Jaundice

• Over 50% of babies have jaundice during their first week
• 8 out of 10 premature babies will have jaundice
• 3-7% of the population have Gilbert's syndrome which causes jaundice

Jaundice (medical name 'icterus') is caused by a build up in the blood of a yellow coloured substance called 'bilirubin'. This occurs when red blood cells are broken down. Usually the liver  takes the bilirubin and filters it through the kidneys for it to then be excreted in urine. If problems arise in the liver or biliary system then excess bilirubin is produced.

Common causes of jaundice include:

Hepatitis – The five hepatitis viruses (A,B,C,D,E) cause the liver to become inflamed. Acute hepatitis can be caused by excessive alcohol consumption or taking certain medicines.

Bile duct obstruction – Small tubes in the liver remove bile and if these become blocked or damaged the result can be a build up of bilirubin.

Anaemia – Haemolytic anaemia occurs when blood cells are destroyed by diseases such as malaria or autoimmune disease. This results in an increased production of bilirubin.

Gilbert's syndrome – This is an inherited condition which prevents enzymes in the body from functioning and preventing the processing bile.

Newborn jaundice – Known as neonatal jaundice, this problem affects over half of all babies in the first week of life and occurs because of the liver not being fully developed to deal with bilirubin. The condition usually clears without treatment after a week.

Other conditions that cause jaundice, although rare, include: Crigler-Najjar syndrome, Dubin-Johnson syndrome, Rotor's syndrome, Pseudojaundice.

The common symptom of jaundice is a yellowing of the skin and whites of the eyes. Jaundice usually begins on the face and then spreads to other areas of the body.

Other symptoms which may accompany the yellow tinge include: fatigue, abdominal pain, nausea, vomiting, fever and weight loss.

Jaundice can also cause itchy skin and affect the colour of urine (darker) and stools (paler).

A diagnosis of jaundice will be easily made from the yellow tinge on the skin and eyes but the underlying cause of the condition will require tests.

The common test is for liver function to determine if the liver is functioning properly and a blood test to check for levels of bilirubin. You are likely to also be tested for hepatitis A, B and C and may require a conjugated bilirubin and unconjugated bilirubin test.

Obstructions in the liver will require an abdominal ultrasound, CT scan or MRI scan. You may also be referred for a scan of the bile ducts (known as a cholangiography) and if necessary, you may require a liver biopsy.