What are the different types of jaundice?
Jaundice happens when too much bilirubin builds up in your blood. This makes your skin and the whites of your eyes look strikingly yellowish.
Bilirubin is a yellowish pigment created as hemoglobin — a component of red blood cells — is broken down.
Normally, bilirubin is delivered from the bloodstream into your liver. Then, it passes through tubes called bile ducts. These ducts carry a substance called bile into your small intestine. Eventually, bilirubin is passed out of your body through urine or stool.
Types of jaundice are categorized by where they happen within the liver’s process of taking in and filtering out bilirubin:
pre-hepatic: before the liver
hepatic: in the liver
post-hepatic: after the liver
All about pre-hepatic jaundice
Pre-hepatic jaundice is caused by conditions that heighten your blood’s rate of hemolysis. This is the process through which red blood cells are broken down, releasing hemoglobin and converting into bilirubin.
Because the liver can only process so much bilirubin at once, bilirubin overflows into bodily tissues.
The most common causesTrusted Source of pre-hepatic jaundice are:
malaria, a blood infection caused by a parasite
sickle cell anemia, a genetic condition in which red blood cells become crescent-shaped rather than the typical disc shape
spherocytosis, a genetic condition of the red blood cell membrane that causes them to be sphere-shaped rather than disc-shaped
thalassemia, a genetic condition that causes your body to make an irregular type of hemoglobin that limits the number of healthy red blood cells in your bloodstream
Common symptoms of pre-hepatic jaundice include:
abdominal pain
fever, including chills or cold sweats
abnormal weight loss
feeling itchy
dark urine or pale stool
Some risk factors for this type of jaundice include:
drug use
having a family member with a blood disorder
traveling to malaria-endemic regions
To diagnose pre-hepatic jaundice, your doctor will likely order the following tests:
a urinalysis to measure the amount of certain substances in your urine
blood tests, such as a complete blood count (CBC) or liver function tests to measure bilirubin and other substances in the blood
imaging tests, such as an MRI or ultrasound, to examine your liver, gallbladder, and bile ducts to rule out other forms of jaundice
a HIDA scan to help find blockages or other issues in the liver, gallbladder, bile ducts, and small intestine
Your doctor will likely diagnose you with pre-hepatic jaundice if there aren’t any issues with bilirubin being processed by your liver or within the gallbladder and biliary ducts.
Treatment for pre-hepatic jaundice may include:
For malaria:
medications to help destroy the parasite and prevent parasites from reinfecting your liver again
For sickle cell anemia:
blood transfusions from a healthy donor
rehydrating with intravenous (IV) fluid
medications for any infections that can cause a sickle cell crisis
For spherocytosis:
folic acid supplements
blood transfusions for anemia
spleen removal surgery to help increase red blood cell life and lower the chance of gallstones
For thalassemia:
blood transfusions
bone marrow transplants
spleen or gallbladder removal surgery
All about hepatic jaundice
Hepatic jaundice happens when your liver tissue is scarred (known as cirrhosis), damaged, or dysfunctional. This makes it less effective at filtering out bilirubin from your blood.
Since it can’t be filtered into your digestive system for removal, bilirubin builds up to high levels in your blood.
The most common causesTrusted Source of hepatic jaundice are:
liver cirrhosis, which means that liver tissues are scarred by long-term exposure to infections or toxic substances, such as high levels of alcohol
viral hepatitis, an inflammation of the liver caused by one of several viruses that can get into your body through infected food, water, blood, stool, or sexual contact
primary biliary cirrhosis, which happens when bile ducts are damaged and can’t process bile, causing it to build up in your liver and damage liver tissue
alcoholic hepatitis, in which your liver tissues are scarred by the heavy, long-term drinking of alcohol
leptospirosis, is a bacterial infection that can be spread by infected animals or infected animal urine or feces
liver cancer, in which cancerous cells develop and multiply within liver tissues
Common symptoms of hepatic jaundice include:
loss of appetite
bloody nose
skin itching
weakness
abnormal weight loss
swelling of your abdomen or legs
dark urine or pale stool
pain in your muscles or joints
darkening skin
fever
feeling sick
throwing up
Some risk factors for this type of jaundice include:
drug use
drinking a lot of alcohol over a long period of time
use of medications that can cause liver damage, such as acetaminophen or certain heart medications
previous infections that affected your liver
To diagnose hepatic jaundice, your doctor will likely order the following tests:
a urinalysis to measure levels of substances in your urine related to your liver function
blood tests, such as a complete blood count (CBC) and antibody tests, or liver function tests to measure bilirubin in the blood and levels of substances that indicate that your liver may not be processing bilirubin properly
imaging tests, such as an MRI or ultrasound, to examine your liver for damage or for the presence of cancerous cells
an endoscopy, which involves inserting a thin, lighted tube into a small incision to look at your liver and take a tissue sample (biopsy) if necessary for analysis for cancer or other conditions
Your doctor will likely diagnose you with hepatic jaundice if they notice liver tissue damage on an imaging test result or see abnormal levels of certain liver substances, such as albumin, or antibodies for infections or cancer.
Treatment for hepatic jaundice can include:
For liver cirrhosis:
quitting drinking
beta-blockers
intravenous (IV) antibiotics
a low-protein diet
For viral hepatitis:
antiviral medications
hepatitis vaccination
plenty of rest and fluids
For primary biliary cirrhosis:
bile acids to help with digestion
bile-lowering medication
antihistamines like diphenhydramine (Benadryl) for itching
For alcoholic hepatitis:
quitting alcohol
nutrition supplements
liver transplant, in severe cases
For leptospirosis:
antibiotics for infection
ventilator for breathing trouble
dialysis for kidney damage
For liver cancer:
chemotherapy or radiation to kill cancer cells
partial liver resection
liver transplant
All about post-hepatic jaundice:
Post-hepatic, or obstructive jaundice, happens when bilirubin can’t be drained properly into the bile ducts or digestive tract because of a blockage.
The most common causesTrusted Source of post-hepatic jaundice are:
gallstones, hard calcium deposits in the gallbladder that can block bile ducts
pancreatic cancer, the development and spread of cancer cells in the pancreas, an organ that helps produce digestive substances
bile duct cancer, the development and spread of cancer cells in your bile ducts
pancreatitis, an inflammation or infection of your pancreas
biliary atresiaTrusted Source, a genetic condition in which you have narrow or missing bile ducts
Common symptoms of post-hepatic jaundice include:
feeling sick
throwing up
dark urine or pale stool
abdominal pain
diarrhea
abnormal weight loss
skin itching
abdominal swelling
fever
Some risk factors for this type of jaundice include:
being overweight
eating a high-fat, low-fiber diet
having diabetes mellitus
having a family history of gallstones
being female
aging
smoking tobacco products
drinking a lot of alcohol
having a previous pancreas inflammation or infection
being exposed to industrial chemicals
To diagnose post-hepatic jaundice, your doctor will likely order the following tests:
a urinalysis to measure levels of substances in your urine
blood tests, such as a complete blood count (CBC) and antibody tests for cancer, or liver function tests to rule out hepatic jaundice
imaging tests, such as an MRI or ultrasound, to examine your liver, gallbladder, and bile ducts for obstructions like gallstones or tumors
an endoscopy, which involves inserting a thin, lighted tube down the esophagus to look at your liver, gallbladder, or bile ducts and take a tissue sample if necessary for analysis for cancer or other conditions
If your doctor sees an obstruction on an imaging test result or finds levels of certain antibodies that may indicate infections or cancer, they’ll likely diagnose your jaundice as post-hepatic.
Treatment for post-hepatic jaundice will address the cause. This includes:
For gallstones:
changing your diet to stop producing gallstones
removing gallstones or your gallbladder entirely
taking medications or treatments to dissolve gallstones
For pancreatic cancer:
surgery to remove cancerous tissue or your whole pancreas
radiation or chemotherapy to destroy cancer cells
For bile duct cancer:
surgery to remove bile ducts and parts of your liver and pancreas
radiation or chemotherapy to destroy cancer cells
liver transplant
For pancreatitis:
rest
intravenous (IV) fluids or pain medication
surgery to remove any causes of inflammation (like gallstones)
For biliary atresia:
the Kasai procedure to remove and replace ducts
liver transplant
All about neonatal jaundice
Neonatal jaundice is a common type of jaundice that happens to newborn babies.
Most babies are born with a lot of red blood cells, and because the liver isn’t fully developed yet, bilirubin can’t be processed quickly. As a result, your child may have jaundice symptoms a few days after they’re born.
Types of neonatal jaundice include:
Physiological. This happens because the liver isn’t fully formed yet.
Prematurity. This results from a baby being born too early and being unable to poop out bilirubin properly.
Breastfeeding. Breast milk jaundice occurs from a baby having trouble breastfeeding or not getting enough breast milk.
Incompatible blood type. This results from a baby and mother having different blood types, which can cause the mother to make antibodies that break down her baby’s red blood cells.
Neonatal jaundice isn’t usually a cause for concern. But if bilirubin builds up to extremely high levels, your child can experience brain damage (known as kernicterus) from bilirubin getting into brain tissue.
Seek emergency medical attention if you notice that your child has any of the following symptoms:
long periods of high-pitched crying
arching of their neck and back
fever
throwing up
having trouble feeding
The outlook
Jaundice clearly means that there’s too much bilirubin in your blood, but the underlying cause can vary widely.
See your doctor right away if you notice yellowing of your skin or the whites of your eyes. Some causes can be treated with a change in your diet or lifestyle, but others may need immediate surgical or long-term treatment.
(Healthline)
