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What is it about ?
Jaundice (jaundice) is characterized by yellowing of the skin or the whites of the eyes. It appears when there is too much bilirubin in the blood. Bilirubin is a yellowish pigment that results from the breakdown of red blood cells. The liver removes bilirubin from the blood. It concentrates bilirubin in the bile. The bile is then stored in the gallbladder. Most bilirubin is passed from the body through the stool, and a small amount is passed from the body through the urine.
Jaundice can be caused by
- Significant destruction of red blood cells,
- A problem with the liver,
- A problem with the evacuation of bile through the bile ducts.
There is also an inherited condition that causes jaundice: Gilbert’s syndrome.
People who eat a lot of carrots may also have orange-yellow skin, but this is not jaundice.
The main causes of sudden onset (acute) jaundice are:
- From stones in the bile ducts,
- A viral infection of the liver,
- Inflammation of the pancreas,
- Medicines or plants,
- Heart failure of the right ventricle,
- The consequences of a surgical intervention,
- A generalized infection,
- Feeding through an intravenous tube (parenteral nutrition),
- a pancreatic cancer.
The most common causes of chronic jaundice are:
- Excessive alcohol consumption,
- Very extensive damage to the liver,
- An autoimmune condition,
- Chronic liver infection,
- Metastasis (from cancer) in the liver.
How to recognize it?
Jaundice can be recognized by the yellowing of the skin and the yellowish color of the whites of the eyes. Sometimes it is also accompanied by dark urine and pale stools.
How is the diagnosis made?
The doctor will try to identify the cause of the jaundice as quickly as possible by asking you a few questions:
- How long have you had yellow skin?
- Are you itchy?
- Do you have stomach aches?
- Have you ever had stomach surgery?
- Have you lost weight?
- Do you have general symptoms, such as fever or loss of appetite?
- Have you recently traveled abroad?
- What medications have you taken recently?
- Do you drink alcohol regularly?
- Do other members of your family have jaundice?
The doctor will also perform a clinical examination of the belly and a blood test. The results of the blood test can often show the cause.
Most often, your GP will also order an ultrasound of your upper abdomen to assess the condition of your liver.
A magnetic resonance imaging (MRI) examination of the bile ducts (cholangio-MRI) will only be performed if there is a suspicion of poor patency of the bile ducts and a high probability of gallstones.
What can you do ?
If you observe jaundice, it is better to contact a doctor without delay. Some conditions with jaundice as a symptom require prompt diagnosis and treatment eg. a stuck gallstone, severe hepatitis (inflammation of the liver), …
What can your doctor do?
Treatment depends on the cause. A stuck gallstone can sometimes be removed by endoscopy (ERCP). This exam looks like a stomach exam (gastroscopy). Surgery may be needed to remove a gallstone.
Some forms of hepatitis require hospital treatment, others will go away on their own.
If the cause of jaundice is chronic liver disease, a liver biopsy is usually taken and you are regularly monitored by the gastrointestinal system specialist (gastroenterologist).
Want to know more?
- Ultrasound here Where to find on this page of Cliniques St Luc UCL
- Cholangio-MRI – Erasme Hospital
- Endoscopic cholangiopancreatography (CPE) – Erasme Hospital
- Preparing for a liver biopsy – CHU Montreal
Sources
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