Jaundice occurs when there are high levels of bilirubin (a yellow bile pigment) in the blood, causing the skin or whites of the eyes (sclera) to turn and look yellow. This condition, called hyperbilirubinemia, is caused when there is a problem in any of the 3 phases during bilirubin production.
Bilirubin is produced when the haemoglobin (red blood cells) is broken down and carried in the bloodstream to the liver where it binds with bile. Then, it is moved into the digestive tract, through the bile ducts, where it will be eliminated from the body, mostly in stools but a small amount in urine too. When bilirubin cannot be moved quickly enough through the liver and bile ducts, the result is a build-up in the blood which gets deposited in the skin, leading to jaundice.
Causes of Jaundice
There are many causes of jaundice that contribute to these factors:
- Interrupt the flow of bile
- Affect the production of bilirubin
- Damage the liver
- Trigger hemolysis (the destruction of red blood cells), which produces more bilirubin than what the liver can handle
Conditions that affect the production of bilirubin include:
- Viruses – Hepatitis A, Chronic Hepatitis B and C
- Autoimmune disorders
- Medicines – NSAIDs, Antibiotics, Acetaminophen
Conditions that may cause an obstruction along biliary tract that prevents the flow of bile into the intestines:
- Gallbladder Cancer
- Pancreatic Cancer
- Cholangiocarcinoma (bile duct cancer)
Symptoms of Jaundice
The obvious characterisation of jaundice is yellow-tinted skin and eyes. You may also have dark urine and light-coloured stools. Other symptoms include vomiting, fever, abdominal pain, weight loss, and skin itching (pruritus).
It is important to not misdiagnose yourself when you experience yellow skin only, as it may be due to excess beta carotene in your system. It is an antioxidant found in foods such as sweet potatoes, pumpkins and carrots. Too much of this antioxidant is not a cause of jaundice.
Look out for warning signs and more serious symptoms like stomach pain and tenderness, blood in vomit or stools, tendency to bruise or bleed easily, and changes in mental function such as confusion, drowsiness or agitation.
How is Jaundice Evaluated and Diagnosed?
When you visit a clinic in Singapore, your doctor will perform a physical examination and carry out blood tests to confirm the presence of jaundice and further determine its cause. Usually, imaging tests such as computed tomography (CT) scanning, magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are done to detect blockages in the bile ducts. Sometimes, a biopsy may be required if certain causes are suspected or when the diagnosis is unclear after receiving the results of other tests. Treatments for jaundice depend on the cause identified.