Jaundice

Jaundice (JAWN-dis) is a yellowish discoloration of the skin and of the whites of the eyes. It is caused by accumulation in the body of a bile pigment called bilirubin (bil-uhROO-bin). Jaundice is a sign of several disorders that affect the liver, the blood, the gallbladder, or bile, which is a fluid secreted by the liver to aid in the digestion of fats. The medical term for jaundice is icterus (IK-ter-us).

When a person is in good health, the bile pigment * bilirubin is formed from the normal breakdown of hemoglobin (HE-mo-glo-bin), which is the oxygen-carrying substance in red blood cells. This process occurs naturally as old red blood cells wear out and are replaced in the body. Bilirubin is then carried in the bloodstream to the liver, where it is combined with bile.

Bile, which is also called gall, gets its greenish-yellow color from bilirubin. Secreted by the liver to aid in the digestion of dietary fat, bile is stored in the gallbladder. When it is needed for digestion, the gallbladder pushes it out into the small intestine through a tube called a bile duct. Much of the dark color of stool is the result of bile pigments.

There are different kinds of jaundice, but they all occur when there is too much bilirubin in the blood.

Hemolytic * jaundice occurs when the rapid breakdown of too many red blood cells results in the overproduction of bilirubin. This may occur in such diseases as malaria, sickle cell anemia, and septicemia * , or blood poisoning.

Hepatocellular * (liver) jaundice occurs when damage to the liver reduces its ability to remove bilirubin from the blood. Hepatocellular jaundice commonly occurs in cases of hepatitis, cirrhosis * of the liver, and liver cancer. Swallowing or inhaling poisonous chemicals and advanced alcoholism can also produce jaundice from liver damage.

Obstructive jaundice, a common form, occurs when the bile duct from the gallbladder to the small intestine narrows or becomes blocked, causing bilirubin to back up and accumulate in the blood. Obstructive jaundice may result from gallstones, injuries, tumors, or inflammation that affects the bile ducts.

Physiologic * jaundice sometimes occurs when newborn babies have too much bilirubin in the blood. This form of jaundice usually disappears within a few days as the infant's liver matures in its ability to handle bilirubin.

Jaundice is not itself a disease, but it is a sign of several disorders that affect the liver, the blood, the gallbladder, or bile. Other signs and symptoms of disease may occur along with jaundice. For example, the urine * may be dark brown due to the excretion of bilirubin, or the stool may be nearly white due to lack of bilirubin, which produces the normal brown color. Blockage of the bile ducts may also cause intense itching as bile products accumulate in the skin. In hepatitis and other liver diseases, jaundice may be only one among many signs and symptoms.

See also Alcoholism • Gallbladder Disease • Gallstones • Hepatitis • Malaria • Pancreatitis

* pigment (PIG-ment) is a substance that imparts color to another substance.

* hemolytic (he-mo-LIT-ik) refers to destruction of red blood cells with the release of hemoglobin into the bloodstream.

* septicemia (sep-ti-SEE-mi-a) is a bacterial infection in the blood that spreads throughout the body, with potentially fatal results.

* hepatocellular (hep-a-to-SELular) refers to the cells of the liver.

* cirrhosis (sir-O-sis) is a condition that affects the liver, involving long-term inflammation and scarring, which can lead to problems with liver function.

* physiologic (fiz-ee-o-LOJ-ik) refers to an organism's healthy and normal functioning.

* urine is the liquid waste material secreted by the kidneys and removed from the body through the urinary tract.