Tuesday 16 April 2013

Symptoms Of Jaundice That We Ignore


Jaundice is not a disease. It is a clinical presentation of the increased amount of bilirubin in blood. The underlying reason for the increase in bilirubin is the disease.  Bilirubin is a breakdown product of red cell destruction, which is normally present in the body at a normal range of 0.2-1.0mg/dl.  General metabolism of bilirubin occurs in the liver. Any disruption in the process of movement of bilirubin from the blood to the liver and then out of the body will result in jaundice.

 Jaundice is categorized into three types. Pre-hepatic jaundice,  which occurs due to increased destruction of red cells. Hepatic jaundice,  which occurs due to liver cell damage and Post-hepatic jaundice,  which occurs due to obstruction in the flow of bile. Most commonly we will suspect jaundice when we notice a yellowish tinge in our eyes or nail beds along with dark yellow urine.  But do you know that these symptoms occur when the amount of bilirubin is already greater than the renal threshold?  

Jaundice has more diverse clinical presentations which we may avoid or leave unnoticed.  Knowing these symptoms will help you to know that whether you have jaundice in its early stage itself. This is most helpful if jaundice occurs as an epidemic in your place. Where increased bilirubin gives the ‘yellow colour symptoms’, other symptoms depend mainly on the underlying cause of jaundice. Here are some common warning-signs of increased bilirubin in adults that we generally fail to identify as the symptoms of jaundice.




Yellow urine: Even though this is a common presentation of jaundice, we may ignore it in certain cases because dark yellow urine can be seen in dehydration as well. Decreased water intake will concentrate urine. But suspect jaundice if it is yellow with a brown tinge.

Yellow skin and eye: Slight yellow colour may not be noticeable in persons with dark coloured skin. Sometimes chances are there to consider it as skin getting pale due to anaemia.

 Abdominal pain: Pain in the right side of the stomach just below the rib case and possibly extending to the upper back may be an indication of jaundice due to liver cell damage or gall stones. The liver will become palpable if it is enlarged.

Joint pain: Joint pain can occur due to many reasons. So, we may not associate it with jaundice. If you have joint pain along with other symptoms that are related to jaundice, then consult your physician.

Loss of appetite: Loss of appetite is also an associated symptom of jaundice, which is usually left unnoticed. If this persists along with vomiting and yellow urine, you should suspect jaundice.

Vomiting: Vomiting can occur due to various reasons. But, if you have nausea or vomiting when there is an epidemic of hepatitis, chances are more for you to have an increase in bilirubin.

Itching: Itching occurs with the obstructive kind of jaundice where the bile duct is blocked, which fails in providing bile for the metabolism of bilirubin. This results in itching all over the body.

Temperature: Increased temperature is found associated with jaundice which we may ignore considering as a general symptom. Fever with chills are related to jaundice.

Clay coloured stool: In case of obstructive jaundice, stool can become lighter in colour or most commonly clay-coloured. This occurs due to the obstruction of bilirubin that normally gives stool its brown color when get converted to its final product, stercobilinogen.

Weakness: The early phase of hepatitis A presents with nonspecific weakness. If you feel weak for two weeks with other symptoms of increased bilirubin, do not avoid it.


Regards
Asha Das


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