Jaundice

Liver damage caused by: Viral hepatitisCirrhosisAlcoholic liver diseaseAdverse effects of certain medications or environmental toxinsIn babies, insufficient amounts of a certain liver enzyme during the first two weeks of life, possibly made worse by breastfeeding Inherited metabolic disorders, including Gilbert's , Crigler-Nager, and Dubin-Johnson syndromes Risk Factors A risk factor is something that increases your chance of getting a disease or condition. The risk factors for jaundice are those that increase the risk for liver and gallbladder disorders. They include: Drinking too much alcoholUse of illegal drugsTaking medications that may harm the liver Exposure to hepatitis A (through contaminated food or water), hepatitis B , or hepatitis C (through contaminated needles or unsafe sex) Exposure to certain industrial chemicals SymptomsJaundice appears as a yellow discoloration of the skin, mucus membranes, and/or whites of the eyes.Depending on the specific disorder that causes jaundice, other symptoms may occur, such as tiredness, fatigue, fever, chills, and unexplained weight loss.

DiagnosisIf you have jaundice, the doctor will ask about your symptoms and medical history, and perform a physical exam. Your doctor will ask you questions about: Use of alcohol, herbal supplements, and medicationsAbdominal surgeriesHIV exposure Family history of liver diseases Tests may include: Blood teststests to detect elevated bilirubin and liver enzyme levels, or other abnormalities related to the suspected cause of jaundiceUltrasound a test that uses sound waves to examine internal organs; in this case, the liver, gallbladder, and bile ducts CT scan a type of x-ray that uses a computer to make pictures of the inside of the body; in this case, the liver, gallbladder, bile ducts, and surrounding tissues Cholangiographyan invasive test that uses x-rays and a large needle inserted into the liver to examine the gallbladder and bile ducts; sometimes performed during abdominal surgeryERCP test combines x-rays and an endoscope, which is a long, flexible, lighted tube that is inserted down the throat. This is done to examine the duodenum (first part of the small intestine), bile ducts, and pancreatic ducts. The magnetic resonance cholangiopancreatography (MRCP) test is an alternative to the ERCP test. Laparoscopy insertion of a tube and other instruments through small incisions in the abdominal wall to directly view the liver, gallbladder, bile ducts, and other structures Liver biopsy removal of a sample of liver tissue for testing. This is usually done with a long needle. Treatment Mild jaundice in newborns is common and usually clears without treatment. If bilirubin levels rise above a certain level, the baby may receive phototherapy , which is treatment with a special ultraviolet light. In Gilbert's syndrome, jaundice tends to occur during stressful periods and clears without treatment.

In most other types of jaundice, the specific condition causing it must be treated. There are many treatments that may be used for liver and gallbladder problems depending on the exact condition. They include: Avoiding a substance (alcohol or a medicine) that is causing the conditionAddressing the cause of anemiaTaking medications to treat causative infectious diseases Relieving bile duct obstructions by: Excising tumorsExtracting gallstonesRemoving the gallbladder Treating inflammation of the pancreas ( pancreatitis ) Prevention Prevention depends on the disorder causing jaundice. You may not be able to prevent some of the disorders. However, you can take the steps below to decrease your chance of developing liver disease: Limit your alcohol intake to no more than two drinks a day for men or one drink a day for women.Be careful in mixing drugs, especially alcohol, with over-the-counter and prescription medicines.Avoid exposure to industrial chemicals.Do not use illegal drugs.Do not share needles or nasal snorting equipment.Practice safe sex. To decrease your risk of hepatitis A, get the hepatitis A vaccine . To decrease your risk of hepatitis B, get the hepatitis B vaccine . RESOURCES:

American Liver Foundationhttp://www.liverfoundation.org American Gastroenterological Associationhttp://www.gastro.org CANADIAN RESOURCES BC Health Guidehttp://www.bchealthguide.org/ Canadian Liver Foundationhttp://www.liver.ca/Home.aspx References: American Liver Foundation website. Available at: http://www.liverfoundation.org . The Columbia Electronic Encyclopedia website. Available at http://www.columbia.edu/cu/cup/cee/cee.html . The Merck Manual of Diagnosis and Therapy. Simon and Schuster, Inc.; 1999. Nemours website. Available at: http://www.nemours.org/internet . Last reviewed February 2008 by Jill D. Landis, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.