18 Jaundice Symptoms, Signs, Causes & Treatment!

What Is Jaundice?

Jaundice is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes caused by increased amounts of bilirubin in the blood. Jaundice is a sign of an underlying disease process.

  • Bilirubin is a by-product of the daily natural breakdown and destruction of red blood cells in the body.
  • The hemoglobin molecule that is released into the blood by this process is split, with the heme portion undergoing a chemical conversion to bilirubin.
  • Normally, the liver metabolizes and excretes the bilirubin in the form of bile.
  • However, if there is a disruption in this normal metabolism and/or production of bilirubin, jaundice may result.

What Diseases Cause Jaundice?

Jaundice may be caused by several different disease processes. It is helpful to understand the different causes of jaundice by identifying the problems that disrupt normal bilirubin metabolism and/or excretion.

Pre-hepatic (before bile is made in the liver)

Jaundice in these cases is caused by a rapid increase in the breakdown and destruction of the red blood cells (hemolysis), overwhelming the liver’s ability to adequately remove the increased levels of bilirubin from the blood.

Examples of conditions with increased breakdown of red blood cells include:

  • malaria,
  • sickle cell crisis,
  • spherocytosis,
  • thalassemia,
  • glucose-6-phosphate dehydrogenase deficiency (G6PD),
  • drugs or other toxins, and
  • autoimmune disorders.

Hepatic (the problem arises within the liver)

Jaundice in these cases is caused by the liver’s inability to properly metabolize and excrete bilirubin. Examples include:

  • hepatitis (commonly viral or alcohol related),
  • cirrhosis,
  • drugs or other toxins,
  • Crigler-Najjar syndrome,
  • Gilbert’s syndrome, and
  • cancer.

Post-hepatic (after bile has been made in the liver)

Jaundice in these cases, also termed obstructive jaundice, is caused by conditions that interrupt the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.

Causes of obstructive jaundice include:

  • gallstones in the bile ducts,
  • cancer (pancreatic and gallbladder/bile duct carcinoma),
  • strictures of the bile ducts,
  • cholangitis,
  • congenital malformations,
  • pancreatitis,
  • parasites,
  • pregnancy, and
  • newborn jaundice.

Jaundice in newborn babies can be caused by several different conditions, although it is often a normal physiological consequence of the newborn’s immature liver. Even though it is usually harmless under these circumstances, newborns with excessively elevated levels of bilirubin from other medical conditions (pathologic jaundice) may suffer devastating brain damage (kernicterus) if the underlying problem is not addressed. Newborn jaundice is the most common condition requiring medical evaluation in newborns.

The following are some common causes of newborn jaundice:

Physiological jaundice

This form of jaundice is usually evident on the second or third day of life. It is the most common cause of newborn jaundice and is usually a transient and harmless condition. Jaundice is caused by the inability of the newborn’s immature liver to process bilirubin from the accelerated breakdown of red blood cells that occurs at this age. As the newborn’s liver matures, jaundice eventually disappears.

Maternal-fetal blood group incompatibility (Rh, ABO)

This form of jaundice occurs when there is the incompatibility between the blood types of the mother and the fetus. This leads to increased bilirubin levels from the breakdown of the fetus’ red blood cells (hemolysis).

Breast milk jaundice

This form of jaundice occurs in breastfed newborns and usually appears at the end of the first week of life. Certain chemicals in breast milk are thought to be responsible. It is usually a harmless condition that resolves spontaneously. Mothers typically do not have to discontinue breastfeeding.

Breastfeeding jaundice

This form of jaundice occurs when the breastfed newborn does not receive adequate breast milk intake. This may occur because of delayed or insufficient milk production by the mother or because of poor feeding by the newborn. This inadequate intake results in dehydration and fewer bowel movements for the newborn, with subsequently decreased bilirubin excretion from the body.

Cephalohematoma (a collection of blood under the scalp)

Sometimes during the birthing process, the newborn may sustain a bruise or injury to the head, resulting in a blood collection/blood clot under the scalp. As this blood is naturally broken down, suddenly elevated levels of bilirubin may overwhelm the processing capability of the newborn’s immature liver, resulting in jaundice.

What Are the Symptoms and Signs of Jaundice in Adults and Newborns?

Jaundice is a sign of an underlying disease process. .

Common signs and symptoms seen in individuals with jaundice include:

  1. yellow discoloration of the skin, mucous membranes, and the whites of the eyes,
  2. light-colored stools,
  3. dark-colored urine, and
  4. itching of the skin.

The underlying disease process may result in additional signs and symptoms. These may include:

  1. nausea and vomiting,
  2. abdominal pain,
  3. fever,
  4. weakness,
  5. loss of appetite,
  6. headache,
  7. confusion,
  8. swelling of the legs and abdomen, and
  9. newborn jaundice.

Jaundice In newborns

As the bilirubin level rises, jaundice in newborns will typically progress from the head to the trunk, and then to the hands and feet. Additional signs and symptoms that may be seen in the newborn include:

  1. poor feeding,
  2. lethargy,
  3. changes in muscle tone,
  4. high-pitched crying, and
  5. seizures.

When Should You Call a Doctor for Jaundice?

  • Call a health care practitioner if you or your baby develops jaundice. Jaundice may be a sign of a serious underlying medical condition.
  • If you are unable to reach and be seen by your health care practitioner in a timely manner, go to the emergency department for further evaluation.

What Tests Diagnose Jaundice?

Once the diagnosis has been established, the health care practitioner will determine whether or not the patient requires a specialist (for example, gastroenterologist, hematologist/oncologist, general surgeon, etc.) to address their particular underlying medical condition. The patient should closely follow the health care practitioner’s recommendations and treatment regimen. Additional blood testing and imaging studies may be required.Treatment depends on the cause of the underlying condition leading to jaundice and any potential complications related to it. Once a diagnosis is made, treatment can then be directed to address that particular condition, and it may or may not require hospitalization.

The health care practitioner will need to take a detailed history of the patient’s illness, and he or she will also be examined to see if there are any findings that indicate the cause of the patient’s jaundice. However, additional testing is usually required to clearly determine the underlying cause of jaundice. The following tests and imaging studies may be obtained:

Blood tests

These may initially include a complete blood count (CBC), liver function tests (including a bilirubin level), lipase/amylase level to detect inflammation of the pancreas (pancreatitis), and an electrolytes panel. In women, a pregnancy test may be obtained. Additional blood tests may be required depending upon the initial results and the history provided to the practitioner.

Urinalysis

Urinalysis is an analysis of the urine and is a very useful test in the diagnosis of screening many diseases.

Imaging Studies

  • Ultrasound: This is a safe, painless imaging study that uses sound waves to examine the liver, gallbladder, and pancreas. It is very useful for detecting gallstones and dilated bile ducts. It can also detect abnormalities of the liver and the pancreas.
  • Computerized tomography (CT) scan: ACT scan is imaging study similar to an X-ray that provides more details of all the abdominal organs. Though not as good as ultrasound at detecting gallstones, it can identify various other abnormalities of the liver, pancreas, and other abdominal organs as well.
  • Cholescintigraphy (HIDA scan): A HIDA scan is an imaging study that uses a radioactive substance to evaluate the gallbladder and the bile ducts.
  • Magnetic resonance imaging (MRI): MRI is an imaging study that uses a magnetic field to examine the organs of the abdomen. It can be useful for detailed imaging of the bile ducts.
  • Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that involves the introduction of an endoscope (a tube with a camera at the end) through the mouth and into the small intestine. A dye is then injected into the bile ducts while X-rays are taken. It can be useful for identifying stones, tumors, or narrowing of the bile ducts.

Liver Biopsy

  • In this procedure, a needle is inserted into the liver after a local anesthetic has been administered. Often ultrasound will be used to guide placement of the needle. The small sample of liver tissue which is obtained is sent to a laboratory for examination by a pathologist (a physician who specializes in the diagnosis of tissue samples). Among other things, a liver biopsy can be useful for diagnosing inflammation of the liver, cirrhosis, and cancer.

What Questions Should You Ask the Doctor About Jaundice?

  1. What is the cause of my jaundice? How can I learn more about it?
  2. Will I require any blood tests or imaging studies?
  3. What is the likely course of this illness? What is the long-term outlook?
  4. What are my treatment options? Will I require surgery or medications? Are there any medications I should avoid?
  5. If my symptoms worsen while at home, what should I do? When do I need to call you? When do I need to go to the emergency department?

What Are Jaundice Treatments?

Treatment depends on the cause of the underlying condition leading to jaundice and any potential complications related to it. Once a diagnosis is made, treatment can then be directed to address that particular condition, and it may or may not require hospitalization.

  • Treatment may consist of expectant management (watchful waiting) at home with rest.
  • Medical treatment with intravenous fluids, medications, antibiotics, or blood transfusions may be required.
  • If a drug/toxin is the cause, these must be discontinued.
  • In certain cases of newborn jaundice, exposing the baby to special colored lights (phototherapy) or exchange blood transfusions may be required to decrease elevated bilirubin levels.
  • Surgical treatment may be required.

Depending on the cause of the patient’s jaundice, he or she may require only a short-term follow-up with visits to the health care professional, or the patient may require lifelong close supervision by a physician. The patient should discuss the potential complications of the condition with their health care practitioner, and always seek medical attention if the symptoms recur or worsen.

What are the diseases caused in summer in India?

diseases caused in summer

All of us are aware of the fact that some diseases are more prominent in certain seasons than others. For instance, cold, flu and cough are common diseases of winters, dengue and malaria of monsoon, and diarrhea of summers. Of these, the diseases of summers bring along a host of other health problems as well that range from simple ones like a headache, skin rashes, sunburns, etc. to severe ones like measles, jaundice, and more.

The months of May and June are usually the hottest in India. While, in some areas, the temperature rises as high as 51 degrees Celsius, there are many regions that experience moderate summers. No matter where one lives, some summer diseases are inevitable. However, as wisely quoted by a learned man, “prevention is better than cure.” You must take necessary preventive measures against summer diseases even if you think you are fit and healthy. Here, we enlist some common summer diseases that you must safeguard yourself against.

Food poisoning

The leading food poisoning causes is the consumption of contaminated food or water. It spreads by bacteria, viruses, toxins, and chemicals which, post entering the human body, cause the onset of stomach pain, nausea, diarrhea or vomiting. Raw meat, food sold in the open by roadside vendors, and contaminated water are common carriers of disease-causing microbes.

Heat Stroke

If on a hot summer day, you experience headache, drying of skin, cramps, weakness, vomit, increased heart rate, or shallow breathing, it’s quite possible you’re suffering from a heat stroke. The very first sign of heatstroke is dizziness which is usually followed by a bunch of other conditions such as nausea, seizures, etc. But when it turns severe, it usually leads to a condition of coma. To prevent heatstroke, doctors advise that one must overdo with clothes, which typically traps the body heat inside and causes problems. Additionally, staying in cooler areas helps avoid heatstroke conditions.

Sun Burns

Exposure to the sun for longer durations is not healthy for humans or animals due to the penetration of UV rays in the body. People who encounter lower levels of melanin formation are even prone to skin cancer as it causes melanoma. During hot summer days when people are exposed to the sun for an extended period, their skin might turn red, dry, itchy and cracks may develop. Afterward, the victim usually feels cold, experiencing chills, nausea, vomit, feverish and at times witness flu-like symptoms. If the skin cells burn too much, then blisters might appear on the skin and peeling of dried/dead skin at a later stage may occur. The best way to prevent sunburns is by using sunscreen with SPF 30 or higher and taking preventive measures to keep the moisture of skin intact.

Skin rashes

During summers, skin rash is a common skin problem among children and adults. This typically happens when an individual sweats too much. The sweat accumulates in the clothes and constant rubbing or wearing the sweat laden clothes for a prolonged period causes itchiness and further leads to a rash. Skin reddening, dryness, irritation are the visible signs of skin rash.

Chicken Pox

Chickenpox makes one of the most common summer diseases. It starts in the form of fluid-filled, red and small rashes accompanied by fever as high as 102 Fahrenheit and ultimately turns into fluid-filled blisters which crust or chip over leaving marks on the skin. People who have diabetes, cancer, blood pressure problem, HIV, tuberculosis, on specific steroids or those with a weak immune system are prone to chickenpox. Usually, the virus (Varicella-zoster) travels through droplets present in the environment exhibited by an infected person either during his/her sneezing or coughing spells. In many individuals, the virus causing chickenpox also remains dormant in the body until it gets exponentially favorable weather conditions to propel again. Common symptoms of chickenpox include scabs, blisters, itchy skin, redness, high-grade fever, loss of appetite, and headache which usually lasts for more than a week or two.

Measles

Measles is yet another common summer disease. Also known as rubeola or morbilli, it’s more or less the same as chickenpox in the way it is transmitted. It usually infects the lining at the back of the throat. The paramyxovirus which causes measles breeds faster during the summers. Its initial symptoms are cough, high fever, sore throat, and reddening in eyes. At a later stage, the tiny white spots and measles rash appear all over the body. In most of the cases, it starts around the hairline and the face. As a preventive measure, it is usually recommended to get the MMR vaccination (Measles, Mumps, and Rubella).

Jaundice

Jaundice is a common water-borne disease. It can be a result of Hepatitis A and is mainly caused due to the consumption of contaminated food and water. Jaundice THAT spreads due to Hepatitis A is transmitted by the feces-oral route. It is when an uninfected person ingests food or water contaminated with the feces of an infected person. It can either be foodborne or waterborne. If not treated on time, this disease can affect the functionality of the liver leading to the overproduction of bile. The visible symptoms include a yellow discoloration of the skin, mucous membranes and the whites of the eyes, light-colored stools, dark-colored urine, and itchy skin.

Typhoid

One of the common diseases in summer is typhoid. Through the oral-fecal route, it is passed on to the healthy individuals. It is also known as typhoid fever it is a waterborne disease. It spreads when the Salmonella typhi bacteria pass through the oral-fecal route. The contaminated food and water sources become the breeding ground for the bacteria leads to the outbreak when consumed. Visible symptoms of typhoid are weakness, loss of appetite, fatigue, pain in the abdomen, high fever. As a preventive measure vaccination is done to protect typhoid. During vaccination, the weakened bacterium is injected in the form of medicine or a pill so as to build the immunity against it.

Mumps

Of all summer diseases, mumps is another extremely contagious viral disease. As a summer disease in India it occurs mainly in children during peak summertime. It is contagious in nature and gets transmitted when an infected person coughs or sneezes. Some of the visible symptoms are swelled salivary gland, muscle ache, fever, headache, loss of appetite and weakness. To prevent the doctor recommends the MMR (Measles, Mumps, and Rubella) vaccine during treatment.

Summer Diseases and Prevention

The primary reason behind the outbreak of diseases in summer is the presence of favorable weather conditions for bacteria, virus and other parasites to breed. Here is the list highlighting the best summer health tips to immune oneself from diseases in summer.

  • Try to avoid activities outside the home during peak sun hours.
  • Avoid exposure to direct sunlight and crowded areas.
  • Increase water or liquid intake so as to prevent dehydration.
  • Use sunscreen with a higher SPF to prevent skin damage.
  • Avoid roadside food or contaminated water.
  • Increase the consumption of fruits and vegetables.
  • Wear wide-brimmed hats to avoid direct exposure to the sun.
  • Prefer light-colored, loose clothing as dark colors absorb heat.
  • Keep your premises healthy and clean.

Summer is a beautiful time to enjoy vacations and spend time with family, friends, making memories only if you are healthy. All that you need to do to stay fit is the little awareness and few precautions to enjoy the good times.

Must know info on World Mental Health Day!

World Mental Health Day is observed on 10th October every year, with the objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health. World Federation for Mental Health founded the awareness day in 1992 to make mental health care a reality for people worldwide.

Half of all mental illness begins by the age of 14, but most cases go undetected and untreated. In terms of the burden of the disease among adolescents, depression is the third leading cause. Suicide is the second leading cause of death among 15-29-year-olds.

Harmful use of alcohol and illicit drugs among adolescents is a major issue in many countries and can lead to risky behaviors such as unsafe sex or dangerous driving. Eating disorders are also of concern. If untreated, these conditions influence children’s development, their educational attainment, and their potential to live fulfilling and productive lives.

As about 356 million people in India are between the ages of 10 to 24 years; India, is a young country, with about 30% of its population being youth. Prevention and management of mental distress among adolescents and young adults should begin from an early age by increasing awareness and understanding the early warning signs and symptoms of mental illness.

National Mental Health Programme: Government of India has been implementing National Mental Health Programme (NMHP) since 1982 to ensure the availability and accessibility of minimum mental healthcare for all with its key implementation unit- District Mental Health Programme. The aim is to integrate mental health care in to primary health care and to proceed towards community health care.  

The National Mental Health Policy announced in October, 2014 and Mental Healthcare Act 2017 also act to strengthen mental health services in India.

Adolescent reproductive and sexual health programme (ARSH) under National Health mission (NHM) provides various health services related to young adults.

The Government of India has several national and international programs and has various schemes and initiatives at the national level (National Social Service Scheme, Nehru Yuva Kendra Sangathan, National Youth Policy 2014) that outline pathways for positive youth development. 

If you feel anyone in need of Mental Support, feel free to contact:

  • 112 is the National emergency number for India.
  • Samaritans Mumbai: (samaritansmumbai.com) – +91 8422984528, +91 8422984529, +91 8422984530 – 3 pm to 9 pm, all days. samaritans.helpline@gmail.com. Helpline providing emotional support for those who are stressed, distressed, depressed, or suicidal.
  • AASRA (http://www.aasra.info/): 91-22-27546669 is a 24-hours a day, 7 days a week nationwide voluntary, professional and confidential services.
  • Sneha India (http://www.snehaindia.org) is available 24/7 on the phone by calling 91 44 24640050.

References-

www.who.int/mental_health/world-mental-health-day/2018/en/

dghs.gov.in/content/1350_3_NationalMentalHealthProgramme.aspx

www.prsindia.org/uploads/media/Mental%20Health/Mental%20Healthcare%20Act,%202017.pdf

pib.nic.in/newsite/PrintRelease.aspx?relid=137749

pib.nic.in/newsite/PrintRelease.aspx?relid=102397

www.ijcmph.com/index.php/ijcmph/article/view/1936/1460

https://en.wikipedia.org/wiki/List_of_suicide_crisis_lines