Jaundice is a condition which causes yellowing of the skin and the whites of the eyes, which occurs when the blood contains an excess of pigment known as bilirubin. This is a natural product which arises when the red blood cells break down and these are excreted in bile, through the actions of the liver. The red blood cells are vital in carrying oxygen all around the body, and each cell has a lifespan of around 120 days. When their life ends, they’re broken down and removed by the circulation of special cells called phagocytes – these are found in the bone marrow, spleen and liver. As the cells breakdown, some of their components, such as amino acids or iron, can be reused by the body. This is when other components such as the bilirubin need to be removed. Understanding how this removal works is vital in order to understand how jaundice occurs. Most of the body’s waste products are removed via the urinary tract, but the liver and bile system act as the other main physical route for these substances. Bilirubin is passed through the bloodstream to the liver, but any failure of removal of this pigment means that there is a build-up in the blood – this is how those with jaundice get their characteristic symptom. The medical term for the red cell breakdown is haemolysis, and it’s a fairly rare condition within the developed world. There is a condition in the foetus which can also develop haemolysis, due to an incompatibility of its Rhesus blood group with their mother – this is rarely seen in the UK though. It’s common for babies to be born with a temporary case of jaundice, as the baby’s liver isn’t capable of breaking down the cells and waste products – this rapidly cures itself without treatment though, so there’s no need to worry.
The most common cause of jaundice is a viral infection of the liver cells (hepatitis), as well as glandular fever being responsible for this too. Anything which affects the liver will increase the risk of developing jaundice – for example, alcohol abuse and cirrhosis of the liver can increase the risk, as well as tumours of the liver. If the bile ducts are blocked, this can also create problems. Tumours of the bile duct are rare, but if they’re large enough or located where the duct meets the duodenum, they can block the flow of bile. This can lead to what is known as ‘obstructive’ jaundice, as there is nowhere for the bile and waste products to go. The symptoms, besides the jaundice itself, will link to the underlying cause – for example, if you have haemolysis, you may be anaemic and tired. Furthermore, if gallstones are responsible then you may have pain in the abdomen. GPs can usually diagnose jaundice merely from your appearance, as your skin and whites of your eyes will become yellow this is the most common symptom of the condition, but you may have other symptoms attributed to the underlying problem that has caused it. You may need a blood test to confirm the presence of bilirubin in your blood, which will confirm whether you have jaundice, as well as confirming the presence of other health problems such as hepatitis and haemolysis. If you have the symptoms of this condition, you should seek medical advice as soon as possible so that the underlying problem can be treated. For example, if you have gallstones, these will need to be removed as soon as possible.
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