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Jaundice

Jaundice is a sign of an underlying disease that occurs when there’s too much bilirubin in your blood. Dr Jeske discusses the causes and diagnosis options in dealing with Jaundice.

Jaundice

Jaundice is a sign of an underlying disease; it occurs when there’s too much bilirubin in your blood. Bilirubin comes from the break down of old red blood cells, which the liver filters from the bloodstream.

Jaundice may develop if there is either an increased breakdown of red blood cells, the liver’s functional capacity decreases or there is a blockage in the excretion of bile. Bilirubin builds up and can cause your skin to look yellow.

What is Bilirubin?

Bilirubin is a yellowish pigment that is made during the normal breakdown of red blood cells. Higher than normal levels of bilirubin may indicate an underlying liver or bile duct problem. Eventually, most of it leaves the body in the faeces.

Causes

Jaundice is divided into 3 groups: according to the different causes.

  1. Pre-hepatic (before bile is made in the liver).
    • Haemolysis (rupture or destruction of red blood cells), the most common cause of prehepatic jaundice, this involves increased production of bilirubin.
    • Less common cause of pre-hepatic jaundice includes Gilbert’s disease and Grigler-Najjar syndrome
  1. Hepatic (problems arising within the liver).

Jaundice in these cases is caused by the liver’s inability to properly metabolize and excrete bilirubin. Examples include:

    • Certain medicines: Drugs like acetaminophen, penicillin, birth control pills, and steroids have been linked to liver disease.
    • Alcohol-related liver disease: If you drink too much over a long period of time — typically 8 to 10 years — you could seriously damage your liver. Two diseases in particular, alcoholic hepatitis and alcoholic cirrhosis, harm the liver.
    • Hepatitis: Most of the time, this infection is caused by a virus. It may be short-lived (acute) or chronic, which means it lasts for at least 6 months. Drugs or autoimmune disorders can cause hepatitis. Over time, it can damage the liver and lead to jaundice.
  1. Post-hepatic (after bile has been made in the liver)
    • Blocked bile ducts: These are thin tubes that carry a fluid called bile from the liver and gallbladder to the small intestine. Sometimes, they get blocked by gallstones, cancer, or rare liver diseases. If they do, you could get jaundice.
    • Pancreatic cancer: This is the 10th most common cancer in men and the ninth in women. It can block the bile duct, causing jaundice.
    • Cancer is also an overlapping cause of post-hepatic jaundice.

Symptoms

  • Yellow discolouration of the skin and mucous membranes
  • Light-coloured stools
  • Dark-coloured urine
  • Itching of the skin
  • Nausea and vomiting
  • Abdominal pain or discomfort
  • Fever
  • Loss of appetite
  • Headache

Tests

Liver function tests.

Blood tests that measure certain enzymes or proteins in your blood as well as your bilirubin levels

Albumin and total protein.

Levels of albumin — a protein made by the liver — and total protein show how well your liver is making proteins that your body needs to fight infections and perform other functions.

Complete blood count.

This test measures several components and features of your blood

Prothrombin time.

This test measures the clotting time of your blood

Treatment

The treatment of jaundice depends on what is causing it. All cases of jaundice require a detailed physical examination and work-up to ensure optimal treatment.

Contact

Please contact our rooms for an appointment if you have experienced or are experiencing any of the above mentioned symptoms at (012) 644 1327, or use any of the provided links on our website or facebook page to book or send us an e-mail at reception@generalsurgery.co.za.

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