What is Jaundice?

Jaundice is derived from the French word jaunise which means yellowing. In this condition, yellowing of the skin and whites of the eyes occurs because of an excess of the yellow-orange pigment known as bilirubin. Bilirubin is present in bile and is synthesized after the breakdown of red blood cells. Jaundice can be caused by several other disorders like gallstones, cancer, and hepatitis. Since bilirubin is the primary cause of yellowness, understanding its origins and metabolism is essential.

Bilirubin metabolism:

The reticuloendothelial system (also known as the macrophage system) is mainly composed of the spleen but also includes lymph nodes and macrophages that chew up or phagocytose the red blood cells as they come to the end of their lifespan, which is approximately 120 days. In the start, the macrophage consumes the blood cells before being further broken down into amino acids; hemoglobin splits into heme and globin. Further catabolization of the heme yields iron and protoporphyrin, which converts into unconjugated bilirubin (UCB). Unconjugated bilirubin, often called indirect bilirubin, is lipid-soluble rather than water-soluble. In the blood, the albumin protein binds to indirect bilirubin. Utilizing albumin-bound circulation, UCB is delivered to the liver, where hepatocytes absorb it and convert it into a form soluble in water by adding glucuronic acid, and the enzyme uridine glucuronyl transferase (UGT) is also present.

The conjugated bilirubin can go to the gallbladder to get stored as bile after being secreted into the bile ducts. When you eat a donut or anything similar, your gallbladder secretes conjugated bilirubin, which goes to the duodenum in the small intestine via the common bile duct along with bile (which is used to break food). It is then transformed by intestinal microbes in the gut into urobilinogen, or UBG, in the small intestine.

The reduction of some of that urobilinogen to stercobilinogen causes the yellow-brown color of feces. However, some of that UBG is recycled, and when reabsorbed into the blood, spontaneously oxidizes to form urobilin. The majority of it is transported to the liver and the kidneys, respectively. It is eliminated, which is why urine has a yellow tint.

The result might be a spike in bilirubin levels in the blood, which could be conjugated, unconjugated, or both. For instance, if your liver cells are damaged and can no longer conjugate bilirubin, or if they die and release their bilirubin, this process can be disturbed causing the yellow color of the skin and eyes. The standard amount of serum bilirubin is 2.5 mg/dL which causes the skin's characteristically yellow shade.

Causes:

Any of the three steps in the production of bilirubin can be problematic and result in jaundice.

1. A person can experience jaundice before the production of bilirubin as a result of elevated levels of bilirubin caused by:

• Reabsorption of a large hematoma (an assortment of coagulated or thickened blood by clotting under the skin)
• Anemias with hemolysis (blood cells are annihilated, and eliminated from the circulatory system before their ordinary life expectancy finish)

2. Jaundice can develop during the production of bilirubin and be caused by:

• Hepatitis A infection, active Hepatitis B and C, and Epstein-Barr virus disease (irresistible mononucleosis)
• Immunity-related problems
• Occasional metabolic abnormalities that run in families
• Medications such as penicillin, oral contraceptives, chlorpromazine, and anabolic or estrogenic steroids, as well as acetaminophen poisoning

3. Jaundice may develop after bilirubin is produced as a result of bile conduit obstruction (deterrent) caused by:

• Gallstones
• Gallbladder enlargement or gallbladder irritation
• Cancerous growth in the gallbladder
• Pancreatic enlargement or tumor

Symptoms:

Most often the disease is discovered by a coincidence as the person may have no signs of jaundice. The severity of the symptoms depends on the root causes and how quickly or gradually the infection develops. If you have jaundice, which is usually caused by contamination, you may experience the following symptoms:

• Fever
• Chills
• Stomach ache
• Skin tone transformation
• Urine with a dull tint or even a mud-colored

You can have adverse effects like weight loss or pruritus, which is an inflammatory skin condition if contamination is not the cause of your jaundice. Abdominal pain is the most common symptom if pancreatic or biliary tract tumors are the cause of the jaundice. If you have liver illness, you may also get jaundice. You may develop jaundice in conjunction with liver disease if you have:

• Hepatitis that is a chronic inflammation of the liver (Hepatitis A, B, or C)
• Pyoderma Gangrenous (a sort of disorder of the immune system)
• Polyarthralgias (joint inflammation)

Treatment:

Adults usually do not require treatment for jaundice (newborn children experience the jaundice to a greater extent).

The jaundice medications may cause some side effects such as:

• Blockage
• Swelling.
• Stomach ache
• Gas
• Loose bowel movements

Preventions:

Given the wide range of causes of jaundice, it is difficult to recommend specific preventive measures. Here are some general guidelines:

• Avoid getting hepatitis
• Keep a healthy weight
• Maintain your cholesterol levels

Men and women who are moderately older are more affected by bilirubin production. People who have hepatitis and drink alcohol are also at risk.

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