Overview

Jaundice is a condition that causes the skin and whites of the eyes to turn yellow. It occurs when there is a buildup of bilirubin in the blood. Bilirubin is a yellow pigment that is formed when red blood cells break down. Normally, the liver processes bilirubin and excretes it in the bile, but if the liver is not functioning properly or if there is a blockage in the bile ducts, bilirubin can build up in the blood and cause jaundice.

In adults, jaundice can be caused by a number of different underlying conditions, including liver disease, cancer, infection, and blockages in the bile ducts. Some common causes of jaundice in adults include hepatitis, cirrhosis, and pancreatic cancer.

Symptoms of jaundice in adults can include yellowing of the skin and whites of the eyes, dark urine, light-colored stool, abdominal pain, and nausea. If you have jaundice, it's important to see a doctor as soon as possible to determine the underlying cause and to receive appropriate treatment. Treatment for jaundice depends on the underlying cause, but may include medications, surgery, or other procedures to remove the blockage or repair the underlying condition.

What is Jaundice?

Jaundice is a condition in which the skin and whites of the eyes become yellow due to a high level of bilirubin in the blood. Bilirubin is a yellow pigment that is formed when red blood cells break down. The liver normally removes bilirubin from the blood and excretes it in the bile, which gives feces their brown color. When the liver is not functioning properly or there is a blockage in the bile ducts, bilirubin can build up in the blood, leading to jaundice. Jaundice can be a symptom of various underlying conditions such as liver disease, hemolytic anemia, and cancer.

What is the Hemoglobin?

Hemoglobin is a protein found in red blood cells that is responsible for carrying oxygen from the lungs to the body's tissues and for carrying carbon dioxide from the body's tissues to the lungs for removal. Hemoglobin is made up of four protein subunits called globins and a heme group. The heme group contains an iron atom, which binds to oxygen and carbon dioxide.

When a person inhales, oxygen binds to the iron atom in the heme group of hemoglobin, forming oxyhemoglobin. Oxyhemoglobin then travels through the bloodstream to the body's tissues, where it releases oxygen to be used by the cells.

As the cells use oxygen, they produce carbon dioxide as a waste product. Carbon dioxide binds to the iron atom in the heme group of hemoglobin, forming carbaminohemoglobin. Carbaminohemoglobin then travels back to the lungs, where it releases carbon dioxide to be exhaled.

Hemoglobin also plays a role in regulating blood pH by binding and releasing protons. When the blood becomes too acidic, hemoglobin releases protons, which helps to neutralize the acidity. When the blood becomes too alkaline, hemoglobin binds protons, which helps to balance the pH.

In summary, Hemoglobin is a protein in red blood cells that binds to oxygen and carbon dioxide, which is responsible for carrying oxygen from the lungs to the body's tissues and for carrying carbon dioxide from the body's tissues to the lungs for removal. It also plays a role in regulating blood pH by binding and releasing protons.

Life Cycle of Hemoglobin

The life course of hemoglobin can be divided into several stages:

1. Synthesis: Hemoglobin is synthesized in the red blood cell precursors called erythroblasts in the bone marrow. The process of hemoglobin synthesis involves the production of globin chains and heme groups, which then come together to form functional hemoglobin molecules.
2. Maturation: As the red blood cell matures, it fills up with hemoglobin. The mature red blood cell is now called erythrocyte.
3. Circulation: Once the red blood cells are mature and contain hemoglobin, they are released into the bloodstream and begin to circulate throughout the body. As they circulate, they deliver oxygen to the body's tissues and pick up carbon dioxide to be transported to the lungs for removal.
4. Breakdown: Red blood cells have a lifespan of about 120 days after which they are broken down by the spleen, liver and bone marrow. Hemoglobin molecules are broken down into their component parts: globin and heme. The iron in heme is recycled and the rest is excreted in the urine as bilirubin.
5. Replacement: The iron and other components of the broken-down hemoglobin are recycled and used to create new hemoglobin molecules. This process is ongoing, as the body constantly produces new red blood cells to replace those that are broken down.

In this way, hemoglobin is continuously produced and broken down throughout an individual's lifetime. The body's need for oxygen and removal of carbon dioxide are continuously met by the production and circulation of new red blood cells and hemoglobin.

How Common is Adult Jaundice?

Jaundice is a relatively common condition, particularly in adults. The exact prevalence of jaundice in adults is difficult to determine because it can be caused by a wide range of underlying conditions and can manifest in varying degrees of severity. However, it's estimated that jaundice occurs in about 2-5% of the adult population.

Hepatocellular jaundice, which is caused by liver disease, is the most common type of jaundice in adults. It is estimated that jaundice occurs in about 20-30% of patients with cirrhosis, a common cause of liver disease.

Obstructive jaundice, which is caused by a blockage in the bile ducts, is also relatively common in adults. It is estimated that jaundice occurs in about 10-15% of patients with gallstones, a common cause of bile duct obstruction.

Hemolytic jaundice, which is caused by an increase in the destruction of red blood cells, is less common in adults. However, it can occur in certain conditions such as hemolytic anemia and sickle cell disease.

Jaundice is a relatively common condition in adults and its prevalence varies depending on the underlying cause. The most common type of Jaundice in adults is Hepatocellular jaundice caused by liver disease. Obstructive jaundice caused by bile duct obstruction and Hemolytic jaundice caused by increased destruction of red blood cells are also relatively common.

Pathophysiology of Jaundice

Jaundice occurs when there is an excess of bilirubin in the blood. Bilirubin is a yellow pigment that is formed when red blood cells break down. Normally, the liver removes bilirubin from the blood and excretes it in the bile. The bile flows into the small intestine, where it helps to digest fats and absorb fat-soluble vitamins.

There are several different types of jaundice, each with a different underlying cause. The pathophysiology of jaundice can be categorized based on where the problem is located in the bilirubin metabolism pathway.

• Hemolytic Jaundice: Hemolytic jaundice is caused by an increase in the destruction of red blood cells. The increased destruction of red blood cells leads to increased bilirubin production, which can overwhelm the liver's ability to remove it from the blood.
• Hepatocellular Jaundice: Hepatocellular jaundice occurs when there is a problem with the liver's ability to remove bilirubin from the blood. This can be caused by liver disease, such as hepatitis or cirrhosis.
• Obstructive Jaundice: Obstructive jaundice occurs when there is a blockage in the bile ducts, which prevents the bile from flowing into the small intestine. This can be caused by gallstones, tumors, or other conditions that block the bile ducts.

In each type of jaundice, the bilirubin level in the blood increases and results in the yellowing of skin and eyes. The specific underlying cause of jaundice will dictate the specific pathophysiology of jaundice.

What Cause of Adult Jaundice?

Jaundice in adults can be caused by a wide range of underlying conditions, which can be broadly categorized into three main types:

1. Hepatocellular jaundice: This is caused by liver disease or injury, which impairs the liver's ability to excrete bilirubin. Common causes of hepatocellular jaundice include viral hepatitis, cirrhosis, and liver cancer.
2. Obstructive jaundice: This is caused by a blockage in the bile ducts, which prevents bilirubin from being excreted. Common causes of obstructive jaundice include gallstones, tumors, and inflammation of the pancreas.
3. Hemolytic jaundice: This is caused by an increase in the destruction of red blood cells, which results in an excess of bilirubin in the bloodstream. Common causes of hemolytic jaundice include sickle cell anemia, thalassemia, and certain medications.

Other Causes of Jaundice include:

• inherited metabolic disorders
• Pancreatic cancer
• Pancreatitis
• Medications and toxins
• Blood transfusions
• Sepsis
• Malaria

In summary, Jaundice in adults can be caused by a wide range of underlying conditions, including liver disease, blockages in the bile ducts, and increased destruction of red blood cells. Other causes include inherited metabolic disorders, Pancreatic cancer, Pancreatitis, certain Medications and toxins, Blood transfusions, Sepsis, and Malaria.

Symptoms & Signs of Adult Jaundice

The symptoms and signs of adult jaundice can vary depending on the underlying cause of the condition. However, some common symptoms and signs include:

1. Yellowing of the skin and whites of the eyes: This is the most obvious and characteristic symptom of jaundice. The yellowing is caused by the build-up of bilirubin in the blood, which gives the skin and eyes a yellow tint.
2. Dark urine: Bilirubin is excreted in the urine, so jaundice can cause the urine to turn a dark color.
3. Pale-colored stools: Jaundice can also cause the stools to turn a pale color, as bilirubin is a component of bile, which gives stools their normal brown color.
4. Fatigue and weakness: Jaundice can cause fatigue and weakness due to anemia, which is a common complication of jaundice caused by increased destruction of red blood cells.
5. Itching: Jaundice can cause itching due to the build-up of bilirubin in the blood.
6. Nausea and vomiting: Jaundice can cause nausea and vomiting due to the underlying liver disease or blockage in the bile ducts.
7. Abdominal pain: Jaundice caused by liver disease or blockage in the bile ducts can cause abdominal pain.
8. Loss of appetite: Jaundice can cause loss of appetite due to underlying liver disease or blockage in the bile ducts.
9. Confusion and memory problems: Jaundice can cause confusion and memory problems due to the underlying liver disease or blockage in the bile ducts.

Symptoms and signs of jaundice can be more severe or subtle. It's important to see a doctor if you suspect you have jaundice, as it can be an indication of a more serious underlying condition.

In summary, the symptoms and signs of adult jaundice can include yellowing of the skin and whites of the eyes, dark urine, pale-colored stools, fatigue, weakness, itching, nausea, vomiting, abdominal pain, loss of appetite, confusion, and memory problems. These symptoms can vary depending on the underlying cause of jaundice.

How Adult Jaundice is Diagnosed?

The diagnosis of adult jaundice typically begins with a physical examination and a review of the patient's medical history. The doctor will look for signs of jaundice, such as yellowing of the skin and whites of the eyes, and will ask about any other symptoms the patient may be experiencing.

To confirm the diagnosis of jaundice, the doctor will typically order a series of laboratory tests, including:

1. Blood tests: Blood tests can measure the level of bilirubin in the blood, which is the substance that causes the yellowing of the skin and whites of the eyes.
2. Liver function tests: These tests can measure the level of enzymes and proteins in the blood that are produced by the liver. Elevated levels of these enzymes and proteins can indicate liver damage or disease.
3. Complete blood count (CBC): This test can measure the number of red blood cells, white blood cells, and platelets in the blood. Anemia, which is a common complication of jaundice, can be diagnosed by low red blood cell count.
4. Coagulation tests: These tests can measure the ability of the blood to clot, which can be affected by liver disease.
5. Imaging tests: Imaging tests such as ultrasound, CT scan, or MRI can be used to visualize the liver, pancreas, and bile ducts, which can help identify any blockages or abnormalities.
6. Biopsy: In some cases, a liver biopsy may be performed to obtain a sample of liver tissue for examination under a microscope.

Based on the results of these tests, the doctor will work to identify the underlying cause of the jaundice, which can help guide treatment.

In summary, Adult jaundice is diagnosed by physical examination and review of patient's medical history. Then, laboratory tests such as blood tests to measure bilirubin level, liver function tests, complete blood count, coagulation tests and imaging tests such as ultrasound, CT scan, or MRI are used to confirm the diagnosis. In some cases, liver biopsy may be performed to obtain a sample of liver tissue for examination under a microscope.

Treatment of Adult Jaundice

The treatment of adult jaundice depends on the underlying cause of the condition. Some common treatments for jaundice include:

1. Medications: Depending on the underlying cause of the jaundice, the doctor may prescribe medications to help alleviate symptoms and treat the underlying condition. For example, antibiotics may be prescribed for jaundice caused by a bacterial infection, or antiviral medications may be prescribed for jaundice caused by a viral infection.
2. Surgery: In some cases, surgery may be required to treat the underlying cause of the jaundice. For example, if the jaundice is caused by a blockage in the bile ducts, surgery may be performed to remove the blockage.
3. Lifestyle changes: Lifestyle changes such as quitting smoking and reducing alcohol consumption can help improve the overall health of the liver and reduce the risk of jaundice.
4. Diet modification: A diet that is low in fat and easy to digest can help support the function of the liver and reduce symptoms of jaundice.
5. Phototherapy: Phototherapy is a treatment used to reduce the level of bilirubin in the blood. Bilirubin is a yellow pigment that causes jaundice. Phototherapy uses special lights that are placed close to the skin to break down bilirubin.
6. Blood transfusion: In case of severe anemia, blood transfusion may be needed.

In summary, the treatment of adult jaundice depends on the underlying cause of the condition. It may include medications, surgery, lifestyle changes, diet modification, phototherapy and blood transfusion.

What is the Adult Jaundice Prognosis?

The prognosis for adult jaundice depends on the underlying cause of the condition and the severity of the symptoms. Some common causes of jaundice, such as viral hepatitis and certain medications, may resolve on their own with time. Other causes, such as cirrhosis of the liver and cancer, can lead to more serious health problems and may require more aggressive treatment.

In cases of acute jaundice, such as viral hepatitis, the prognosis is generally good with proper treatment and management. However, if jaundice is caused by chronic liver disease, such as cirrhosis or cancer, the prognosis may be more guarded.

Early diagnosis and treatment can greatly improve the prognosis of jaundice. Regular check-ups with a physician and monitoring of the bilirubin level can help manage the symptoms and prevent progression of the disease.

In summary, the prognosis for adult jaundice varies depending on the underlying cause of the condition and the severity of the symptoms. Acute jaundice such as viral hepatitis has a good prognosis with proper treatment and management. However, if jaundice is caused by chronic liver disease such as cirrhosis or cancer, the prognosis may be more guarded. Early diagnosis and treatment can greatly improve the prognosis.

Conclusion

Jaundice is a condition characterized by yellowing of the skin and whites of the eyes due to an accumulation of bilirubin in the blood. Bilirubin is a yellow pigment that is normally produced by the breakdown of red blood cells and is normally excreted by the liver. Adult jaundice occurs when there is an imbalance between the production and excretion of bilirubin, leading to a buildup of the pigment in the blood.

There are several causes of adult jaundice, including liver disease, viral hepatitis, gallstones, and certain medications. Symptoms of jaundice can include yellowing of the skin and whites of the eyes, dark urine, and light-colored stools.

Jaundice can be diagnosed by a physical examination and blood tests to measure the level of bilirubin in the blood. The treatment of adult jaundice depends on the underlying cause of the condition.

In summary, Adult jaundice is a condition characterized by yellowing of the skin and whites of the eyes due to an accumulation of bilirubin in the blood. It can be caused by several factors such as liver disease, viral hepatitis, gallstones, and certain medications. It can be diagnosed by physical examination and blood tests, and treatment depends on the underlying cause of the condition.