What is Jaundice
In infants, jaundice is a yellow discoloration of the skin and eyes of a newborn baby.
Infant jaundice occurs because the baby’s blood contains excess bilirubin or the yellow pigment of red blood cells.
Jaundice in babies is a common condition. Especially in babies born before 38 weeks of pregnancy or premature babies.
This disease usually occurs because the baby’s liver is not mature enough to remove bilirubin in the bloodstream.
In some babies, an underlying disease can cause jaundice.
Most babies born between 35 weeks’ gestation and full term do not require treatment for this disease.
In rare cases, very high blood bilirubin levels can put a newborn at risk for a number of serious problems.
One of them is brain damage, especially in the presence of certain risk factors for severe symptoms.
While in adults, this condition indicates a disease.
Therefore, you need to see a doctor to determine the underlying cause.
Symptoms of Jaundice
In general, jaundice in babies can be detected from yellowing of the skin and eyes and yellowing of the lining of the mouth or nose.
However, adults may not have any symptoms of jaundice, and the condition may be detected incidentally.
The severity of symptoms depends on the underlying cause and how quickly or slowly the disease progresses.
If an adult has short-term jaundice (usually due to an infection), here are some symptoms that may appear:
- Fever.
- Chills.
- Stomach ache.
- Flu-like symptoms.
- Changes in skin color.
- Dark urine and/or clay-colored stools.
If the cause of jaundice is not due to infection, the sufferer may experience symptoms such as weight loss or itchy skin (pruritus).
However, when the cause of the disease is pancreatic or bile duct cancer, the most common symptom is abdominal pain.
Sometimes, sufferers may also experience jaundice which occurs with liver disease if they have:
- Chronic hepatitis or inflammation of the liver.
- Pyoderma gangrenosum (a type of skin disease).
- Acute hepatitis A, B or C.
- Polyarthralgias (joint inflammation).
Types of Jaundice
There are three main types of jaundice that you need to know, namely:
- Prehepatic. This condition occurs before the liver processes waste and produces high levels of unconjugated bilirubin.
- Hepatic. This condition occurs in the liver and produces high levels of conjugated and unconjugated bilirubin.
- Posthepatic. This condition occurs after the liver processes waste and produces high levels of conjugated bilirubin.
Causes of Jaundice
The causes of jaundice vary depending on the type, namely:
1. Prehepatic
There are a number of factors that can cause prehepatic jaundice, namely:
- Bilirubin problem. Increased bilirubin due to excessive breakdown of red blood cells in the blood vessels can trigger prehepatic jaundice in infants.
- Thalassemia. A blood disorder condition where red blood cells are not formed properly, so they are easily destroyed.
- Sickle cell disease. This condition can be detected by abnormalities in the shape of blood platelets. It should be shaped like a moon but instead has a shape that resembles a crescent moon. This has an impact on the performance of red blood cells which are not perfect.
- Malaria. This condition can be seen from the presence of acute fever due to infection by the Plasmodium parasite, which is transmitted to humans through the bite of an infected female Anopheles mosquito.
2. Hepatic
- Viral infections. Examples include hepatitis A, hepatitis B, hepatitis C, and Epstein-Barr virus infections.
- Excessive alcohol consumption. The occurrence of cirrhosis of the liver or changes in the structure of the liver to become hard and can no longer function normally.
- Cancer. It is a malignancy of the liver.
3. Posthepatic
- Gallstones. The presence of gallstones that block the bile duct causes the bilirubin that the body produces to become trapped in the gallbladder and unable to exit.
- Pancreatitis. This condition is an infection or inflammation of the pancreas.
- Other conditions. The presence of infection or inflammation of the gallbladder and gallbladder cancer can trigger this disease.
Meanwhile, if differentiated based on age group, here are the differences in the causes of this disease in infants and adults:
1. Causes of Jaundice in Babies
Babies who are at highest risk for this disease in newborns are:
- Premature babies (babies born before 37 weeks of gestation)
- Not getting enough breast milk or formula, either because of difficulty breastfeeding or because the mother’s milk has not come in yet.
- His blood type is not compatible with his mother’s blood type. This condition can develop a buildup of antibodies that can destroy red blood cells and cause a sudden increase in bilirubin levels.
- Other causes include bruising at birth or other internal bleeding, liver problems, and abnormalities in the baby’s red blood cells.
2. Causes of Jaundice in Adults
This disease is rare in adults, but a person can get it for a variety of reasons, including:
- Having hepatitis. Most of the time, this infection is caused by a virus and can be chronic (long-lasting) or acute (quick). Drugs or autoimmune disorders can cause hepatitis.
- Alcohol-related liver disease. Alcohol consumption can damage the liver and trigger diseases such as alcoholic hepatitis or alcoholic cirrhosis.
- Pancreatic cancer. This condition is a cancer that can block the bile duct, causing jaundice.
Risk Factors
There are several conditions that can increase the risk of jaundice. Here are some of them:
- Hepatitis. Over time, sufferers will experience liver damage that leads to jaundice.
- Blood type. If the mother’s blood type is different from that of the baby, the baby may have received antibodies through the placenta that cause rapid destruction of red blood cells.
- Alcohol-related liver disease. Long-term and excessive alcohol consumption can damage the liver. Without proper treatment, alcohol-related liver disease can increase the risk of jaundice.
- Premature birth. Babies born before 38 weeks of gestation may not be able to process bilirubin as quickly as full-term babies. Premature babies may also nurse less and have fewer bowel movements, resulting in less bilirubin being excreted in the stool.
- Blocked bile duct. This condition is usually caused by gallstones, cancer, or rare liver diseases.
- Pancreatic cancer. Abnormal tissue can block the bile duct and cause jaundice.
- Certain medications. Acetaminophen, penicillin, birth control pills, and steroids have been linked to an increased risk of liver disease leading to jaundice.
Medical Treatment for Jaundice
Medical treatment for jaundice will be based on anamnesis and physical examination.
The doctor will then carry out other supporting examinations to determine the exact level of bilirubin in the blood.
However, the medical actions that doctors take for jaundice will differ depending on the age of the sufferer.
1. Medical Action on Babies
Newborns should be examined at least every 8 to 12 hours in the first 48 hours of life before they are 5 days old.
Here are some procedures that doctors can perform:
- Transcutaneous bilirubin (TcB) measurement. This procedure involves attaching a device to the baby’s head to check transcutaneous bilirubin (TcB) levels.
- Blood test levels. This procedure involves taking a blood sample from the baby’s heel to measure bilirubin levels.
2. Medical Actions in Adults
Yellowing of some parts of the body of adults is easy to recognize.
However, the doctor will need further medical action to find out the underlying cause.
Here are some of the procedures performed:
- Blood tests. A variety of blood tests may be used, including a complete blood count, blood cultures, liver enzyme tests, and hepatitis tests.
- Imaging tests. Abdominal ultrasound is commonly used to detect blockages in the bile ducts.
- Liver biopsy. The procedure is necessary if viral hepatitis, drug use, or toxin exposure is suspected in the sufferer.
- Endoscopic Retrograde Cholangiopancreatography (ERCP). This procedure is done by viewing the bile ducts through an endoscope.
- Laparoscopy. The procedure involves making a small incision below the navel and inserting a tube equipped with a camera (laparoscope) to examine the liver and gallbladder.
How to Treat Jaundice
How to treat jaundice will be divided based on age, here is the explanation:
1. How to Treat Jaundice in Babies
Here are some treatment options if your baby has moderate or severe jaundice:
- Providing additional food or supplements.
- Phototherapy procedure to help break down bilirubin in the skin so it can be excreted.
- A blood protein transfusion procedure is performed if the baby’s jaundice is related to blood type incompatibility with the mother.
- Exchange transfusion procedure if in severe cases the sufferer does not respond to previous treatment.
2. How to Treat Jaundice in Adults
Treatment of jaundice in adults will be based on the underlying cause.
For example, if jaundice occurs due to liver disease such as hepatitis, then the treatment will be based on the hepatitis.
On the other hand, if the cause is a blocked bile duct, the doctor can perform a surgical procedure to open the bile duct.
Complications of Jaundice
High levels of bilirubin that cause severe jaundice can lead to serious complications.
Based on age group, the following is an explanation of the complications that can arise due to jaundice:
1. Complications of Jaundice in Babies
Bilirubin is toxic to brain cells. If a baby has severe jaundice, there is a risk that bilirubin will enter the brain, triggering acute bilirubin encephalopathy.
Prompt treatment can prevent significant permanent damage.
Signs of acute bilirubin encephalopathy in infants with jaundice include:
- Lethargy.
- Difficulty waking up.
- High-pitched cry.
- Sucking or suckling poorly.
- Arch the neck and body backward.
- Fever.
In addition, jaundice in babies can also cause kernicterus.
Kernicterus is a syndrome that occurs when acute bilirubin encephalopathy causes permanent damage to the brain.
Kernicterus can result in:
- Involuntary and uncontrolled movements (athetoid cerebral palsy).
- Permanent upward gaze.
- Hearing disorders.
- Improper development of tooth enamel.
2. Complications of Jaundice in Adults
In adults, jaundice can cause complications of varying severity, depending on the cause.
Here are some complications that can occur:
- Electrolyte disturbances.
- Chronic hepatitis.
- Encephalopathy.
- Hemolytic anemia.
- Bleeding.
- Infections, such as sepsis.
- Liver failure.
- Kidney failure.
- Cancer.
Prevention of Jaundice
How to minimize the risk of getting jaundice?
There are a number of ways you can do as a preventive measure, namely:
1. Prevention in Infants
Many people ask whether there is a vaccine that can be given to babies to prevent jaundice or not.
In fact, there is no real way to prevent jaundice in newborns.
However, mothers can do blood type tests during pregnancy.
Additionally, the best way to prevent illness in babies is to ensure they get enough nutrients in the first few days of life.
Mothers should breastfeed 8-12 times a day. Regular breastfeeding can help lower bilirubin levels.
2. Prevention in Adults
Take the following steps to prevent jaundice in adults:
- Avoid hepatitis infection.
- Consume alcohol in moderation.
- Avoid being overweight or obese.
- Maintain normal cholesterol levels.
