WHY IS MY SKIN YELLOW?

Mr. K was one to hardly fall sick. His health was remarkable and even as he reached his 50’s, his blood pressure and sugar levels were considered optimal. There was no cause for alarm until Mr. K’s skin turned yellow. His family was really concerned on how such a healthy man’s skin would turn yellow overnight. A visit to the hospital told them the reason.

 

What do you think happened to Mr. K?

 

After proper diagnosis by the doctor with the aid of lab tests and appropriate scans, it was discovered that Mr. K had bile duct obstruction which prevented his liver from removing excess bilirubin, this in turn caused his liver to malfunction which led to Jaundice.

 

Jaundice is a condition where the skin, mucous membranes and white part of the eyes turn yellow due to high levels of bilirubin in the blood.

 

Bilirubin is formed from break down of red blood cells. It is passed into the bile ducts from liver cells where it is processed and passed on to the small intestine for excretion.

 

Jaundice is not a disease but arises due to malfunction of processes that interfere with the removal of bilirubin from the blood. Once the underlying condition is treated, it goes away. Jaundice is also known as icterus.

 

SIGNS AND SYMPTOMS THAT ACCOMPANY JAUNDICE

Jaundice is a symptom of an underlying disease process. Due to the underlying cause of jaundice, individuals may however exhibit different symptoms together with jaundice or no symptoms at all.

Individuals can experience varying degrees of yellow discoloration to the skin, mucous membranes and eyes depending on the severity of the underlying cause.

Other signs and symptoms that may arise with jaundice include: Skin itching; nausea and vomiting; fever, chills and weakness; weight loss due to loss of appetite; abdominal pain and swelling; colored urine; bloody diarrhea; swelling of the legs amongst others.

 

RISK FACTORS

Factors that give rise to diseases and conditions that cause jaundice are:

  • People with hereditary blood disorders like thalassemia are at high risk of developing jaundice from hemolysis.
  • Liver diseases or cancer affect the function of the liver leading to jaundice.
  • Healthcare professionals and individuals who are unvaccinated against viral hepatitis are at risk of having jaundice if they are exposed to infected persons.
  • Heavy alcohol consumption and smoking predisposes one to developing hepatitis, liver cirrhosis and pancreatitis which can lead to jaundice

 

CAUSES OF JAUNDICE

The different conditions that cause jaundice affect the normal functioning and process (i.e., metabolism and excretion) of organs that work on bilirubin. This can occur at different stages and this can be used to classify the causes of jaundice.

 

Pre-hepatic Jaundice

This occurs before metabolism in the liver. Excess bilirubin can build up if the breakdown (hemolysis) of red blood cells is higher than the liver’s capacity to effectively metabolize it. Disease conditions that can lead to increased breakdown of red blood cells are complicated malaria, sickle cell disease, thalassemia, and autoimmune disorders.

 

Hepatic Jaundice

This occurs from dysfunction or diseases affect the liver directly, reducing its ability to process bilirubin, leading to its build-up. Disease conditions that can cause this include: Hepatitis (acute or chronic which could be viral or alcohol induced); liver cirrhosis, liver cancer, drugs or other toxins.

 

Post-hepatic Jaundice

This occurs when there is an obstruction in the normal excretion and removal of conjugated bilirubin in the form of bile from the liver leading to increased levels of bilirubin in the blood. Conditions that are responsible for this are: bile duct obstruction; gallstones; pancreatitis; cancer of the bile ducts, pancreas, and gall; parasitic infections like liver fluke.

 

DIAGNOSIS

The doctor will require you to carry out a physical examination and get detailed history about your lifestyle and social life which include your alcohol intake, smoking habit and eating habits to determine the underlying cause.

You will also be required to carry out blood tests which would include a full blood count, liver function test, hepatitis screening and so on.

Further testing can be required like urinalysis, imaging studies (like CT scan, abdominal ultrasound, Magnetic resonance imaging amongst others) to check for any abnormalities in the liver, pancreas, and gall bladder

 

TREATMENT OPTIONS IN JAUNDICE IN ADULTS

Once the underlying disease or condition is tackled, jaundice goes away. Therefore, treatment options will include:

  • Lifestyle modification is advised for people whose lifestyle predisposes them to diseases that cause jaundice. For example:
  • Alcohol cessation for individuals who have alcoholic hepatitis, cirrhosis, or acute pancreatitis due to its use
  • Discontinuation of drugs, toxins, medications, and substances that affect the liver function.
  • Blood transfusion is necessary for people whose disease condition cause anemia.
  • Surgery and different invasive procedures can be used for certain conditions like gallstones, bile ducts obstruction and liver failure.

 

PREVENTION

  • Some conditions responsible for jaundice can be prevented while some cannot be prevented.
  • Get vaccinated against viral hepatitis like hepatitis B
  • Take medications according to your physicians’ prescription.
  • Visit the hospital for any ailment, avoid taking drugs based on people’s opinions and recommendations. Taking drugs and medications without proper authorization from a health professional can put you at risk of developing liver problems.
  • Drink alcohol in moderation; and avoid smoking either actively or passively.

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