Jaundice

What is jaundice?

This is caused by bilirubin, a health condition that causes yellowing of the skin, mucous membranes and pupils. Bilirubin, one of the liver fluids, is formed by the breakdown of red blood cells. If bilirubin levels rise, a disease called jaundice occurs. Jaundice is a disease that can be seen in newborn babies as well as in adults.

Diagnostic criteria for jaundice

Among the points that doctors consider in the diagnosis of jaundice are the following:

• Yellowing of the skin
• Palmar erythema (discoloration of the palm and fingers)
• Abnormal collection of veins close to the skin surface

Urine test

Excess bilirubin in the body is excreted in the urine. For this reason, a urine test should be performed to evaluate the bilirubin level.

Blood test

Patients with positive bilirubin in urine test should also have their serum bilirubin levels checked. This value, called CBC, determines the level of bilirubin in the blood.

Imaging methods

Imaging methods such as ultrasonography and CT are used to determine the size and tenderness of the liver.

Biopsy

A liver biopsy can also be performed to determine the cause of jaundice and to diagnose possible liver problems.

Causes of jaundice

Jaundice is caused by problems in the production of bilirubin. In addition to the problem in the production of bilirubin, which is produced in three stages, jaundice can also be seen for the following reasons:

• Reabsorption of clotted blood (hematoma) under the skin
• Hemolytic anemias, which are explained as a condition in which blood cells are destroyed and removed from the bloodstream before their normal life span expires

If jaundice is seen due to problems that may occur during bilirubin production, the causes are as follows:

• Hepatitis A, chronic hepatitis B and C viruses
• Epstein-Barr virus
• Alcohol
• Autoimmune diseases
• Rare genetic disorders
• Acetaminophen toxicity
• Penicillins
• Oral contraceptives
• Chlorpromazine
• Estrogenic or anabolic steroids
• Cirrhosis

In addition to these causes, jaundice can also be caused by obstruction of the bile duct. Among the factors that cause obstruction of the bile duct are the following:

• Gallstones
• Pancreatic tumor
• Inflammation of the gallbladder
• Gallbladder cancer
• Sickle cell anemia
• Lymphoma
• Having surgery

Symptoms of jaundice

In some cases, patients do not show any signs of jaundice. In these patients, jaundice is diagnosed incidentally. The severity of the symptoms of jaundice varies depending on the causative agent and how fast it develops. Symptoms of jaundice, which is usually caused by infection, include the following:

• Fire
• Flu-like symptoms
• Tremor
• Change in skin color (people with brown and black skin will have less noticeable skin discoloration).
• Abdominal pain
• Dark urine and/or clay-colored stools
• Loss of appetite
• Weight loss
• Fatigue
• Confusion

In addition, in cases where jaundice is not caused by infection, patients may experience weight loss and itchy skin.

If jaundice is caused by pancreatic or gallbladder cancer, the most common symptom is abdominal pain. There is also a risk of developing liver-related jaundice in the following cases

• Joint inflammation (polyarthralgia)
• Chronic hepatitis or liver inflammation
• Acute hepatitis A, B, C
• Pyoderma gangrenosum

Jaundice treatment methods

Jaundice in adults does not need to be treated. However, the causative agent of jaundice needs to be identified and treated. In addition, complications caused by jaundice, such as itching, can also be treated. In infants, jaundice is considered a serious health problem. For this reason, babies are treated for jaundice.

In order to alleviate the symptoms caused by jaundice, patients can do the following:

• Plenty of rest is needed
• Drink plenty of fluids
• Alcohol should be avoided
• Medicines that affect the liver should not be used.

If jaundice is caused by causes such as gallstones, then surgery is recommended to treat the jaundice and the underlying cause. Among the health problems for which surgery is recommended are the following.

• Pancreatic cancer
• Gallstones
• Blockage of the Safa canal

Side effects caused by treatment of jaundice

Treatments for jaundice may cause some side effects in patients. These side effects include the following.

• Diarrhea
• Constipation
• Vomiting
• Bloating
• Vomiting
• Abdominal pain
• Stomach upset
• Gas

Phototherapy

Phototherapy, which is a form of treatment using rays of specific wavelengths, is also the rays contained in natural sunlight. It is a method applied not only in the treatment of jaundice but also in the treatment of diseases such as eczema, vitiligo and psoriasis.

Thanks to the wavelengths used in phototherapy, excess bilirubin in the blood is dissolved in the urine and thus excreted outside the body. If babies are treated with phototherapy, which does not cause any harm to babies, 24 hours of treatment is usually sufficient for recovery.

It is considered natural to see some bilirubin increase in newborns after the end of phototherapy treatment, which is a treatment method applied when the bilirubin level in the blood of newborn babies is above 15 mg/dL.

Neonatal jaundice

Jaundice in newborn babies is quite common and usually harmless. In newborn babies, jaundice causes the skin and pupils to turn yellow. However, skin color changes are more difficult to notice in dark babies. The change in the skin of these babies can be seen more easily on the palms of the hands and soles of the feet. Other symptoms of jaundice that can be seen in newborn babies include the following.

• The urine of newborn babies should be colorless. However, in babies with jaundice, urine is dark yellow in color.
  
• Another symptom seen in newborn babies with jaundice is the pale color of their poop.
• Babies are sleepier than usual
• Babies have difficulty feeding

The first symptoms of jaundice in newborn babies usually start 2 weeks after birth and disappear spontaneously after 2 weeks without any treatment. During the first examination for newborns, the pediatrician will also examine the babies for jaundice. Although it usually does not require treatment, in some cases newborn babies may need to be treated.

Why do newborn babies get jaundice?

The reason why jaundice is common in babies is the rapid breakdown and renewal of blood cells. As a result of this natural and necessary process, high levels of bilirubin in the blood are expected.

In addition, the livers of newborn babies are not fully developed. Therefore, it is more difficult to remove bilirubin from the blood. However, by the time babies are 2 weeks old, their livers are able to process bilirubin more efficiently. For this reason, jaundice usually disappears on its own.

However, in some cases, jaundice in newborns is a sign of another underlying health problem. This risk increases especially if jaundice develops in the first 24 hours after birth.

The rare causes of neonatal jaundice are as follows:

• Incompatible blood groups of the mother and father
• Biliary atresia is one of the causes of jaundice (usually lasting more than 2 weeks). Babies with this disease continue to develop normally. However, if left undiagnosed, they may develop serious liver disease at an older age).

How common is neonatal jaundice?

Jaundice, one of the most common conditions affecting newborn babies, occurs in 6 out of every 10 babies. 37th day of pregnancy Jaundice is seen in 8 out of every 10 babies born before their due date.

Despite jaundice being so common in newborn babies, 1 in 20 sick babies need treatment. In addition, although the cause is unknown, breastfeeding can cause jaundice to persist for 1 month or longer in babies.

Treatment of jaundice in newborn babies

Treatment of jaundice in newborn babies is performed in case of very high levels of bilirubin in blood tests. This is because bilirubin can cross the blood-brain barrier and cause brain damage. For this reason, treatment of jaundice in newborn babies is applied under hospital conditions. There are 2 main methods that can be used to treat jaundice.

The first of these methods is phototherapy. This method uses a special type of light to break down bilirubin so that it can be more easily metabolized by the liver.

Another method used in the treatment of jaundice in newborn babies is blood exchange. In this treatment, the babies' blood is removed and replaced with blood from a suitable donor. Blood exchange is the fastest method of jaundice treatment.

Although bilirubin levels are very high in newborns, if left untreated, babies are at risk of developing permanent brain damage. This condition is called kernicterus.

Jaundice in the elderly

The symptoms of jaundice in older people may be different from those in younger people. In elderly patients, the symptoms are more vague. It is therefore more difficult to diagnose. For example, abdominal pain is less severe in older patients. In addition, jaundice can easily be mistaken for dementia if it causes confusion. For this reason, symptoms in elderly patients can be confused with symptoms of other diseases.

Jaundice in older people is usually caused by a blockage of the bile duct. A possible cause of this blockage is cancer. For this reason, cancer is usually suspected in elderly patients with itching, weight loss, abdominal swelling but no abdominal pain.

Evaluation of jaundice according to its occurrence

The types of jaundice seen depending on the cause of jaundice include the following.

Hepatic

Hepatic jaundice is caused by the inability of the liver to convert indirect bilirubin to direct bilirubin. Therefore, indirect bilirubin levels are high. The reason why the liver cannot fulfill this function is due to diseases that affect the liver tissue.

Posthepatic

It refers to jaundice caused by problems with the gallbladder ducts. In this form, indirect bilirubin is converted to direct bilirubin in the liver, but bile fluid cannot be delivered to the intestines due to obstruction of the bile ducts. This causes bilirubin to enter the bloodstream. If the disease becomes chronic, indirect bilirubin levels also start to rise. Because over time, the liver also begins to fail to fulfill its function.

Prehepatic

It is the name given to jaundice due to high levels of erythrocyte destruction. It is especially seen in newborn babies born by caesarean section and prematurely.

Types of jaundice

Jaundice is divided into 3 groups.

Hemolytic jaundice

The destruction of red blood cells in the blood causes bile to enter the blood. In hemolytic jaundice, patients have normal urine color but dark stools.

Hepatic jaundice

It is a type of jaundice caused by infections in the liver due to viruses. The infection causes swelling of the liver cells and blockage of the bile duct. Symptoms of hepatic jaundice appear slowly. It is the most common type of jaundice. The most common symptoms include the following.

• Fire
• Loss of appetite
• Diarrhea
• Vomiting

Obstructive jaundice

Jaundice caused by blockage of the bile ducts.

Is jaundice contagious?

Jaundice, which is generally considered an infectious disease, is more common especially in the summer months. For jaundice to be contagious, it must be caused by a virus that causes infection in the liver. Otherwise, jaundice in people with jaundice due to obstruction of the bile duct or neonatal jaundice is not contagious.

Is jaundice fatal?

Jaundice is generally not a fatal disease. In fact, treatment methods that are appropriate for the treatment of jaundice are often not applied. However, the cause of jaundice needs to be treated. If this factor is left untreated, serious liver damage can occur. Serious liver diseases are life-threatening.

What should the jaundice values be?

The bilirubin level in the blood of a healthy person is between 0 and 0.3 mg/dL. In order to talk about jaundice, the value must be between 0.3 and 1.2 mg/dL.