Jaundice in adults and newborn: All you need to know

Jaundice in adults and newborn All you need to know

Jaundice in adults and newborn

What is the term Jaundice?

The term jaundice is defined from the french word “Jaune” which means yellow. Jaundice is not a disease, but a visible sign of an underlying process of disease.

Jaundice is a yellow discoloration of the eyes caused by increased levels of the chemical element bilirubin (hyperbilirubinemia) in the skin, mucous membranes, and blood.

Bilirubin is a yellow-colored waste substance or by-product of daily natural breakdown and destruction of red blood cells in the body.

Skin color and eye white color will vary depending on the level of bilirubin. The middle level leads to a yellow color, while the very high level will appear brown.

This process leads to the splitting of the hemoglobin molecule released into the blood, in which the heme portion undergoes chemical conversion to bilirubin.

Normally, in simple words, the liver metabolizes and excretes bilirubin in the form of bile.

However, if this normal metabolism is disturbed or bilirubin is produced, jaundice can occur.

Jaundice in adults and newborn are usually seen when the level of bilirubin in the blood exceeds 2.5–3 mg / dL (mg per dl).

Jaundice in adults and newborn

Jaundice Types:

Types of jaundice can be classified in two ways adults and newborn as:

Jaundice in adults:

Pre-Hepatic phase: Problems arise before the discharge of bilirubin from the liver.

Hepatic phase: Problems occur within the liver.

Post-Hepatic phase: Problems arise after the discharge of bilirubin from the liver.

Jaundice in newborn babies is known as neonatal jaundice:

Types of neonatal jaundice:

Physiological

Prematurity

Blood group incompatibility

Breastfeeding

Cephalohematoma jaundice

Jaundice Causes in adults

Jaundice is yellowing of the skin and whitening of the eyes which occurs when the body does not process bilirubin properly. This can be caused by a liver problem, also known as icterus.

The liver filter becomes useless with blood when bilirubin reaches the liver and other chemicals attach to it which results to form conjugated bilirubin.

The liver produces bile, a digestive juice. The conjugated bilirubin enters the bile, then it leaves the body. It is this type of bilirubin that gives the stool its brown color.

If there is too much bilirubin in the blood, it can leak into the surrounding tissue. This is known as hyperbilirubinemia, and it causes yellowing of the skin and eyes.

Jaundice in adults and newborn can also be caused by a variety of medical conditions, some of which are serious and potentially life-threatening.

Any adult who develops jaundice undergoes an extensive medical evaluation to determine its cause.

Pre-Hepatic jaundice causes:

Jaundice occurring during the pre-hepatic phase is caused by excessive destruction of red blood cells (hemolysis) from various conditions.

This rapid increase in bilirubin levels in the bloodstream overwhelms the ability of the liver to metabolize bilirubin well and increases unconventional bilirubin levels.

Hemolysis of red blood cells may be increased which include common causes of pre-hepatic jaundice:
Malaria,

Sickle cell disease,

Hereditary spherocytosis,

Thalassemia,

Glucose-6-phosphate dehydrogenase deficiency (G6PD),

Drugs or other toxins, and

Autoimmune disorder.

Pre-hepatic jaundice symptoms:

Stomach ache

Fever including cold or chills

Abnormal weight loss

Itching

Dark-colored urine or yellow stool

How pre-hepatic jaundice can be diagnosed?

Blood tests (A sample of blood is collected by doctors to examine it)

Urine test (A sample of urine is collected by doctors to examine it)

MRI (Magnetic Resonance Imagining)

HIDA scan (A radioactive tracer is injected in bloodstreams to find the blockage in the liver, gall bladder, small intestine, and bile ducts)

Endoscopy (A non- Surgical process to examine the digestive tract and liver)

Hepatic jaundice causes

Jaundice occurring during the liver phase may arise from abnormalities in metabolism and/or excretion of bilirubin.

This may increase both unconjugated and/or conjugated bilirubin levels. Conditions with an anomalous cause of hepatic jaundice include:

Acute or chronic hepatitis (usually viral [hepatitis A, B, C, D, E] or alcohol-related)

Liver cirrhosis (due to various conditions including alcohol poisoning)

Drugs or other toxins

Kriegler-Najjar syndrome

Autoimmune disorder

Gilbert syndrome

Liver cancer

Hepatic jaundice symptoms:

Loss of appetite

Bloody nose

Vomiting

Skin itching

Weakness

Abnormal weight loss

Swelling of your stomach or feet

Dark-colored urine or yellow stool

Pain in your muscles or joints

Darkening of the skin

Fever

To feel sick

How hepatic jaundice can be diagnosed?

Blood tests (A sample of blood is collected by doctors to examine it)

Urine test (A sample of urine is collected by doctors to examine it)

MRI (Magnetic Resonance Imagining)

HIDA scan (A radioactive tracer is injected in bloodstreams to find the blockage in the liver, gall bladder, small intestine, and bile ducts)

Endoscopy (A non- Surgical process to examine the digestive tract and liver)

Also read: 10 Amazing health benefits of ginger

Post-Hepatic jaundice causes:

Jaundice arises from normal drainage disruption (an obstruction) and excretion of conjugated bilirubin in the form of bile from the intestine to the liver. This increases the level of conjugated bilirubin in the bloodstream.

Conditions that can cause hepatic jaundice to include:

Gallstones,

Pancreatic cancer, Gallbladder cancer, and Bile duct cancer,

The hardness of bile ducts,

Cholelithiasis,

Pancreatitis,

Parasites (eg, liver flukes).

Post-Hepatic symptoms:

To feel sick

Vomiting and nausea

Dark-colored urine or yellow stool

Stomach ache

Diarrhea

Abnormal weight loss

Skin itching

Stomach bloating

Fever

How post-hepatic jaundice can be diagnosed?

Blood tests (A sample of blood is collected by doctors to examine it)

Urine test (A sample of urine is collected by doctors to examine it)

MRI (Magnetic Resonance Imagining)

HIDA scan (A radioactive tracer is injected in bloodstreams to find the blockage in the liver, gall bladder, small intestine, and bile ducts)

Endoscopy (A non- Surgical process to examine the digestive tract and liver)

Neonatal jaundice (Jaundice in newborn)

Neonatal jaundice (Jaundice in newborn), Jaundice in adults and newborn

Neonatal jaundice, a condition seen in newborns, is often a benign condition that improves severely without impact.

Jaundice in newborns can be caused by several different conditions, although it is often a normal physiological consequence of the newborn’s liver.

Even though it is usually harmless in these conditions, other medical conditions (pathologic jaundice) can cause devastating brain damage (kernicterus) to newborns with extremely high levels of bilirubin if the underlying problem is not resolved.

Neonatal jaundice is the most common condition of medical evaluation in newborns.

Some common causes of neonatal jaundice are:

Physiological jaundice

Physiological jaundice is usually evident on the second or third day of newborn life. It is the most common cause of neonatal jaundice and is usually a transient and harmless condition.

Jaundice is caused by the inability of the immature liver of the newborn to process bilirubin by the rapid breakdown of red blood cells occurring at this age.

Physiological Jaundice eventually disappears as the newborn’s liver matures.

Prematurity jaundice

Prematurity jaundice results in a child being born too early and being unable to poop the bilirubin out properly.

Maternal-fetal blood group incompatibility (RH, ABO)

This form of jaundice occurs when there is an incompatibility between the blood type of the mother and the newborn.

This increases the level of bilirubin by the breakdown or destruction of the fetal red blood cells (hemolysis).

Breastfeeding jaundice

This form of jaundice occurs in lactating newborns and usually appears at the end of the first week of life. This form of jaundice occurs when the lactating newborn does not get enough breast milk.

This is usually a harmless condition that resolves spontaneously. Mothers usually do not have to stop breastfeeding.

This may be due to delayed or inadequate milk production by the mother or poor feeding by the newborn.

Its insufficient intake leads to dehydration and reduced bowel movements for the newborn, after which the excretion of bilirubin from the body is reduced.

Cephalohematoma jaundice (collection of blood under the scalp)

Sometimes during the birthing process, a newborn’s head may be damaged or injured, resulting in a blood coagulation/blood clot under the scalp.

Because this blood naturally breaks down, a suddenly elevated level of bilirubin can affect the processing capacity of the newborn’s immature liver, resulting in cephalohematoma jaundice.

Treatment for jaundice in adults

Treatment for jaundice in adults and newborn mainly depends on the underlying cause.

Once a diagnosis is established, an appropriate course of treatment can be initiated. Some patients will need to be hospitalized, while others can be managed at home as outpatients.

In some individuals with jaundice, treatment will include supportive care and can be managed at home. For example, most cases of mild viral hepatitis can be managed at home with attentive waiting and close monitoring by your doctor. Medications for hepatitis C can now treat the condition.

In jaundice caused by drugs/medications/ toxins, the offending agent needs to be discontinued. In cases of intentional or unintentional acetaminophen (Tylenol) overdose, the antidote N-acetylcysteine ​​(Mucomist) may be required.

Alcohol withdrawal is necessary for patients with cirrhosis, alcoholic hepatitis, or acute pancreatitis for alcohol use.

Various medications can be used to treat conditions leading to jaundice, such as steroids in the treatment of some autoimmune disorders. Some patients with cirrhosis, for example, may require treatment with diuretics and lactulose.

Infectious causes of jaundice may require antibiotics, or jaundice may occur for complications associated with certain conditions (eg, cholangitis).

Lack of iron (Anemia) jaundice in adults and newborn can be treated by increasing the amount of iron in the blood, either by taking iron supplements or by eating more iron-rich foods or by blood transfusion.

Surgery and various invasive procedures may be required for some patients with obstruction induced jaundice to remove the obstruction. For example, some patients with gallstones may require surgery.

Other individuals with liver failure/cirrhosis may require liver transplantation.

Prevention of jaundice in adults

Some conditions leading to jaundice can be prevented, while others may be less preventable. However, some measures can be taken to reduce the risk of developing jaundice.

Take medicines as directed to prevent possible liver damage or inadvertent overdose. Individuals with certain medical conditions (eg, G6PD deficiency or cirrhosis) should avoid certain medications altogether. Discuss medicines with your health care professional.

Avoid potentially contaminated food products or unnatural water, as this may reduce the risk of developing hepatitis A.

Avoid high-risk behaviors like unprotected intercourse or intravenous drug use and take universal precautions when working with blood products and needles. This may reduce the risk of developing hepatitis B or hepatitis C.

When traveling to areas where malaria is endemic, take recommended precautions and prophylactic medications to prevent the development of malaria.

Avoid alcohol which can prevent alcoholic hepatitis, alcoholic cirrhosis and pancreatitis among other conditions.

Avoid smoking, as it is a risk factor for the development of pancreatic cancer, as well as many other pathologies.

Also read: Nocturia: Frequent urination at night, causes, symptoms, and treatment

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