is a condition in which a person's skin and the whites of the eyes are discolored yellow due to an increased level of bile pigments in the blood resulting from liver disease . Jaundice is sometimes called icterus, from a Greek word for the condition. Description In order to understand jaundice, it is useful to know about the role of the liver in producing bile. The most important function of the liver is the processing of chemical waste products like cholesterol and excreting them into the intestines as bile. The liver is the premier chemical factory in the body—most incoming and outgoing chemicals pass through it.

It is the first stop for all nutrients, toxins, and drugs absorbed by the digestive tract. The liver also collects chemicals from the blood for processing. Many of these outward-bound chemicals are excreted into the bile. One particular substance, bilirubin, is yellow. Bilirubin is a product of the breakdown of hemoglobin, which is the protein inside red blood cells. If bilirubin cannot leave the body, it accumulates and discolors other tissues. The normal total level of bilirubin in blood serum is between 0.2 mg/dL and 1.2 mg/dL. When it rises to 3 mg/dL or higher, the person's skin and the whites of the eyes become noticeably yellow. Bile is formed in the liver. It then passes into the network of hepatic bile ducts, which join to form a single tube. A branch of this tube carries bile to the gallbladder, where it is stored, concentrated, and released on a signal from the stomach. Food entering the stomach is the signal that stimulates the gallbladder to release the bile. The tube, which is called the common bile duct, continues to the intestines.

Before the common bile duct reaches the intestines, it is joined by another duct from the pancreas. The bile and the pancreatic juice enter the intestine through a valve called the ampulla of Vater. After entering the intestine, the bile and pancreatic secretions together help in the process of digestion. Causes and symptoms There are many different causes for jaundice, but they can be divided into three categories based on where they start-before, in, or after the liver (prehepatic, hepatic and post-hepatic). When bilirubin begins its life cycle, it cannot be dissolved in water. The liver changes it so that it is soluble in water. These two types of bilirubin are called unconjugated (insoluble) and conjugated (soluble). Blood tests can easily distinguish between these two types of bilirubin. Hemoglobin and bilirubin formation Bilirubin begins as hemoglobin in the blood-forming organs, primarily the bone marrow. If the production of red blood cells (RBCs) falls below normal, the extra hemoglobin finds its way into the bilirubin cycle and adds to the pool.

Once hemoglobin is in the red cells of the blood, it circulates for the life span of those cells. The hemoglobin that is released when the cells die is turned into bilirubin. If for any reason the RBCs die at a faster rate than usual, bilirubin can accumulate in the blood and cause jaundice. Hemolytic disorders Many disorders speed up the death of red blood cells. The process of red blood cell destruction is called hemolysis, and the diseases that cause it are called hemolytic disorders. If red blood cells are destroyed faster than they can be produced, the patient develops anemia. Hemolysis can occur in a number of diseases, disorders, conditions, and medical procedures: Malaria . The malaria parasite develops inside red blood cells. When it is mature it breaks the cell apart and swims off in the blood. This process happens to most of the parasites simultaneously, causing the intermittent symptoms of the disease. When enough cells burst at once, jaundice may result from the large amount of bilirubin formed from the hemoglobin in the dead cells. The pigment may reach the urine in sufficient quantities to cause "blackwater fever," an often lethal form of malaria.

Side effects of certain drugs. Some common drugs can cause hemolysis as a rare but sudden side effect. These medications include some antibiotic and anti-tuberculosis medicines; drugs that regulate the heart-beat; and levodopa, a drug used to treat Parkinson's disease. Certain drugs in combination with a hereditary enzyme deficiency known as glucose-6-phosphate dehydrogenase (G6PD). G6PD is a deficiency that affects more than 200 million people in the world. Some of the drugs listed above are more likely to cause hemolysis in people with G6PD. Other drugs cause hemolysis only in people with this disorder. Most important among these drugs are anti-malarial medications such as quinine, and vitamins C and K. Poisons. Snake and spider venom, certain bacterial toxins, copper, and some organic industrial chemicals directly attack the membranes of red blood cells. Artificial heart valves. The inflexible moving parts of heart valves damage RBCs as they flutter back and forth. This damage is one reason to recommend pig valves and valves made of other organic materials. Hereditary RBC disorders. There are a number of hereditary defects that affect the blood cells.

There are many genetic mutations that affect the hemoglobin itself, the best-known of which is sickle cell disease . Such hereditary disorders as spherocytosis weaken the outer membrane of the red cell. There are also inherited defects that involve the internal chemistry of RBCs. Enlargement of the spleen. The spleen is an organ that is located near the upper end of the stomach and filters the blood. It is supposed to filter out and destroy only worn-out RBCs. If it has become enlarged, it filters out normal cells as well. Malaria, other infections, cancers and leukemias, some of the hereditary anemias mentioned above, obstruction of blood flow from the spleen—all these and many more diseases can enlarge the spleen to the point where it removes too many red blood cells. Diseases of the small blood vessels. Hemolysis that occurs in diseased small blood vessels is called micro-angiopathic hemolysis. It results from damage caused by rough surfaces on the inside of the capillaries. The RBCs squeeze through capillaries one at a time and can easily be damaged by scraping against the vessel walls. Immune reactions to RBCs.

Several types of cancer and immune system diseases produce antibodies that react with RBCs and destroy them. In 75% of cases, this reaction occurs all by itself, with no underlying disease to account for it. Transfusions. If a patient is given an incompatible blood type, hemolysis results. Kidney failure and other serious diseases. Several diseases are characterized by defective blood coagulation that can destroy red blood cells. Erythroblastosis fetalis . Erythroblastosis fetalis is a disease of newborns marked by the presence of too many immature red blood cells (erythroblasts) in the baby's blood. When a baby's mother has a different blood type, antibodies from the mother may leak into the baby's circulation and destroy blood cells. This reaction can produce severe hemolysis and jaundice in the newborn. Rh factor incompatibility is the most common cause. High bilirubin levels in newborns. Even in the absence of blood type incompatibility, the newborn's bilirubin level may reach threatening levels.

Normal jaundice in newborns Normal newborn jaundice is the result of two conditions occurring at the same time—a pre-hepatic and a hepatic source of excess bilirubin. First of all, the baby at birth immediately begins converting hemoglobin from a fetal type to an adult type. The fetal type of hemoglobin was able to extract oxygen from the lower levels of oxygen in the mother's blood. At birth the infant can extract oxygen directly from his or her own lungs and does not need the fetal hemoglobin any more. So fetal hemoglobin is removed from the system and replaced with adult hemoglobin. The resulting bilirubin loads the system and places demands on the liver to clear it. But the liver is not quite ready for the task, so there is a period of a week or so when the liver has to catch up. During that time the baby is jaundiced. Hepatic jaundice Liver diseases of all kinds threaten the organ's ability to keep up with bilirubin processing.

Starvation , circulating infections, certain medications, hepatitis, and cirrhosis can all cause hepatic jaundice, as can certain hereditary defects of liver chemistry, including Gilbert's syndrome and Crigler-Najjar syndrome. Post-hepatic jaundice Post-hepatic forms of jaundice include the jaundices caused by failure of soluble bilirubin to reach the intestines after it has left the liver. These disorders are called obstructive jaundices. The most common cause of obstructive jaundice is the presence of gallstones in the ducts of the biliary system. Other causes have to do with birth defects and infections that damage the bile ducts; drugs; infections; cancers; and physical injury. Some drugs—and pregnancy on rare occasions—simply cause the bile in the ducts to stop flowing. Symptoms and complications associated with jaundice Certain chemicals in bile may cause itching when too much of them end up in the skin. In newborns, insoluble bilirubin may get into the brain and do permanent damage. Long-standing jaundice may upset the balance of chemicals in the bile and cause stones to form.

Apart from these potential complications and the discoloration of skin and eyes, jaundice by itself is inoffensive. Other symptoms are determined by the disease producing the jaundice. Diagnosis Physical examination In many cases the diagnosis of jaundice is suggested by the appearance of the patient's eyes and complexion. The doctor will ask the patient to lie flat on the examining table in order to feel (palpate) the liver and spleen for enlargement and to evaluate any abdominal pain . The location and severity of abdominal pain and the presence or absence of fever help the doctor to distinguish between hepatic and obstructive jaundice. Laboratory tests Disorders of blood formation can be diagnosed by more thorough examination of the blood or the bone marrow, where blood is made. Occasionally a bone marrow biopsy is required, but usually the blood itself will reveal the diagnosis. The spleen can be evaluated by an ultrasound examination or a nuclear scan if the physical examination has not yielded enough information. Liver disease is usually assessed from blood studies alone, but again a biopsy may be necessary to clarify less obvious conditions. A liver biopsy is performed at the bedside. The doctor uses a thin needle to take a tiny core of tissue from the liver.

The tissue sample is sent to the laboratory for examination under a microscope. Assessment of jaundice in newborns Newborns are more likely to have problems with jaundice if: They are premature. American Liver Foundation. 1425 Pompton Ave., Cedar Grove, NJ 07009. (800) 223-0179. jaundice [jawn´dis] yellowness of skin, sclerae, mucous membranes, and excretions due to hyperbilirubinemia and deposition of bile pigments . It is usually first noticeable in the eyes, although it may come on so gradually that it is not immediately noticed by those in daily contact with the jaundiced person. Called also icterus . Jaundice is not a disease; it is a symptom of a number of different diseases and disorders of the liver and gallbladder and of hemolytic blood disorders. One such disorder is the presence of a gallstone in the common bile duct, which carries bile from the liver to the intestine. This may obstruct the flow of bile, causing it to accumulate and enter the bloodstream.

The obstruction of bile flow may cause bile to enter the urine, making it dark in color, and also decrease the bile in the stool, making it light and clay-colored. This condition requires surgery to remove the gallstone before it causes serious liver injury. The pigment causing jaundice is called bilirubin . It is derived from hemoglobin that is released when erythrocytes are hemolyzed and therefore is constantly being formed and introduced into the blood as worn-out or defective erythrocytes are destroyed by the body. Normally the liver cells absorb the bilirubin and secrete it along with other bile constituents. If the liver is diseased, or if the flow of bile is obstructed, or if destruction of erythrocytes is excessive, the bilirubin accumulates in the blood and eventually will produce jaundice. Determination of the level of bilirubin in the blood is of value in detecting elevated bilirubin levels at the earliest stages before jaundice appears, when liver disease or hemolytic anemia is suspected. Patient Care.

Assessment of the patient with jaundice includes observations of the degree and location of yellowing, noting the color of urine and stools, and the presence of itching. Since jaundice can be accompanied by severe itching, frequent skin care is important to preserve skin integrity. Tepid sponge baths can help reduce discomfort and promote rest. Patients with severe jaundice are at risk for encephalopathic changes that produce confusion, impaired mentation, and altered levels of consciousness. The potential for injury is increased and demands vigilance and safety measures to protect the patient. Jaundice may be attributable to prehepatic (A), hepatic (B), or posthepatic (C) causes. From Damjanov, 2000. acholuric jaundice jaundice without bilirubinemia, associated with elevated unconjugated bilirubin that is not excreted by the kidney. Familial acholuric jaundice is another name for the hereditary form of hemolytic jaundice .

breast milk jaundice elevated unconjugated bilirubin in some breast-fed infants due to the presence of an abnormal pregnane that inhibits glucuronyl transferase conjugating activity. cholestatic jaundice that resulting from abnormality of bile flow in the liver. neonatal jaundice (jaundice of the newborn) icterus neonatorum. nonhemolytic jaundice that due to an abnor-mality in bilirubin metabolism. obstructive jaundice that due to blockage of the flow of bile. physiologic jaundice mild icterus neonatorum during the first few days after birth. jaun·dice (jawn'dis), Avoid the redundant phrase yellow jaundice. A yellowish staining of the integument, sclerae, deeper tissues, and excretions with bile pigments, resulting from increased levels in the plasma. [Fr. jaune, yellow] jaundice /jaun·dice/ (jawn´dis) icterus; yellowness of the skin, scleras, mucous membranes, and excretions due to hyperbilirubinemia and deposition of bile pigments.

acholuric jaundice jaundice without bilirubinemia, associated with elevated unconjugated bilirubin that is not excreted by the kidney. (jôn′dĭs, jän′-) n. 1. Yellowish discoloration of the whites of the eyes, skin, and mucous membranes caused by deposition of bile salts in these tissues. It occurs as a symptom of various diseases, such as hepatitis, that affect the processing of bile. Also called icterus. 2. A state or feeling of negativity or bitterness arising especially from envy or world-weariness. tr.v. jaun·diced, jaun·dicing, jaun·dices 1. To affect with the discoloration of jaundice. 2. To affect with the negativity or bitterness of jaundice. jaundice [jôn′dis, jän′dis] Etymology: Fr, jaune, yellow a yellow discoloration of the skin, mucous membranes, and sclerae of the eyes caused by greater than normal amounts of bilirubin in the blood.

Because persons with dark skin sometimes have yellow-tinged sclerae, the hard palate of the mouth is often the best place to assess for jaundice. Persons with jaundice may experience nausea, vomiting, and abdominal pain and may pass dark urine and clay-colored stools. Jaundice is a symptom of many disorders, including liver diseases, biliary obstruction, and the hemolytic anemias. Physiological jaundice commonly develops in newborns and disappears after a few days. Rarer disorders causing jaundice are Crigler-Najjar syndrome and Gilbert's syndrome. Useful diagnostic procedures include a clinical evaluation of the signs and symptoms, tests of liver function, and techniques for direct or indirect visualization, such as x-ray film, computed tomographic scan, ultrasound, endoscopy or exploratory surgery, and biopsy. Also called icterus [ik′tərəs] . See also anicteric hepatitis, hyperbilirubinemia . jaundiced, adj.

Jaundiced sclera jaundice Icterus Hepatology A condition characterized by the deposition of excess–> 2 mg/dL, 34 µmol/L free or conjugated BR in peripheral circulation, and in skin, mucosa and sclerae; it is either physiologic–eg, due to hemolysis or pathologic–eg, seen in hepatitis or bile stasis. See Breast milk jaundice , Hyperbilirubinemia , Obstructive jaundice .

Jaundice types–unconjugated hyperbilirubinemia Physiologic jaundice Jaundice develops ≥ 72 hrs after birth; total BR rises to greater than 15 mg/dL; direct BR is < 15% of total BR; jaundice resolves within 1–2 weeks Etiology Sluggish glucuronyl transferase activity, ↑ of BR 'load,' ↓ plasma clearance of BR Management Phototherapy, exchange transfusion Pathological jaundice Jaundice develops in 72 hrs after birth; total BR peaks at ≤ 15 mg/dL; direct BR is > 15% of total BR; jaundice may require > 2 weeks to resolve Etiology HDN, hemolysis, extravascular loss of blood, ↑ enterohepatic circulation, breast feeding, defective BR metabolism, sepsis, metabolic disease Management Phototherapy, exchange transfusion jaun·dice (jawn'dis) 1. A yellowish staining of the integument, sclerae, and deeper tissues and of the excretions with bile pigments, which are increased in plasma. 2. Symptom of various disorders, including liver disease.

(jon'dis) [Fr. jaunisse, fr. jaune, yellow] JAUNDICE: Skin of the abdomen Yellow staining of body tissues and fluids, due to excessive levels of bilirubin in the bloodstream. Jaundice is not usually visible until the total bilirubin level rises above 3 mg/dl. It is a symptom of many illnesses, including those marked by any of the following: obstruction of the biliary tract by gallstones, inflammatory masses, or tumors (such as cholecystitis, pancreatic carcinoma); slowing of the release of bile from hepatic portals (such as cholestasis); alteration of bile metabolism at the cellular level (such as in genetic diseases such as Gilbert's disease); release of bilirubin because of liver cell injury by toxins or viruses (such as acetaminophen overdose; hepatitis B virus infection); release of bile pigments as a result of the destruction or ineffective manufacturing of red blood cells (such as hemolysis; hereditary spherocytosis); or resorption of bile from hematomas within the body, esp. after trauma.

See: illustrationjaundiced (jon'dist), adjective Synonym: icterus Symptoms Deposits of bilirubin in the skin often cause itching. Other symptoms of jaundice depend on whether the bilirubin is direct (conjugated [i.e., soluble in body fluids]) or indirect (unconjugated). Obstructive jaundice causes conjugated hyperbilirubinemia; in this disease, bile pigments dissolve in the urine, which turns bright green, and the stool appears gray or white owing to the deprivation of bile. Diagnosis Tests to determine the cause of jaundice include a carefully performed history and physical exam, urinalysis (positive for bilirubin only in conjugated hyperbilirubinemia), liver function tests, blood tests for hepatitis, and abdominal ultrasonography. Invasive diagnostic testing with cholangiography, endoscopic retrograde cholangiopancreatography, or percutaneous trans-hepatic cholangiography is performed when occult biliary obstruction is suspected. Treatment The precise cause of jaundice must be determined in each patient to provide suitable therapies.

For example, patients with gallstones obstructing the cystic duct need surgical treatment, and newborns with severe jaundice may require treatment with ultraviolet light to prevent kernicterus, but jaundiced patients with acute hepatitis A usually heal with symptomatic rather than specific remedies. acholuric jaundice Jaundice without bile pigment in the urine. Most of the excess bilirubin is unconjugated. breast milk jaundice , breast-feeding jaundice Hyperbilirubinemia resulting from pregnanediol or free fatty acids that inhibit bilirubin conjugation. Serum bilirubin level usually peaks above 20 ml/dl by 14 to 21 days of age. Some pediatricians recommend stopping breast-feeding for 24 to 36 hr if the level exceeds 20 ml/dl. If the infant's bilirubin level drops rapidly, the mother may resume nursing. It typically lasts for the first week of life or until the mother produces adequate milk. cholestatic jaundice Jaundice produced by failure of bile to flow to the duodenum.

It may be caused by intrahepatic bile duct obstruction (as in certain drug reactions), liver cell damage (as in viral hepatitis), or extrahepatic obstruction to the flow of bile (as in cholecystitis). congenital jaundice Jaundice resulting from chemical injury to the liver or sepsis. jaundice Yellowing of the skin and of the whites of the eyes (scleras) from deposition of the natural pigment, bilirubin, that is released when HAEMOGLOBIN is broken down. Bilirubin is normally excreted in the bile but cannot do so in certain liver diseases and in obstruction to the outflow of bile into the intestine. In such cases it accumulates in the blood causing jaundice. jaundice yellowing of the skin and whites of the eyes due to the presence of BILIRUBIN . The condition is caused by blockage of the bile duct, disease of the liver (e.g. hepatitis), or excessive destruction of red blood cells.

jaun·dice (jawn'dis) A yellowish staining of the integument, sclerae, deeper tissues, and excretions with bile pigments, due to increased plasma bile levels. Jaundice Symptoms, Causes, and Diagnosis Children's Health Jaundice in Babies and Children Jaundice can occur in babies, children, and adults. Jaundice is not an illness in itself, but a medical condition in which too much bilirubin -- a compound produced by the breakdown of hemoglobin from red blood cells -- is circulating in the blood. The excess bilirubin causes the skin , eyes , and mucus membranes in the mouth to turn a yellowish color. Because bilirubin is processed by the liver , the symptoms of jaundice may indicate damage to the liver in adults. If the cause is not identified and treated, it can lead to liver failure . In newborn babies, though, jaundice is common because they have extra red blood cells that begin to break down soon after they are born and their liver is often slower to process bilirubin. In otherwise healthy newborns, jaundice usually peaks at about three to five days of life and then begins to go away on its own.

In breastfed babies, this is called “ breastfeeding jaundice,” which is thought to be caused by inadequate milk intake. Another cause, although less common, is called breast milk jaundice, which usually isn't apparent until the baby is a week old and then peaks during the second or third week of life. It is caused by substances in the mother's milk that reduces the baby's liver's ability to process bilirubin. It does not require treatment, nor mean that the mother should stop breastfeeding. Jaundice during the first 24 hours of life is not considered normal and will prompt your pediatrician to do some tests on your baby to look for the cause. Newborns will often have their bilirubin measured before they are sent home from the hospital. If the level is too high, they may be placed under special "bili lights" to help them break down bilirubin. This is important, because very high levels of bilirubin can, although rarely, affect the brain in a condition called kernicterus . If your baby is jaundiced when you are discharged, it is important to ensure that he or she is getting enough to eat and to follow up with the baby’s doctor.

If you are having trouble with breastfeeding , be sure to discuss that with your doctor. Jaundice in older babies and children is not considered normal. It can be a clue to problems with the liver, infection, or other illness,. If you notice it, you should bring your child to the doctor. Jaundice: Causes, Symptoms, and Treatments - Medical News Today Jaundice: Causes, Symptoms, and Treatments Written by Caroline GillottReviewed by University of Illinois-Chicago, School of Medicine 4 31 Jaundice, also known as icterus, is a term used to describe a yellowish tinge to the skin and sclerae (the white part of the eye) that is caused by an excess of bilirubin in the blood (hyperbilirubinemia). Body fluids may also be yellow. The color of the skin and sclerae varies depending on levels of bilirubin; mildly elevated levels display yellow skin and sclerae, while highly elevated levels display brown. In this article, we will discuss what jaundice is, why it happens, and how it is diagnosed and treated.

Contents of this article: Fast facts on jaundice Here are some key points about jaundice. More detail and supporting information is in the main article. Jaundice is caused by a build up of bilirubin Jaundice can be caused by a number of conditions, including an inflamed liver and an obstructed bile duct Symptoms include a yellow tinge to the skin and whites of the eyes, dark urine, and itchiness Diagnosis of jaundice can involve a range of tests What is jaundice? A yellow tinge to the whites of the eyes is a common symptom of jaundice Bilirubin (bil-ih-ROO-bin) is a yellow-colored substance that is responsible for the yellowing of the skin and sclerae in jaundice. Bilirubin is a waste product that remains in the bloodstream after iron is removed from hemoglobin in red blood cells. When there is an excess of bilirubin, it can leak out into surrounding tissues, saturating them with this yellow substance. Bilirubin that is circulating freely in the blood is called unconjugated bilirubin.

One of the liver's functions is to filter out waste, such as bilirubin, from the blood. Once bilirubin is in the liver, other chemicals are latched on to it, creating a substance called conjugated bilirubin, which is secreted in bile (a digestive juice released by the liver) and then excreted. A product of bilirubin is what gives feces its brown color. Causes of jaundice Jaundice most often occurs as a result of an underlying disorder that either causes overproduction of bilirubin or prevents the liver from disposing of it, both of which result in bilirubin being deposited in tissues. Some underlying conditions that may cause jaundice are: Acute inflammation of the liver - may impair the ability of the liver to conjugate and secrete bilirubin, resulting in a buildup. Inflammation of the bile duct - may prevent the secretion of bile and removal of bilirubin, causing jaundice. Obstruction of the bile duct - prevents the liver from disposing of bilirubin. Hemolytic anemia - production of bilirubin increases when large quantities of red blood cells are broken down.

Gilbert's syndrome - an inherited condition that impairs the ability of enzymes to process the excretion of bile. Cholestasis - a condition where the flow of bile from the liver is interrupted. The bile containing conjugated bilirubin remains in the liver instead of being excreted.

More rare conditions that may cause jaundice include: Crigler-Najjar syndrome - an inherited condition that impairs the specific enzyme responsible for processing bilirubin Dubin-Johnson syndrome - an inherited form of chronic jaundice that prevents conjugated bilirubin from being secreted out of the liver's cells Pseudojaundice - a harmless form of jaundice in which the yellowing of the skin results from an excess of beta-carotene , not from an excess of bilirubin; usually from eating lots of carrots, pumpkin , or melon Symptoms of jaundice There are three main types of jaundice: Hepatocellular jaundice - occurs as a result of liver disease or injury Hemolytic jaundice - occurs as a result of hemolysis (an accelerated breakdown of red blood cells) leading to an increase in production of bilirubin Obstructive jaundice - occurs as a result of an obstruction in the bile duct (a system of tubes that carries bile from the liver to the gallbladder and small intestine), which prevents bilirubin from leaving the liver Jaundice, not to be confused with infant jaundice , is usually a sign of an

 underlying disorder.

Treatments for jaundice Treatment of jaundice typically requires a diagnosis of the specific cause in order to select suitable treatment options. Treatment would then target the cause, rather than the jaundice itself. Anemia-induced jaundice may be treated by increasing the amount of iron in the blood; either by taking iron supplements or eating more iron-rich foods. Hepatitis-induced jaundice may be treated with anti-viral or steroid medications. Obstruction-induced jaundice may be treated via surgery to remove the obstruction. Medication-induced jaundice is treated by selecting an alternative medication and by discontinuing medications that caused jaundice. Diagnosis of jaundice Doctors will most likely diagnose jaundice based on the patient's history and a physical exam, paying close attention to the abdomen. Doctors will be feeling for masses (tumors) in the abdomen and/or checking the firmness of the liver; a firm liver indicates cirrhosis , while a rock-hard liver indicates cancer . The severity of jaundice is determined by several tests, the first of which is a liver function test to find out whether or not the liver is functioning properly.

If the cause of the symptoms cannot be identified, a doctor may require blood tests to check levels of bilirubin and evaluate the composition of the blood. Some of these tests include: Bilirubin tests - a high level of unconjugated bilirubin relative to levels of conjugated bilirubin indicates hemolysis (accelerated breakdown of red blood cells) Full blood count (FBC), or complete blood count (CBC) - measures levels of red blood cells, leukocytes (white blood cells), and thrombocytes (platelets) Hepatitis A, B, and C tests If an obstruction of the liver is suspected, the liver's structure will be looked at with the help of imaging tests. Some of these tests include: MRI scan - uses magnetic signals to create image "slices" of the soft tissues of the human body.

Abdominal ultrasonography (ultrasound) - uses high-frequency sound waves to create a two-dimensional image of the soft tissues inside the human body CT or CAT scan - uses a thin X-ray beam to create image "slices" of soft tissues in the body Endoscopic retrograde cholangiopancreatography ( ERCP ) - a procedure that combines an endoscopy and X-ray imaging A liver biopsy is particularly useful in checking for inflammation , cirrhosis, cancer, and fatty liver. This test involves injecting a needle through the skin and into the liver to obtain a sample of the tissue, which is examined under a microscope. Complications from jaundice The symptom pruritis (itching) can sometimes be so intense that patients scratch their skin raw, have insomnia , or even commit suicide. Most complications that arise are a result of the underlying cause of jaundice, not from jaundice itself. For example, jaundice caused by a bile duct obstruction may lead to uncontrolled bleeding due to a deficiency of vitamins needed for normal blood clotting.

Prevention of jaundice Jaundice is related to the function of the liver, so it is essential that individuals maintain this vital organ's health by eating a balanced diet, exercising regularly, and refraining from exceeding recommended amounts of alcohol. Written by Caroline Gillott Click the stars to rate this article Jaundice: Causes, Symptoms, and Treatments Public / Patient Definition of Jaundice Our Jaundice (Adults) Main Article provides a comprehensive look at the who, what, when and how of Jaundice (Adults) Definition of Jaundice Take the Alcohol Quiz Jaundice: Yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment bilirubin . The yellowing extends to other tissues and body fluids. Jaundice was once called the "morbus regius" (the regal disease) in the belief that only the touch of a king could cure it. When red blood cells are removed from the bloodstream, hemoglobin , the molecule in red cells that carries oxygen, is broken down into bilirubin. The bilirubin is carried to the liver and excreted into the intestine as a component of bile.

Jaundice can indicate liver or gallbladder disease . When the excretion of bilirubin is hindered, excess bilirubin passes into the blood, resulting in jaundice. Inflammation or other abnormalities of liver cells hinder the excretion of bilirubin into bile. Or the bile ducts outside the liver may be blocked by a gallstone or a tumor. Jaundice can also result from the excessive breakdown of red blood cells (a process called hemolysis ) and too much bilirubin is released into the bloodstream. This occurs typically in the hemolytic anemias (as opposed to the aplastic anemias in which not enough red cells are produced). Jaundice is common in newborns because there is some hemolysis during labor and delivery and the newborn's liver is immature and may not be fully up to the task of handling the bilirubin for a few days. In Gilbert syndrome , the blood bilirubin levels are slightly increased, enough to cause mild jaundice. This genetic condition is usually discovered serendipitously during routine screening tests of liver function. It causes no symptoms and no problems.

The figurative use of "jaundice" in "to view things with a jaundiced eye" refers to an attitude of distaste. This may reflect the distaste with which a jaundiced person views food, since severe jaundice typically brings loss of appetite and feelings nausea . "Jaundice" is often said to have come from the French "jaune" for yellow. This is incorrect. The word "jaundice" stemmed from the Latin "galbinus" which described a light greenish-yellow color. In Old French this became "jaunisse" and, in crossing the English Channel, it became "jaundice." In French "jaundice" is still "jaunisse." The term icterus is synonymous with jaundice. A person who is icteric is jaundiced. Abnormally high blood bilirubin is termed hyperbilirubinemia . Last Editorial Review: 5/13/2016 Newborn Jaundice: Causes, Symptoms and Treatment Shares 31 Newborn Jaundice: Causes, Symptoms and Treatment After the birth of a baby, it is common for care providers to watch a newborn closely.

One of the things that your care provider will be monitoring is jaundice. Jaundice is normal in most all newborns, however if the jaundice appears out of the normal range then steps will be taken to get it back under control. What is Newborn Jaundice? Jaundice is a condition that can occur in newborns, within 2-3 days of birth. Jaundice is actually a yellowing of the skin or whites of the eyes’. This is caused by elevated bilirubin levels in the newborns blood. Jaundice normally appears first on the face and then will move down the body to the chest, abdomen, arms and legs. Jaundice is best seen in natural light and can be harder to detect in dark skinned babies. If jaundice is suspected, your health care provider will run blood tests to measure the amount of bilirubin in the blood. What can cause Jaundice or increase the chances of Jaundice? The most common type of jaundice is called Physiologic Jaundice, which can affect up to 60% of full term babies in the first week of life. It is caused by elevated bilirubin levels.

Bilirubin is a substance created by the normal breakdown of red blood cells. Bilirubin is processed and removed by the liver. Jaundice will develop when a baby’s liver is not efficient enough to remove the bilirubin from the bloodstream. Once the baby begins to mature and the red blood cell amounts diminish, the jaundice will subside with no lasting effects on the baby. This usually happens about 1-2 weeks after birth. There are other less common reasons that can cause jaundice to occur. Other causes of Jaundice include: Blood incompatibility with mom which causes an increase release of bilirubin from red blood cells Prematurity Older than 72 hours What are the Symptoms of Jaundice? The symptoms of jaundice include yellowing of the skin and yellowing of the eyes. Some times in severe cases of jaundice, a baby will seem very sleepy and have a hard time feeding. Is Jaundice Harmful? If jaundice is left untreated and bilirubin levels reach limits exceeding 25mg, there is the possibility of cerebral palsy , deafness, or certain forms of brain damage to occur.

Jaundice in itself may not become harmful to a baby, but it may be the symptom of an underlying medical condition that can cause other issues. A less serious side effect that may occur from jaundice is sleepiness in the newborn. This can cause the baby to not eat well, which can make the jaundice worsen. How is Jaundice treated? In most full term, healthy babies, jaundice will resolve on its own and no treatment other than frequent feedings will be necessary. But, dependent on the levels of bilirubin in the baby’s blood, and the age of the baby, a more aggressive approach to treatment may be needed. Treatment for jaundice includes: Frequent feedings to encourage frequent bowel moments. Bowel movements help to eliminate the bilirubin out of the body. Phototherapy- Phototherapy is a light that helps break down the bilirubin in the baby’s skin. If a baby is still in the hospital or is readmitted to the hospital, Phototherapy may be administered by placing the baby in a special warmer surrounded by these lights.

New technology also allows parents to treat mild jaundice at home by using “bili lights” or “bili-blankets” to reduce the jaundice. Some health care providers feel that placing a baby near a window where he/she can receive indirect sunlight can also help with mild cases of jaundice. In severe cases of jaundice, a blood transfusion or blood exchange may be needed. Last Updated: 08/2015 Compiled using information from the following sources: American Family Physician, Kids Health/Nemours Foundation, eMedicineHealth, American Academy of Pediatrics (AAP). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297-316. [Medline] Mercier CE, Barry SE, Paul K, et al. Improving Newborn Preventive Services at the Birth Hospitalization: A Collaborative, Hospital-Based Quality-Improvement Project. Pediatrics. 2007 Sep;120(3):481-488. [Medline] Moerschel SK, Cianciaruso LB, Tracy LR.

A practical approach to neonatal jaundice. American Family Physician. 2008 May;77(9). [Medline] Sign-Up For The APA Newsletter Get a roundup of all the best pregnancy news and tips from around the web with exclusive discounts and giveaways from our sponsors. SUBSCRIBE What Is Jaundice in Newborns? Definition, Symptoms, Causes Medical Author: Steven Doerr, MD Steven Doerr, MD Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident. Medical Editor: John Mersch, MD, FAAP John Mersch, MD, FAAP Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC.

He attended internship and residency at Children's Hospital Los Angeles. Read more about newborn jaundice and kernicterus » Jaundice definition Jaundice is the yellowish discoloration of the skin, mucous membranes and the whites of the eyes (sclerae) caused by elevated levels of bilirubin in the blood (hyperbilirubinemia). The term jaundice is derived from the French word jaune, which means yellow. Jaundice is not technically a disease, but rather it is a visible sign of an underlying condition causing increased levels of bilirubin in the blood. Jaundice in newborns (neonatal jaundice) Neonatal jaundice is the most common condition requiring medical evaluation in a newborn . Though it is often a normal and transient physiologic consequence of the newborn's immature liver , there are a variety of other medical conditions which can cause severe neonatal jaundice. Jaundice in the newborn must be carefully monitored, as excessively elevated levels of bilirubin that go untreated for too long, can lead to permanent brain damage (a condition termed kernicterus). What causes jaundice in newborns?

Jaundice is caused by the accumulation of bilirubin in the blood, typically from an increased production of bilirubin or a decreased ability to metabolize and excrete it. Bilirubin is formed when red blood cells break down and is normally metabolized in the liver and excreted in urine and feces. Neonatal jaundice can be caused by several different conditions, and it is very commonly seen in newborns. The most common cause in newborns is physiologic jaundice, which affects most newborns and is usually benign. However, there are many other causes of neonatal jaundice that can be more serious, and require further medical evaluation and intervention. A newborn that develops jaundice within the first 24 hours of life requires immediate medical attention. The following are some of the causes of neonatal jaundice. Medically Reviewed by a Doctor on 9/6/2016 Hyperbilirubinemia in the Newborn - Health Encyclopedia - University of Rochester Medical Center Hyperbilirubinemia in the Newborn What is hyperbilirubinemia in the newborn?

Hyperbilirubinemia happens when there is too much bilirubin in your baby’s blood. Bilirubin is made by the breakdown of red blood cells. It’s hard for babies to get rid of bilirubin at first. It can build up in their blood, tissues, and fluids. Bilirubin has a color. It makes a baby’s skin, eyes, and other tissues turn yellow (jaundice). Jaundice may first appear when your baby is born. Or it may also show up any time after birth. What causes hyperbilirubinemia in the newborn? During pregnancy, the placenta removes bilirubin from your baby’s blood. When a baby is born, the baby's liver takes over this job. Your baby may have too much bilirubin for many reasons. Physiologic jaundice During the first few days of life, babies aren’t able to get rid of much bilirubin. This normal type of jaundice happens as a response to a baby’s reduced ability to remove bilirubin. But it may be hard at first to tell if jaundice is being caused by another problem.

Breastfeeding failure jaundice Some babies don’t breastfeed well at first. This causes breastfeeding failure jaundice. Not feeding well makes your baby dehydrated. It also causes your baby to urinate less. This makes bilirubin build up in your baby’s body. Babies born between 34 to 36 weeks of pregnancy are more likely to get this problem. These babies often don’t have the coordination and strength to breastfeed well. But this condition is also common in early-term newborns (37 to 38 weeks). It can also happen in any newborns who have had a difficult start, especially if they were separated from their mother and unable to feed frequently. It usually gets better once a baby learns how to breastfeed well. Breastmilk jaundice About 2% of breastfed babies get jaundice. This happens later in their first week of life. It peaks at about 2 weeks of age. It can last 3 to 12 weeks. It is not dangerous but tests may need to be done for other problems that are dangerous. This issue may be caused by a substance in breastmilk.

This substance may increase how much bilirubin the baby's body can reabsorb. Jaundice from hemolysis If your baby has Rh disease (hemolytic disease of the newborn due to having a different blood type from the mother's), he or she may get this type of jaundice. This issue can also be from having too many red blood cells or rare problems in which the red blood cells are more fragile than normal. Hemolysis is the word for the process in which the red blood cells break down and release bilirubin. Jaundice caused by poor liver function Jaundice can happen if your baby’s liver doesn’t work well. This may be because of an infection or other factors. The liver is the part of the body most responsible for getting rid of bilirubin. A problem with the liver can cause higher levels of bilirubin. Who is at risk for hyperbilirubinemia in the newborn? About 60% of full-term newborns get jaundice. So do 80% of premature babies. Babies born to mothers with diabetes or Rh disease are more likely to have this condition.

What are the symptoms of hyperbilirubinemia in the newborn? Symptoms can occur a bit differently in each child. They can include: Yellowing of your baby’s skin and the whites of his or her eyes. This often starts on a baby’s face and moves down his or her body. Poor feeding Lack of energy The symptoms of this health problem may be similar to symptoms of other conditions. Make sure your child sees a healthcare provider for a diagnosis. How is hyperbilirubinemia in the newborn diagnosed? The timing of when your child’s jaundice first starts matters. It may help his or her healthcare provider make a diagnosis. First 24 hours. This type of jaundice is often serious. Your child will likely need treatment right away. Second or third day. This is often physiologic jaundice. Sometimes it can be a more serious type of jaundice. It's important to be sure the baby is getting enough milk at this point. Toward the end of the first week. This type of jaundice may be from breastmilk jaundice but may be due to an infection or other rare serious problems. In the second week.

This is often caused by breastmilk jaundice but may be caused by rare liver problems. Your child’s healthcare provider may do the following tests to confirm the diagnosis: Direct and indirect bilirubin levels. These levels show if bilirubin is bound with other substances by your child’s liver. Normal physiologic jaundice involves indirect bilirubin. Jaundice due to more serious problems can have high levels of either type of bilirubin. Red blood cell counts Blood type and testing for Rh incompatibility (Coomb's test) How is hyperbilirubinemia in the newborn treated? Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Phototherapy Bilirubin absorbs light. High bilirubin levels often decrease when a baby is put under special blue spectrum lights. This is called phototherapy. Your child may get this treatment in the day and night. It may take several hours for it to start working. During light treatment, your baby’s eye will be protected. Your baby’s healthcare provider will check your baby’s temperature. He or she will also test your baby’s bilirubin levels.

This will tell if phototherapy is working. Fiber optic blanket A fiber optic blanket is another form of phototherapy. The blanket is usually put under your baby. It may be used alone or with regular phototherapy. Exchange transfusion This treatment removes your baby’s blood that has a high bilirubin level. It replaces it with fresh blood that has a normal bilirubin level. This raises your baby’s red blood cell count. It also lowers his or her bilirubin level. During the procedure, your baby will switch between giving and getting small amounts of blood. This will be done through a vein or artery in the baby's umbilical cord. It is only done in an intensive care nursery when bilirubin levels are extremely high. Your baby may need to have this procedure again if his or her bilirubin levels stay high. Feeding with breastmilk The American Academy of Pediatrics says that you should keep breastfeeding a baby with jaundice. If your baby has not been getting enough milk at the breast, you may need to supplement with pumped breastmilk or formula. Treating any underlying cause of the condition This may include treating an infection. In very rare conditions a liver transplant may be needed.

What are the complications of hyperbilirubinemia in the newborn? High levels of bilirubin can travel to your baby’s brain. This can cause seizures and brain damage. This is called kernicterus. Can hyperbilirubinemia in the newborn be prevented? This condition can’t really be prevented except in the case of breastfeeding failure jaundice. Feedings should start within the first hour of life and continue at least every 2 or 3 hours, or sooner if the baby shows signs of wanting to eat. The more premature the baby, the more likely he or she is to need supplements of expressed milk or formula at first. For all babies, spotting jaundice early and getting treatment right away are key. This can stop your baby’s bilirubin levels from rising to dangerous levels. Key points about hyperbilirubinemia in the newborn Hyperbilirubinemia happens when there is too much bilirubin in your baby’s blood. About 60% of full-term newborns and 80% of premature babies get jaundice. The most common symptom is yellowing of your baby’s skin and the whites of his or her eyes.

The timing of when your child’s jaundice first starts matters. It can help his or her healthcare provider make a diagnosis. Make sure you feed your baby early and often. Spotting jaundice early and getting treatment right away are key. This can stop your child’s bilirubin from rising to dangerous levels. Next steps

Question: What is the medical condition icterus commonly called?
Answer: Jaundice