Jaundice in adults is often associated with what diseases?

This is an automatically translated article.

The article was consulted with Specialist Doctor I Dong Xuan Ha - Gastroenterologist - Department of Medical Examination and Internal Medicine - Vinmec Ha Long International Hospital and MSc.BSCKII Phan Thi Minh Huong - Doctor Doctor of Gastroenterology, Vinmec Da Nang International General Hospital.
The phenomenon of jaundice in adults is not only yellow skin, but also yellowing of the mucous membranes and conjunctiva of the eyes. Although not a disease, but jaundice is a warning symptom of hepatobiliary disease or other diseases that need attention and follow-up.

1. What is Jaundice? What causes jaundice?

Jaundice is a condition in which the skin and conjunctiva of the eyes are yellow, due to high levels of bilirubin in the blood caused by medical conditions. Yellow color usually appears in the conjunctiva first and the degree of jaundice depends on the concentration of bilirubin in the blood.
Thus, it can be seen that the increase in bilirubin concentration is the cause of jaundice that occurs due to metabolic disorders in the body. Bilirubin is produced from broken red blood cells to be replaced by new red blood cells. When circulating in the blood, through the liver and liver cells, liver enzymes change the structure of bilirubin to form a form of bilirubin. water soluble is called conjugated bilirubin. The liver cells distribute conjugated bilirubin into the small bile ducts, causing the bilirubin to become part of the bile, the network of bile ducts coalesce into the common bile duct to reach the duodenum. Eventually, bilirubin will get in the stool and give it a yellow-brown color. So any disorder that causes bilirubin to build up in the blood can cause jaundice.
Causes of jaundice are divided into 4 groups of causes including:
Diseases related to red blood cells; Diseases related to liver cells; Disease involving the small bile ducts in the liver; Disease involving the common bile duct outside the liver.

2. Is jaundice in adults dangerous?

Jaundice is only a suggestive symptom for the general medical condition of a person, so it is not possible to assess the severity and course of the disease by simply relying on the phenomenon of jaundice in adults. From that fact, after detecting jaundice, people will think of groups of causes and assess the level of danger depending on the disease as follows:
Group of diseases related to red blood cells (Pre-hepatic jaundice): The condition in which red blood cells are destroyed at an accelerated rate due to disease, causing bilirubin to be overproduced compared to normal and circulating in the blood, which will cause liver cells to not be able to metabolize this large amount of bilirubin, leading to bilirubin accumulation. in the blood causes jaundice.
Pathologies that destroy red blood cells include: sickle cell disease, thalassemia, glucose 6-phosphate dehydrogenase deficiency, hemolytic uremic syndrome, malaria or tissue hematoma.
Group of diseases related to hepatocytes (Hepatic jaundice): This is the main group of diseases causing jaundice in adults because liver cells are affected and do not receive bilirubin, are eliminated and eventually is stasis in the blood. In addition, the destruction or decrease in the number of liver cells can also cause the liver to increase the concentration of bilirubin in the blood. Groups of diseases related to liver cells include:
Acute hepatitis is an inflammatory process in the liver caused by viruses, bacteria or alcohol, drugs, autoimmune diseases that cause liver cells to be destroyed; Cirrhosis is a process where the tissues of the liver are replaced by scar tissue, affecting liver function gradually, difficult to detect but will worsen as liver function worsens. The main causes of cirrhosis are chronic hepatitis B, chronic hepatitis C, alcoholic liver damage or autoimmune hepatitis; Cancer metastasis to the liver should also be considered and classified as a cause in the liver; Certain genetic syndromes are rare but can also cause jaundice, such as Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome.

Group of diseases related to the common bile duct (Post-hepatic jaundice): Bile fluid containing bilirubin will be led from the small bile ducts in the liver to the common bile duct, if the common bile duct is narrow or blocked, the bile will spill into the blood. causes jaundice; Gallstones are a disease caused by bile in the form of gallstones, usually stones will form in the gallbladder without affecting anything, but if gallstones escape from the gallbladder and get stuck in the common bile duct, it will cause bile to leak. unable to enter the intestines and penetrate into the bloodstream causing jaundice; Pancreatic head cancer can also cause obstruction of bile flow; Acute pancreatitis causing edema leading to obstruction of bile flow will also cause jaundice; Narrowing of the biliary tract: Due to the sclerosing complications of inflammation, the narrowing of the bile ducts leads to jaundice; Gallbladder cancer develops causing obstruction of the common bile duct; Cholangitis due to primary cirrhosis or sclerosing cholangitis and some drugs reduce the outflow of bile, excrete bilirubin, causing jaundice. Drug-induced jaundice: Some drugs can also cause cholestatic jaundice or hepatitis due to jaundice; Drugs that cause inflammation of the biliary tract also lead to biliary obstruction and jaundice; The drug interferes with the metabolism in hepatocytes and biliary tract of the process of creating and excreting bile through the intestines, also causing jaundice because the components of bile with bilirubin are trapped in the body.

3. How to diagnose the cause of jaundice?

To diagnose the cause of jaundice, it is necessary to rely on both history, physical examination and laboratory tests to determine the exact cause.
History: A history to suspect the cause of jaundice is important, for example, a patient who drinks heavily is suspected of alcoholic liver disease, a drug addict is suspected of viral hepatitis or is on medication. then suspected drug-induced jaundice, patients with intermittent abdominal pain suspected biliary obstruction due to stones.
Physical examination: Physical examination needs a comprehensive examination, but pay attention to abdominal examination. Abdominal tumor suggests jaundice due to cancer infiltrating the liver with metastases. Hard liver will suggest cirrhosis, hard liver with many nodules suggests liver cancer.
Subclinical (test):
Quantification of blood bilirubin is the first test to determine the cause of jaundice. Indirect bilirubin is significantly increased, suggesting hemolysis, elevated liver enzymes suggest hepatitis. Other liver tests such as alkaline phosphate suggest biliary obstruction; Abdominal ultrasound is a simple and safe test to probe the abdominal organs to detect tumors in the liver or gallstones; CT Scanner is useful in detecting liver and pancreatic tumors and dilated bile ducts.

4. What to do when suspected jaundice?

The first thing when detecting any abnormal signs of the body is to go to a medical facility for examination and monitoring. However, because the Vietnamese are yellow, it is difficult to detect if the level of jaundice is mild. At medical facilities, patients will be more closely evaluated for jaundice and do tests to find out the cause.
Treatment of jaundice will be conducted when the cause is identified and there are specific treatment methods, which can be medical treatment or surgical treatment such as stone removal can solve the cause of jaundice. skin.
Jaundice, yellow eyes is an important symptom of many diseases, closely related to diseases of red blood cells, liver, bile or some harmful effects of drugs with many levels and conditions from mild to especially severe. important. Some diseases can be detected early through jaundice and can be completely cured.
Should go to the doctor early when only symptoms of jaundice, yellow sclera or only dark yellow urine.
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