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What Is Jaundice? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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Jaundice is a condition that causes the skin and eyes’ whites to become yellow as per the Centers for Disease Control and Prevention (CDC). It is formed when a yellow substance known as bilirubin accumulates in the blood. Bilirubin is formed in hemoglobin when it (the protein present in red blood cells that carries oxygen) is destroyed, according to Merck Manual.

 

It is bound to bile in the liver and then moves to the digestive tract, which is then disposed of in the stool. (A tiny amount is removed through the urine.) If bilirubin is unable to traverse the liver or the bile ducts as quickly as it should it builds up in the bloodstream and is stored in the eyes, skin as well as other tissues, causing jaundice.

 

The common occurrence of jaundice in newborns is. If a baby is suffering from jaundice, it will usually go disappears on its own but in rare instances, it may become more serious and lead to bigger problems. The condition can also develop in adults with a particular disease.

 

The signs and symptoms of jaundice

Infants

Typically, the distinct color of jaundice begins on the face of babies and then spreads throughout the body, to the abdomen, chest, legs, and arms as per the CDC.

 

The eyes’ whites may also develop an orange-yellow color. Baby signs that require an appointment on the same day with the doctor are:

  • Very yellow or orange-colored skin
  • Extremely fussy
  • It is difficult to get up
  • Sleeping in the middle of the night
  • Poor feeding
  • Only a few diapers are dirty or wet.

 

If your baby displays any of the following signs Seek medical help immediately:

  • Crying in high-pitched or heavy-pitched
  • They are able to arch their bodies like bows
  • A stiff or limp body
  • Eye movements that are unusual

 

Adults

A few adults also are prone to jaundice, as per researchers at the Cleveland Clinic.

 

Although some people don’t show any signs For others, the signs might be:

  • Change in skin color
  • The flu-like symptoms include chills and fever
  • Dark urine
  • Colored stool made of clay
  • Itchy skin
  • Weight loss

 

According to the Merck Manual Other indicators of jaundice for adults include:

  • The presence of blood in the vomit or in stool
  • Tarry black stool
  • Extreme abdominal discomfort and tenderness
  • Sudden drowsiness, agitation, or confusion
  • The bleeding or bruising can be painful Sometimes, it can cause an eruption consisting of reddish, purple-red dots or bigger streaks

 

Causes and Risk Factors for Jaundice

Infants

There are several ways that infants can develop jaundice. It is possible to have:

Physiologic Jaundice The mother’s organs are charged with eliminating any bilirubin that the child has. When the baby is born the liver will take over. However, if the liver of the baby isn’t fully developed enough to handle bilirubin, it builds up and jaundice can occur, according to the CDC.

 

It’s the most typical reason given for infant jaundice and is usually nothing to be concerned about. Suboptimal intake of jaundice Sometimes referred to as breastfeeding jaundice It usually occurs during the infant’s first week and when they may not be getting the right quantity of breast milk. Due to this, there is an increase in bilirubin reabsorption within the intestines, which results in elevated levels of bilirubin in the blood. In the same way, insufficient consumption of breast milk could slow the flow of bilirubin-rich meconium, which is the baby’s first stool. This first bowel movement is a crucial method to eliminate bilirubin from the body, says the CDC.

 

Milk Jaundice Milk JaundiceThis kind of jaundice usually is seen in the infant’s second or subsequent stage of development. It isn’t clear the exact reason behind jaundice in breast milk however, it is believed that the components in the milk of the breast can hinder the baby’s liver from processing bilirubin properly.

 

Blood Type If a baby and a mother possess distinct (incompatible) blood kinds the body of the mother produces antibodies that attack the baby’s blood cells, which makes the infant more likely to develop jaundice, as per KidsHealth.

 

This happens it happens when the blood type of the mother is O, that of the child’s blood type is B or A, and the mother’s Rh factor (a protein that is found within red blood cells) is negative, and it can be Rh-positive.

 

Glucose-6-Phosphate Dehydrogenase Deficiency An enzyme known as G6PD (glucose-6-phosphate dehydrogenase) aids red blood cells in their function. If you have a deficiency in G6PD baby’s blood cells aren’t producing enough G6PD or the ones that are made don’t work, causing Red blood cells to split into pieces, which can cause jaundice, according to KidsHealth.

 

G6PD deficiency is the most frequent among males of African origin.

 

“Infants of Mediterranean descent may also be at increased risk for G6PD deficiency,” Explains David L. Hill, MD, adjunct assistant professor of pediatrics at the University of North Carolina School of Medicine in Chapel Hill. “But as long as doctors follow standard bilirubin monitoring guidelines, these issues shouldn’t overly concern parents.”

 

Other Disorders Underlying the Same In this instance, jaundice may surface in a different timeframe, or be present earlier than the more common types of jaundice that are born according to the Mayo Clinic.

 

The factors that can cause jaundice are:

  • Internal bleeding
  • Infections of the blood ( sepsis)
  • Infections caused by bacteria or viruses
  • Scarred or blocked bile ducts
  • Anomalies in red blood cells
  • A condition that can affect the liver similar to cystic fibrosis In accordance with the March of Dimes

 

Risk Factors

Although jaundice is a common occurrence, however, there are a variety of factors that can increase the likelihood of a baby developing the condition, which include:

Being born before 37 weeks is more likely that the liver of a baby born prematurely isn’t fully developed, this means that it might not be able to properly process and be able to pass enough Bilirubin.Siblings with jaundice if you have a child who was diagnosed with jaundice when they were babies it is more likely that the children of yours will also develop jaundice.At Birth, BruisedA baby who is born in a state of bruises has a higher chance be afflicted with jaundice. This is because the time that large bruises heal they can result in an increase in bilirubin levels. 

Adults

In adults, jaundice is typically caused by reactions to medications or other conditions that affect the liver, hinder liver bile flow, or cause the degeneration in red blood cells according to Merck Manual.

 

According to the Cleveland Clinic, causes of jaundice among adults range from not only:

  • Reabsorption of massive hemoglobin (a collection of blood that has clotted under the skin)
  • Hemolytic anemias are blood cells that are destroyed in a hurry and removed from the bloodstream.
  • Medicines, such as Acetaminophen penicillin, acetaminophen oral contraceptives chlorpromazine (Thorazine), and anabolic steroids that are estrogenic or anabolic.
  • Viruses, which include Hepatitis A chronic Hepatitis B and C, as well as Epstein-Barr
  • Autoimmune Disorders
  • Overuse of alcohol can lead to hepatitis
  • Rare genetic metabolic defects
  • Gallstones
  • Inflammation in the gallbladder
  • Gallbladder cancer
  • Pancreatic cancer
  • The nonalcoholic fat-liver disease is caused by risk factors such as obesity and diabetes

 

Hereditary disorders that alter the process by which the body uses bilirubin, for instance, Gilbert syndrome or Dubin-Johnson Syndrome, may cause jaundice, but it is not as common as per the Merck Manual.

 

What is the best way to diagnose jaundice?

Infants

The CDC states that infants must be examined for jaundice at a minimum every 8-12 hours during the first 48 hours of their life and again prior to 5 days old.

 

Testing Options include:

Light Meter This light meter is mounted on the baby’s head to determine the transcutaneous bilirubin (TcB) amount.

The Blood TestThe infant’s serum total bilirubin (TSB) levels are measured following a small amount of blood taken from the heel of the infant. According to CDC, this is the most reliable method to determine the bilirubin level in the infant.

 

Adults

In adults, the fading of jaundice might be obvious however, determining the cause of the problem requires an examination. According to the Merck Manual Additional testing might include:

  • Testing for Blood Different types of blood tests can be used for blood tests, such as a complete test for blood counts, blood culture and liver enzyme tests, and Hepatitis tests.
  • Testing for Imaging The abdomen ultrasound is typically used to find obstructions in the bile drains. Computerized tomography (CT) scan Magnetic resonance imaging ( MRI) or other tests that examine the flow of the liver’s bile may be performed.
  • Liver Biopsy If you suspect that you have hepatitis virus, or drug use, as well as exposure to toxic substances, are suspects (or when the diagnosis is not clear) it is possible that a biopsy might be required.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP) ERCP is an operation that examines the bile ducts with an endoscope. According to MedlinePlus.
  • Laparoscopy (Rarely) This is where your doctor makes a small cut beneath the navel and inserts a tube equipped with cameras (laparoscope) to study the gallbladder and the liver. (If an incision larger than the navel is needed, the procedure is called a laparotomy.)

 

Prognosis for Jaundice

Jaundice born to a baby isn’t a problem in the majority of cases It is usually able to heal without treatment, says MedlinePlus.

 

Jaundice isn’t usually treated in adults. But, its sources and causes are the main focus in treatment and treatment, according to the Cleveland Clinic.

 

The duration of jaundice

It’s quite normal for jaundice to last for around one month for breastfed infants. For infants, fed formula jaundice typically subsides after two weeks, as per HealthyChildren.org.

 

In adults, the length of jaundice can depend on the root cause of the problem and can range from short-term to non-resolvable. For instance, if your jaundice was caused by an infection the symptoms are likely to improve after your infection is gone as per an American family physician.

 

If you’re taking a medication that causes your jaundice, it’ll likely fade once your stop using the medication. If you have gallstones your jaundice will go away after the gallbladder has been removed. If you’ve got chronic Liver disease If you have chronic hepatitis or non-treatable hepatobiliary tumors jaundice you experience may not get better.

 

Treatment and Alternatives to Medication for Jaundice

Infants

Treatment options and medications for jaundice vary for adults and infants. As per the Mayo Clinic If the baby suffers from severe or moderate jaundice, these treatment choices could apply:

  • Extra Feeding Your physician may recommend regular feedings or supplements.
  • Phototherapy The baby is dressed in diapers and placed under blue-green light sources which help to break down bilirubin inside the skin, so it can be eliminated.
  • blood Protein TransfusionWhen a baby’s jaundice can be traced to blood types incompatible between mom and dad, an intravenous transfusion of the immunoglobulin (IVIg) could be necessary. Immunoglobulin is a blood protein, that reduces the number of antibodies contributing to the destruction of the baby’s red blood cells.
  • Exchange Transfusion In rare instances where severe jaundice does not respond to treatments previously administered the baby might require an exchange blood transfusion. In this case, tiny quantities of blood are regularly taken away and then replaced by blood donated by a donor. This procedure helps to dilute antibodies and bilirubin from the mother.

 

Adults

For adults, the primary causes of jaundice are addressed but not the actual jaundice is noted by the Merck Manual.

 

If, for instance, jaundice is the result of acute viral hepatitis (VIH), it can disappear gradually as the liver heals. If the reason is due to a blocked bile duct it is possible to have a procedure done to clear the bile drain.

 

Medical Options

The focus of treatment is always on the root cause. Injecting cholestyramine through the mouth can ease itchy skin due to jaundice. However, the majority of patients do not suffer from itchy skin.

 

alternative and complementary therapies

HealthyChildren.org states that exposing babies to the sun through windows can lower their bilirubin levels.

 

It is, however, only will work if the baby’s unclothed. (Newborns should not be exposed to direct sunlight outdoors. )There are a few studies that have been conducted on herbal medicines used in conjunction in combination with or without phototherapy to treat neonatal jaundice. The results aren’t conclusive enough and further research is needed to be conducted in the United States.

 

Talk with your pediatrician before beginning any complementary and alternative medical (CAM) method, particularly with babies.

 

Prevention of Jaundice

Infants

The best method to prevent jaundice in infants is to ensure that they are getting enough nutrition According to Mayo Clinic.

 

In the initial few days of life, nursing infants should receive eight to twelve feedings per day. Infants who are formula-fed typically need one to two ounces of formula every 2 to 3 hours during the first week of their life.“Regular feeding can help bring the bilirubin level down, so be sure your newborn is going no longer than four hours between feeds,” says Dr. Hill.

 

Adults

Because there are many causes of jaundice among adults There are no definitive prevention guidelines. To help there are some useful steps to take as per The Cleveland Clinic.

  • Beware of hepatitis infections
  • If you consume alcohol moderately, you should drink or quit if you have any history of hepatitis or liver damage
  • Do your best to avoid becoming overweight or obese.
  • Maintain the level of cholesterol in check

 

Complications of Jaundice

Jaundice that is severe can cause grave complications for babies According to CDC.

 

This includes:KernicterusThis disease is a form of brain injury and may be seen in infants when severe jaundice persists for too long without treatment. It could result in the condition known as athetoid cerebral palsy and hearing loss along with problems with teeth and vision and occasionally intellectual impairments.

 

Acute Bilirubin Encephalopathy This can happen when a baby suffers from severe cases of jaundice. Bilirubin can enter the brain (bilirubin is harmful to the brain). As per the Mayo Clinic, some signs of this disorder include:

  • Lack of motivation
  • Problems waking up
  • High-pitched crying
  • Poor nutrition or sucking
  • A body that is arching like bows
  • Fever

 

Research and Statistics What is the average number of babies and adults get jaundice?

The jaundice of newborns is quite frequent. Around 3 in 5 infants (60 percent) are affected by jaundice, in accordance with the March of Dimes.

 

Jaundice is the most common reason newborns are admitted to the hospital. However, serious jaundice cases are seen in less than 2 percent of full-term babies according to an American family physician.

 

Jaundice isn’t common among adults, however, if it’s evident it could be a sign of serious health issue, as per American Family Medicine.

 

BIPOC Communities as well as Jaundice

Asian Babies and Jaundice

Baby girls who are of East Asian descent have a greater chance of developing jaundice in the opinion of the CDC.

 

Particularly, a study from 2018 was published in the journal Hospital Pediatrics Researchers have found that babies from Far East Asian (Chinese, Korean, Taiwanese, Japanese, Mongolian) and Southeast Asian (Laotian, Cambodian, Indonesian, Vietnamese, Filipino) descendants are at a higher risk of contracting jaundice.

 

Black Babies and Jaundice

Black babies make up more than one-quarter of all cases of kernicterus that occur within the U.S., even though they account for only 14 percent of births, as per a study published in JAMA Pediatrics. This is related to the fact that there’s an elevated rate of jaundice-related glucose-6-phosphate deficit (G6PD) among this Black population.

 

Furthermore, “it can be more difficult to identify jaundice in darker-skinned babies,” states the pediatrician Whitney Casares, MD, the author of The New Baby Blueprint: Caring for You and Your Little One. That’s because melanin is the substance that gives us color skin, and may conceal the yellow hue from the chemical bilirubin that is responsible for jaundice. It’s not impossible to recognize jaundice in babies with darker skin tones. It’s simply that it requires more effort. “Checking the gums or inner lips for a yellow hue can help, as can pressing down gently on the skin with a finger,” the doctor. Casares. The most common sign of jaundice is that it shows on the eye’s whites before any other place even the gums. If you are in doubt about the presence of bilirubin, a test must be scheduled.

 

Related Conditions and the Causes of Jaundice and Related Conditions

According to MedlinePlus Certain conditions can trigger jaundice, such as:

  • Liver infections caused by viruses (hepatitis A, hepatitis B, hepatitis Chepatitis D, and the hepatitis E) or the parasite
  • Birth defects or conditions that make them difficult to breakdown the bilirubin (such as Gilbert syndrome Dubin-Johnson syndrome Rotor syndrome or Crigler-Najjar disorder)
  • Chronic liver disease
  • Gallstones and gallbladder issues
  • Blood disorders
  • Pancreatic cancer
  • A gallbladder is a place where bile accumulates because of abdominal pressure during pregnancy.

 

Resources We Love

Centers for Disease Control and Prevention

The CDC is the country’s healthcare protection organization. Their website provides information on the symptoms, signs, and diagnosis, as well as risks, and treatments of jaundice.

 

Cleveland Clinic

Cleveland Clinic, a nonprofit academic medical facility, is one of the most prestigious and largest healthcare facilities in the United States and a leader in education, research in health, and medical information. Their website contains information about the reasons, symptoms, diagnosis treatment, and prevention of jaundice among adults.

 

March of Dimes

The non-profit group that is focused on babies and mothers has details on Jaundice’s causes and also treatment and diagnosis.