Contrary to common understanding, Jaundice is not a disease but a symptom or a warning sign pointing to any number of metabolic dysfunctions or diseases. The word “jaundice” in English originated from the French word “jaune” which means yellow. Hence, it is the abnormally elevated levels of bilirubin (a naturally occurring chemical in the blood) which staining the skin and the sclera (the white portion of the eyes) from a pale yellow in slight elevations to bright orange yellow or brownish in high elevations.
Additional Symptoms of Jaundice
Besides the unnatural yellow tint of the skin and the sclera that was mentioned above, jaundice is accompanied by several other symptoms such as:
• The stool becomes whitish as the bilirubin that gives it its darker brown coloring is missing.
• The urine becomes brown as the bilirubin that accumulates in the blood begins to make its way out of the body through the urinary tract.
• Severe itching of the skin throughout the body which is also referred to as pruritus.
Causes for Jaundice
Red blood cells have an average life span of 120 days and then they are destroyed. The hemoglobin, which is the chemical within the red blood cell that contains iron, is released, its contents are extracted and the remaining chemical is then transformed to bilirubin which is essentially a waste product within the bloodstream that is ultimately processed by the liver and then transported into the intestines for elimination in the fecal matter. Jaundice becomes evident when:
1/ More bilirubin is produced than the liver can handle, and this often occurs in patients with -
- Hemolytic anemia because this condition results is an extraordinarily rapid destruction of red blood cells which, in turn, leads to the productions of tremendous amounts of bilirubin and its huge deluge into the bloodstream.
- Ineffective erythropoiesis is a dysfunction of the red blood cells that leads to over-production of hemoglobin in the bone marrow.
- Hematomas that are caused by severe bleeding and the absorption of too much hemoglobin by the soft tissues.
2/ The liver is malfunctioning and failing to remove the bilirubin from the blood. This may be due to a disease of the liver such as –
- Cirrhosis whose symptoms are extreme weakness and fatigue, swollen ankles, muscle atrophy, a buildup of fluids in the abdomen, mental confusion, bleeding intestines and coma.
- Inflammations of the liver such as viral hepatitis, alcoholic hepatitis, Tylenol-induced liver toxicity, chronic hepatitis B and C and autoimmune hepatitis.
- Cancer of the liver.
3/ The bile ducts have become blocked by various cancers (pancreatic, liver, bile ducts), gallstones, an inflammation or abnormal development of the bile ducts such as in Caroli’s disease, therefore, the bile and bilirubin cannot pass through on their way to the intestines. Bile breaks down fats within the intestines to excrete vitamins and release them into the bloodstream. Insufficient flow of bile may lead to unhealthful vitamin deficiencies.
4/ There is a long list of prescribed, over-the-counter and recreational drugs that may cause hepatitis or inflammation of the liver, inflammation of the bile ducts as well as interferences in the normal chemical processes within the cells of the bile ducts and/or the liver.
5/ Genetic disorders such as –
- Crigler-Najjar syndrome is caused by the absence or the low level of an enzyme that processes the glucuronic acid into bilirubin.
- Dubin-Johnson and Rotor’s syndromes are brought about because of an irregular discharge of bilirubin into the bile.
- Gilbert’s syndrome is a mild form of the Crigler-Najjar syndrome and usually causes no ill effects.
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