What are the symptoms of jaundice?

Bilirubin, a yellow-colored substance which is responsible for the yellow pigmentation of the skin and this causes jaundice when it exceeds its normal range.

Bilirubin is considered to be a waste product which remains in the blood after the iron content is removed from hemoglobin. In the case of excess of bilirubin, it leaks out and affects the surrounding tissues, infecting them with this yellow substance. Bilirubin while circulating in the blood leads to unconjugated bilirubin and causes jaundice.

Jaundice is the discoloration of the skin, mucous membranes and also the white part of the eyes which turn yellow and is caused due to an increase of bilirubin in the blood. Jaundice is seen when the level of bilirubin exceeds 2.5-3 mg/dL in the blood.

The various symptoms of jaundice are as follows:

• Yellowness of skin and the whites of the eyes, usually starts from the head, spreading down the body
• itching
• fatigue
• Abdominal pain which indicates the blockage in the bile duct
• Loss of weight
• Frequent vomiting
• Unusual fever
• Pale stools
• Dark urine, usually dark yellow or orange in color

The disease might result in additional signs including:

• nausea
• loss of appetite
• headache
• confusion
• swelling and pain in legs and abdomen

Signs and symptoms that could be seen in the newborn are as follows:

• poor feeding,
• lethargy,
• changes of muscle tone,
• high-pitched crying
• seizures

Jaundice is caused by bilirubin which is a yellow colored substance responsible for the yellow color of the skin and sclerae.

Bilirubin:

Bilirubin is a waste product which remains in the bloodstream after iron is removed from hemoglobin in red blood cells. When the bilirubin increases in the body, it can leak out into adjacent tissues, saturating them with this yellow substance. Bilirubin that is circulating freely in the blood is called unconjugated bilirubin. It also affects the liver. The working of the liver is to remove the waste including bilirubin from the blood.

Symptoms of Jaundice:

The symptoms of jaundice can be seen with naked eyes. Symptoms of jaundice are as given below

• Yellow tinge to the skin and whites of eyes.
• Itchiness
• Fatigue
• Abdominal pain
• Weight loss
• Vomiting
• Fever
• Dark urine
• Pale stool

Causes for increase in Bilirubin:

As per the above mentioned symptoms, people can see jaundice in a person whose skin and white of eyes becomes yellow due to increased amount of Bilirubin in the blood. The majority of the bilirubin comes from breakdown of heme from the expired red blood cells. It travels to the liver through the blood stream because it is not soluble. Normally the liver metabolizes and excretes the bilirubin in the form of bile. However, if there is a disruption in this normal metabolism and/or production of bilirubin, jaundice may result.

Jaundice in Newborn Babies:

Jaundice in newborn babies is the yellowing of baby’s skin and eyes. Jaundice in a newborn is very common and can occur when babies have a high level of bilirubin. In most cases it disappears within two to three weeks.

Jaundice also called Icterus, it is pigmentation of the skin (yellowish/ greenish), whitening of the eyes. It is caused due to Hyperbilirubinemia- elevated levels of the chemical bilirubin in the body.

Jaundice is derived from Jaune means color yellow.

When bilirubin contents exceed 2.5 - 3 mg/dL (milligram/deciliter) in the body, it is regarded as Jaundice. Majorly Jaundice is a disease which occurs in newborns called as (Neonatal Jaundice). Though in adults it is caused due to several medical conditions and is mostly life threatening.

Jaundice in Adults:

It is caused due to various medical conditions and abnormal metabolism of the body due to excess of Bilirubin excretion in the body. Bilirubin is mostly formed due to daily ruptures of Red Blood Cells (RBCs). Breakdown of RBCs releases hemoglobin, heme present in hemoglobin is further converted to Bilirubin. Bilirubin is carried to Liver and intestine which helps in metabolism and excretion process of the body. Dysfunction of the normal body metabolism or excretion of bilirubin in excess causes Jaundice.

Jaundice occurs at different stages in bodies:

• Pre- hepatic - Excess of Bilirubin in blood vessels, before excretion to the liver.
• Hepatic - Abnormalities in Bilirubin in the liver.
• Post- hepatic - Dysfunction of intestine and excretion process due to bilirubin excess outside the liver.

Jaundice is not a disease rather it's a visible sign of an underlying disease process.

Symptoms and Signs of Jaundice:

• Pale stools
• Dark colored urine
• Skin itching
• Recursive feeling of nausea and vomiting
• Heavy rectal bleeding
• Feeling feverish and chills
• Sudden weight loss
• Weakness
• Less appetite or loss of appetite
• Pain in abdomen or legs and headache
• swelling of abdomen and legs

In adults Jaundice with Pale Yellow, skin color is not chronic in nature. It is a symptom of Unconjugated Hyperbilirubinemia.

Orangish yellow skin color is significant for hepatic and Moderate Cholestatic Jaundice.

Yellow-green skin color is complete chronic Jaundice.

Neonatal Jaundice (Jaundice in Newborns): Newborns generally suffer from physiological jaundice when they are 2 to 3 days old. This generally gets cured within  weeks. Jaundice in the newborn are very common and not at all risky.

In babies, it occurs because their liver takes a little time to adjust and perform excretion of excess bilirubin. In mother's womb, this is carried by the placenta. Generally, in babies, this occurs due to 

• Increase in RBCs and abnormal RBCs shapes.
• Rh incompatibility between mothers and baby.
• Sometimes difficult delivery also leads to Jaundice.
• Higher counts of RBCs (common in gestational babies and in twins)
• Lack of Enzymes (proteins)
• Medication also lead to infections at times like rubella, syphilis which leads to the risk of jaundice.
• Genetic disorders.
• Premature birth.
• Hypoxia: low oxygen level.

In the newborn, the biggest symptom of Jaundice can be incompatible Rh factor between mother and the baby.This should be the "take precaution triggers" for the mother and the doctors. Other symptoms are:

•  Yellowish nails and paling of skin.  
• Sclerae of eyes (white of eyes).
• Drowsiness and excessive sleeping in newborns.
• Pale stools
• Poor feeding/ sucking.
• Dark urine- newborn urine is transparent (colorless).
• Paling of the tongue.

How can you know if your baby is suffering from Jaundice?- Gently press on the forehead of baby and just visualize the skin color. If it is pale, your baby must have Jaundice. Have a check on nails and tongue color. They tend to be pale.