What most people fail to realize is that jaundice is a symptom of an underlying disease, not the disease itself.
With jaundice, regular metabolism and excretion of bilirubin is disrupted. Bilirubin is formed when red blood cells are broken down. This process releases hemoglobin with the “heme” part turning to bilirubin where it goes to the liver for further processing – metabolic and excretion. It is then transported to the gallbladder where it is stored for use by the intestines or excreted.
Types of Jaundice
The disruption of metabolism and excretion happens at any stage. Classification of these ailments depends on where the problem lies. “Pre-hepatic” is when the problem crops up before the liver is involved; “hepatic” is where the problem is in the liver, and “post-hepatic” is where the problems strike after the bilirubin is excreted by liver.
Causes of these illnesses differ depending on where the problem occurs. In pre-hepatic problems, the rapid increase in blood bilirubin overwhelms the liver’s capacity to metabolize bilirubin.
Hepatic problems usually occur because of abnormal metabolism or excretion of bilirubin. This results in the rise of conjugated and unconjugated bilirubin levels. “Conjugated” means the bilirubin has been through the liver, “unconjugated” means that the bilirubin has not been through the liver and is circulating through the bloodstream.
Post-hepatic problems are the result of the disruption of normal excretion of conjugated bilirubin. This elevates bilirubin levels in the blood.
Not sure what's at the root of your jaundice? Check out these five surprising causes of jaundice:
1. Overdose of acetaminophen or exposure to poisons can seriously damage the liver. The recommended daily dose of acetaminophen, or Tylenol, was dropped to 3,000 mg because so many other over-the-counter medications contain acetaminophen. It is found in Actifed, Benadryl, Contact, Percocet, Darvocet, Unisom with Pain, Vick’s Nyquil and Dayquil. Liver damage can be so severe that a transplant may be the only remedy for the patient.
The antidote to acetaminophen overdose is NAC which is more effective if given within the first eight hours of the poisoning. If given early enough, this drug can prevent liver failure.
Since acetaminophen is primarily processed by the liver, if the liver is already damaged by alcohol or other drugs, this makes it even more susceptible to further acetaminophen damage.
Fatty liver, or steatosis, is caused by heavy alcohol use. There is also a phenomenon known as non-alcoholic fatty liver disease. This is associated with obesity and diabetes. Use of some drugs can cause fatty liver with or without hepatitis.
With cirrhosis, fatty liver and hepatitis, scar tissue forms as liver cells die. Severe scarring can cause cirrhosis, the most common type which is alcohol-induced.
Poisoning symptoms are vomiting, nausea, not able to eat or poor appetite, and not feeling well. See a doctor right away, early treatment is essential.
2. Jaundice of pregnancy is caused by bile build-up in the gallbladder because of belly pressure on this organ during pregnancy. This illness may have several causes including viral hepatitis or acute fatty liver of pregnancy that disrupt liver functioning and could become medical emergencies very quickly.
Fatty liver of pregnancy and hemorrhages are both associated with blood poisoning. Diagnosis should be made within 24 to 48 hours after onset of symptoms. A basic health exam should reveal whether there is a pre-existing liver condition, family history of jaundice, needle use of illicit drugs, or if there is a possibility of hepatitis exposure.
3. Hepatitis A, B, or C. Hepatitis is inflammation of the liver caused by a virus, alcohol or drug overuse. Hepatitis can be chronic. There are three types.
Hepatitis A is a liver-disease causing virus. Typically it leads to chronic infection with very few complications. It is spread through eating or drinking contaminated food. This is usually a problem in developing countries where sanitation can be poor. The liver usually heals within two months of infection. Hepatitis A can be prevented by a vaccination. Some deaths are attributed to acute liver infection.
Hepatitis B causes liver damage. It can cause a chronic infection, though most with this form of hepatitis heal within six months. This disease spreads through the sharing of contaminated needles, having sex with an infected person, contact with infected blood, an infected pregnant mother to her baby and needle-stick injuries. Hepatitis B can be prevented by a vaccination.
Hepatitis C is the most common cause of liver disease and number one cause of liver transplants. About 60 percent of hepatitis C patients develop chronic infection of the liver, often without knowing it because of the lack of symptoms. There is no vaccination available.
Hepatitis C is a serious health issue because it destroys liver tissue, causes liver cancer, spreads from one person to another, can cause liver failure and death. It can be passed along by contaminated needle sharing, direct contact with infected blood, needle-stick injuries and rarely, having sex with an infected person.
4. Breast-milk jaundice. This usually affects breast-fed newborns about the end of the first week of feeding. There is no identifiable reason found for this. Chinese, Japanese, Korean and Native Americans seem to have a greater prevalence than other ethnic groups. This phenomenon manifests by the end of the first week and can persist for three to 12 weeks. It usually resolves on its own.
5. Pancreatic and liver cancer and malignancy of bone or bone marrow may all cause jaundice. Cancer situated at the head of the pancreas can shut down operations and cause a back-up of bilirubin in the blood.
Liver cancer is the second most common cancer. The liver’s job of filtering all kinds of toxins and waste products out of the blood makes it vulnerable to cancer. Causes of liver cancer include cirrhosis, hepatitis B and C, smoking and diabetes.
Malignancy of bone or bone marrow may cause jaundice because of the release of excessive bilirubin. The amount of bilirubin overwhelms the liver’s ability to filter out this substance. Hence, the jaundice.
The last and most important thing you need to know about jaundice is that it could be minor, but more than likely it may be very, very serious. Most experts say contact your doctor as early as possible as some of these “fixes” are time sensitive. Don't be mellow about the yellow.