Jaundice is sign of problem

Ask The Expert Dr. Richard Mackey St. Joseph Medical Center

November 03, 2008|By Holly Selby

In jaundice, the skin, whites of the eyes and mucus membranes take on a yellowish color. Jaundice itself is not an illness, but a sign of an underlying disease, says Dr. Richard Mackey, a hepatobiliary surgeon with the Cancer Institute at St. Joseph Medical Center. If you think you or someone else is showing the symptoms of jaundice, you should seek medical attention.

What is jaundice?

Jaundice is more a sign that something is abnormal than a disease process in itself. It's a sign of an abnormality, of an underlying disease. It occurs as a result of elevated bilirubin levels [a byproduct of old red blood cells].

Most people think of yellowish skin being associated with jaundice. Are there other symptoms?

Symptoms can vary and usually only occur when your bilirubin level is over about 2 1/2 (typically, a normal level is 1). In general, symptoms include dark urine; clay-colored [pale] stools; puritis, which is itching; and some people get GI symptoms such as loss of appetite and nausea. And symptoms include changes in eye and skin color and under the tongue to a yellowish color.

What causes jaundice?

There are surgical and medical causes, and the list for each is quite long. The more common surgical causes are related to gallstone disease and tumors either located in the bile duct itself, the gall bladder or the pancreas.

The medical causes include hemolytic anemia, blood transfusions, hereditary disorders, hepatitis (alcohol-induced) or medications.

How do you treat jaundice?

Treatment is contingent upon the cause. For instance, if you had viral hepatitis such as hepatitis C, then your treatment would be medical and would include antiviral meds. If there was a surgical cause such as a tumor in the pancreas, the tumor would be removed if the patient was fit enough. So the treatment is tailored to the cause. But before treatment, you would begin with a full history and physical. Then you would want to look at the [patient's] lab values, particularly related to liver function.

At that point, depending upon what direction you decide to go in, you may do an ultrasound to look for gallstone disease, or a CAT scan to look for different types of tumors, or blood tests.

Is jaundice reversible or curable?

In most cases, it is reversible.

What causes jaundice in babies?

Jaundice in babies can occur in the first few weeks of life and is a result of the inability to conjugate (which is a process in the liver) bilirubin. In children who are premature or whose liver isn't quite up to speed yet, the result can be high bilirubin levels. It is self-limiting, meaning it resolves itself with medical treatment: The children need to be under UV lights for a few weeks until the liver takes over.

What else would you want people to know about jaundice?

The take-home message is that if you think someone is jaundiced or if you are told you are jaundiced, seek medical attention. Typically the symptom of dark urine presents before the skin changes, so this is where you might see it first.

Jaundice is not normal, and it can be one of the early signs of a surgical problem such as a tumor, and so you should not wait before seeking medical attention.

Holly Selby is a former reporter for The Baltimore Sun.

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