Jaundice is a condition that causes the skin, the whites of the eyes, and sometimes the inside of the mouth to turn yellow. This happens when a substance called bilirubin builds up in the body. Bilirubin is produced when old red blood cells are broken down. Normally, the liver processes bilirubin and removes it from the body through bile.
Jaundice itself is not a disease. Instead, it is often a sign that something else is affecting the liver, blood, or bile ducts. Some causes are mild and temporary, while others can be serious and require urgent medical attention. Understanding why jaundice occurs is important because early diagnosis can help prevent life-threatening complications.
If you or a loved one has noticed yellow eyes, yellow skin, dark urine, or other signs of jaundice, it is important not to ignore these symptoms. Different conditions, including hepatitis, malaria, gallstones, and sickle cell disease, can cause jaundice. If you are experiencing these symptoms and would like guidance on what to do next, you can explore Hope Plus to quickly connect with a licensed healthcare provider for assessment, advice, and referral when needed.
Key Takeaways
- Jaundice causes yellowing of the eyes and skin due to a buildup of bilirubin.
- It can result from problems in the blood, liver, or bile ducts.
- Common causes in Uganda include hepatitis, malaria, sickle cell disease, and gallstones.
- Some cases are harmless, while others can be life-threatening.
- Treatment depends on identifying and managing the underlying cause.
What Is Jaundice?
Jaundice occurs when there is too much bilirubin in the bloodstream.
Bilirubin is a yellow substance produced when the body breaks down old red blood cells. The liver normally processes bilirubin and removes it through bile, which eventually leaves the body in stool.
When this process is disrupted, bilirubin accumulates and causes yellow discoloration of the eyes and skin.
Signs and Symptoms of Jaundice
The most noticeable symptom is yellowing of the eyes and skin.
Other symptoms may include:
- Dark urine
- Pale or clay-coloured stool
- Itchy skin
- Fatigue
- Loss of appetite
- Nausea and vomiting
- Fever, depending on the cause
- Abdominal pain
- Unexplained weight loss
The symptoms vary depending on the underlying condition responsible for the jaundice.
What Causes Jaundice?
Healthcare providers often group the causes of jaundice into three main categories.
Pre-Hepatic Causes
These occur before bilirubin reaches the liver.
They are usually caused by excessive breakdown of red blood cells, a process known as haemolysis.
Common causes include:
- Malaria
- Sickle cell disease
- Severe infections (sepsis)
- Disseminated intravascular coagulation (DIC)
- HELLP syndrome during pregnancy
- Certain blood disorders
When large numbers of red blood cells are destroyed, the liver may not be able to process all the bilirubin produced.
Hepatic Causes
These occur when the liver itself is damaged or inflamed.
Common causes include:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Alcohol-related liver disease
- Liver tumours
- Certain medicines
- Herbal remedies that damage the liver
- Exposure to toxins
- Autoimmune liver disease
- Cholangitis
- Liver disease related to pregnancy
Post-Hepatic Causes
These occur when bile cannot flow normally from the liver into the intestines.
Common causes include:
- Gallstones
- Narrowing of the bile ducts (strictures)
- Tumours affecting the bile ducts or pancreas
- Pancreatitis
- Previous surgery affecting the bile ducts
- Other biliary tract diseases
When bile flow is blocked, bilirubin accumulates in the bloodstream and causes jaundice.
Common Causes of Jaundice in Uganda
Several conditions commonly seen in Uganda can cause jaundice.
These include:
- Viral hepatitis
- Malaria
- Sickle cell disease
- Gallstones
- Alcohol-related liver disease
- Liver cancer
- Severe infections
- Certain traditional herbal medicines that may damage the liver
Because the causes vary widely, proper medical evaluation is important.
How Is Jaundice Diagnosed?
Healthcare providers first assess symptoms, medical history, and perform a physical examination.
Several investigations may then be recommended.
Blood Tests
Blood tests help determine the cause and severity of jaundice.
These may include:
- Liver function tests
- Bilirubin levels
- Complete blood count (CBC)
- Kidney function tests
- Blood clotting tests (INR)
- Lactate dehydrogenase (LDH)
- Haptoglobin levels
- Coombs test
Tests for Infections
Depending on the suspected cause, healthcare providers may request tests for:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Malaria
Sickle Cell Screening
Testing may be performed when sickle cell disease is suspected.
Ultrasound Scan
An abdominal ultrasound can help identify:
- Gallstones
- Enlarged bile ducts
- Gallbladder disease
- Liver abnormalities
- Tumours
ERCP
An Endoscopic Retrograde Cholangiopancreatography (ERCP) may sometimes be performed.
This specialised procedure allows healthcare providers to examine and treat problems affecting the bile ducts.
Liver Biopsy
In selected cases, a small sample of liver tissue may be collected and examined under a microscope.
Complications of Jaundice
The complications depend on the underlying cause.
Serious complications may include:
Kidney Failure
Severe liver disease can affect kidney function and lead to renal failure.
Blood Clotting Problems
The liver produces many proteins involved in blood clotting.
When liver function is severely impaired, bleeding problems may develop.
Sepsis
Some causes of jaundice, particularly infections affecting the liver or bile ducts, can lead to severe bloodstream infections.
Treatment of Jaundice
Treatment focuses on identifying and managing the underlying cause.
Step 1: Identify the Cause
Healthcare providers will perform investigations to determine whether the problem originates from the blood, liver, or bile ducts.
Step 2: Treat the Underlying Condition
Examples include:
- Antimalarial treatment for malaria
- Treatment for hepatitis
- Management of sickle cell complications
- Removal of gallstones when appropriate
- Treatment of infections
- Treatment of liver disease
Step 3: Stop Harmful Substances
Healthcare providers may advise stopping medicines, alcohol, herbal remedies, or toxins that may be damaging the liver.
Step 4: Referral to a Specialist
Patients with severe jaundice or complex liver conditions may be referred to a specialist for further assessment and treatment.
Jaundice in Newborn Babies
Jaundice is common in newborn babies and often appears during the first few days of life.
Although many cases are mild and resolve on their own, some newborns require treatment to prevent complications.
Phototherapy
Healthcare providers may use phototherapy, a treatment that exposes the baby to special light that helps the body break down excess bilirubin.
Sunlight Exposure
In some settings, carefully supervised exposure to natural sunlight may be recommended by healthcare providers. However, parents should always seek medical advice before relying on sunlight alone because some newborns may require hospital treatment.
Any newborn with jaundice should be assessed by a healthcare professional.
Can Jaundice Be Prevented?
Not all causes can be prevented, but the risk can be reduced by:
- Getting vaccinated against hepatitis B
- Seeking prompt treatment for malaria
- Managing sickle cell disease appropriately
- Limiting alcohol consumption
- Avoiding harmful herbal remedies and toxins
- Seeking medical attention early when symptoms develop
- Attending regular follow-up appointments for chronic liver disease
When Should You Seek Medical Attention?
Seek medical care as soon as possible if you develop:
- Yellow eyes or skin
- Dark urine
- Pale stools
- Persistent abdominal pain
- Fever with jaundice
- Unexplained weight loss
- Severe itching
- Confusion or drowsiness
Seek emergency care immediately if jaundice is accompanied by severe illness, bleeding, confusion, or difficulty staying awake.
Frequently Asked Questions (FAQ)
1. What causes jaundice?
Jaundice occurs when bilirubin builds up in the body. This can result from blood disorders, liver disease, or blockage of the bile ducts.
2. Is jaundice a disease?
No. Jaundice is usually a sign of another underlying medical condition.
3. Can malaria cause jaundice?
Yes. Severe malaria can cause destruction of red blood cells, leading to jaundice.
4. Does jaundice always mean liver disease?
No. While liver disease is a common cause, blood disorders and bile duct blockages can also cause jaundice.
5. When should jaundice be treated urgently?
Jaundice should be assessed promptly, especially if it is accompanied by fever, severe abdominal pain, confusion, bleeding, or rapid worsening of symptoms.
6. Is jaundice dangerous?
It can be. Some causes are mild, while others may lead to liver failure, kidney failure, severe infection, or other serious complications.
7. Can newborn babies develop jaundice?
Yes. Newborn jaundice is common, but every baby with jaundice should be assessed by a healthcare professional to determine whether treatment is needed.
