What is a home remedy for Joindice

Jaundice in adults

With jaundice, the skin and the whites of the eyes appear yellow. Jaundice is caused by what is known as hyperbilirubinemia, in which there is too much bilirubin (a yellow bile pigment) in the blood.

Bilirubin is formed as part of the normal breakdown of old or damaged red blood cells and is an intermediate product in the breakdown of hemoglobin (the oxygen-binding part of red blood cells). The bilirubin is carried in the blood to the liver, where it combines with bile (the digestive fluid made by the liver). It is then excreted through the bile ducts into the digestive tract and ultimately from the body. Most of the bilirubin is excreted in the stool, but a small amount is also excreted in the urine. If bilirubin cannot be cleared quickly enough through the liver and bile ducts, it accumulates in the blood and is then deposited in the skin. This leads to the yellowish discoloration typical of jaundice.

Many people with jaundice also have dark urine and pale stools. These changes happen when constipation or other problem prevents bilirubin from being excreted in the stool so that more bilirubin has to be excreted in the urine.

When bilirubin levels are high, substances that are formed when the bile is broken down can accumulate, causing itching all over the body. Otherwise, however, jaundice causes few other symptoms in adults. However, in newborns with jaundice, high levels of bilirubin (hyperbilirubinemia) can cause damage to the central nervous system (bilirubin encephalopathy or kernicterus).

Many of the disorders that cause jaundice, particularly severe liver disease, are also associated with other symptoms or serious problems. In people with liver disease, these symptoms include nausea, vomiting, and abdominal pain, as well as small but visible spider-like blood vessels on the skin (called spider nevus). In men, testicles may shrink and breasts and pubic hair may develop as in women.

Serious problems caused by liver disease can include:

  • Ascites: accumulation of fluid in the abdominal cavity

  • Hepatic encephalopathy: deterioration in brain function due to a malfunction in the liver, in which toxic substances can build up in the blood and reach the brain where they can cause abnormalities in consciousness (e.g. confusion and drowsiness)

  • Portal hypertension: high blood pressure in the veins that carry blood to the liver, which can cause bleeding in the esophagus and occasionally in the stomach

People who eat large amounts of foods containing beta-carotene (e.g. carrots, pumpkins, certain melons) may have a slight yellow tinge to their skin; but their eyes do not turn yellow. This condition is not jaundice and has nothing to do with liver disease.

Did you know ...

  • If you eat too many carrots, your skin may turn yellow, but this has nothing to do with jaundice.

What causes jaundice in adults?

There are many possible causes of jaundice in adults. Most often they have to do with disorders and drugs that are responsible for:

  • Damage to the liver

  • Disturbance of the outflow of bile

  • Destruction of red blood cells (hemolysis) with increased bilirubin production that the liver cannot break down

View of the liver and gallbladder

The portal vein receives blood from the whole intestine as well as from the spleen, pancreas and gallbladder and carries this blood to the liver. After entering the liver, the portal vein divides into left and right branches, and then into tiny canals that run through the liver. When the blood leaves the liver, it flows back into the general circulation through the hepatic vein.

The most common reasons for jaundice

hepatitis

Hepatitis is an inflammation of the liver that is usually caused by a virus, but it can also be caused by an autoimmune disease or the use of certain medicines. Hepatitis damages the liver and affects the elimination of bilirubin through the bile ducts. Hepatitis can be acute (short-lived) or chronic (lasting at least 6 months). Acute viral hepatitis often causes jaundice, especially in young, otherwise healthy people. In these cases the disease is not communicable.

Alcohol-related liver disease

Long-term ingestion of large amounts of alcohol damages the liver. The amount of alcohol that is harmful over what period of time varies, but heavy alcohol consumption is usually sufficient for at least 8 to 10 years. Other drugs, poisons, and certain herbal products can also damage the liver (see table Causes and Features of Jaundice).

Biliary obstruction

When the bile ducts are blocked, bilirubin can build up in the blood. Such blockages are mostly caused by gallstones, but cancer (e.g. tumors of the pancreas or bile ducts) or rare liver diseases (e.g. primary biliary cholangitis or primary sclerosing cholangitis) can also lead to it.

Other causes of jaundice

Less common causes of jaundice are inherited diseases that affect the body's processing of bilirubin. These include Gilbert syndrome as well as other, rarer diseases such as Dubin-Johnson syndrome. In Gilbert syndrome, bilirubin levels are slightly increased, but most often not enough to cause jaundice. This disease is most often diagnosed in young adults during routine screening tests. It does not cause any further symptoms or problems.

How is jaundice diagnosed?

The presence of jaundice is obvious, but determining the underlying cause requires a medical exam, blood tests, and possibly other tests.