Jaundice is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes .

1. Jaundice
Someone with jaundice is likely to have a yellow look to their skin and the whites of the eyes. Many newborn babies develop jaundice, but the condition can affect people of all ages. This article looks at older children and adults. Jaundice is caused by a buildup of bilirubin in the blood and body tissue. That buildup is often due to conditions affecting the liver, such as cirrhosis, hepatitis or gallstones. If someone shows signs of jaundice, doctors will look to treat the condition thats causing it rather than jaundice itself.

2. Symptoms of jaundice
As well as the classic yellow tinge to the skin and whites of the eyes, someone with jaundice may also have yellowing of mucous membranes in the mouth and nose.Stools faeces or poo can be pale in colour and urine dark in colour.Some underlying conditions, which lead to jaundice, may feel like flu, and may also result in fever, chills, stomach pain, itching or weightloss or be without an explanation such as a diet.

3. Causes of jaundice
When red blood cells break down naturally in a 120day cycle, bilirubin is produced as a waste byproduct. The journey bilirubin takes out of the bodys waste disposal systems takes it carried by blood to the liver. There is it combined with bile digestive fluid from the gallbladder. This mixture exits the body through faeces and urine. If everything is working well, faeces should be brown and urine light yellow. Infections or damage can disrupt this process, leading to jaundice.

4. Prehepatic jaundice
If an infection or medical condition makes the red blood cells break down sooner than usual, bilirubin levels rise. This is known as prehepatic jaundice.
Conditions which may trigger this include malaria, sickle cell anaemia, thalassaemia, Gilberts syndrome, hereditary spherocytosis and CriglerNajjar syndrome.

5. Intrahepatic jaundice
If the liver is damaged, it may be less able to process bilirubin. This causes what doctors call intrahepatic jaundice. The liver damage may be a result of causes that include hepatitis, alcoholic liver disease, glandular fever, liver cancer, illegal drug use including ecstasy, and paracetamol overdose. Obesity and non alcoholic fatty liver disease can be a cause of cirrhosis of the liver and jaundice.

6. Posthepatic jaundice
Gallstones, pancreatitis, pancreatic cancer and cancers of the gallbladder or bile duct may also disrupt the bilirubin removal process leading to jaundice. This is called posthepatic jaundice. Eating a highfat diet can raise your cholesterol levels and increase the risk of having gallstones.

7. Jaundice diagnosis
The yellowing of skin and eyes are likely to be the main clues a doctor will use before confirming a jaundice diagnosis. A person will be asked about other symptoms and risks, such as foreign travel or illegal drug use. A physical examination will be carried out to look for signs of swelling of the liver and legs, ankles or feet which might indicate cirrhosis of the liver.

Urine can be tested for urobilinogen, which is produced when bilirubin is broken down. Finding high or low levels can help pinpoint the type of jaundice. Blood tests may be used to check for conditions like malaria or hepatitis. A liver function blood test may indicate hepatitis, cirrhosis or alcoholic liver disease. Sometimes a liver biopsy removal of small tissue sample is needed to confirm or rule out conditions such as cirrhosis or liver cancer. Doctors may also need to look inside the body for problems with the liver or bile duct using ultrasound, Xray with contrast, MRI or CT scans.

8. Jaundice treatment
The treatment given to someone with jaundice will depend on what type they have, how serious it is and what caused it. It may include tackling an underlying condition such as malaria and bothersome symptoms, such as itching. For genetic conditions that dont get better, like sickle cell anaemia, a blood transfusion may be given to replenish red blood cells in the body. If the bile duct system is blocked, an operation may be needed to unblock it. During these procedures measures may be taken to help prevent further problems, such as removal of the gallbladder. If the liver is found to be seriously damaged, a transplant may be an option.

9. Preventing jaundice
As many things can cause jaundice, it is hard for doctors to give specific prevention advice in all cases.General tips include avoiding hepatitis infection, staying within recommended alcohol limits, maintaining healthy weight and managing cholesterol.

10. When to see a doctor
Most hospitals have a policy of examining babies for jaundice before discharge. The American Academy of Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital.

Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours following birth, make a followup appointment to look for jaundice within two days of discharge.

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