Jaundice is a result of gallbladder disease, and is usually associated with gallbladder infection.
An infected gallbladder leads to difficulty in processing bilirubin, a by-product excreted from the body when blood is transported through the liver.
Common symptoms of jaundice include yellowing of the whites of the eyes and skin, along with dark urine or light stools.
A liver function test is recommended to detect signs of jaundice or liver malfunction.
As jaundice is a result of a blocked bile duct, surgery to remove gallstones from the gallbladder may be required to treat jaundice entirely.
What Is Jaundice?
Bilirubin is a yellow-coloured substance which is responsible for the yellow colouration in your skin and the white outer layers of your eyeballs. Bilirubin is produced as a waste by-product when red blood cells break down naturally during each 120-day cycle. Bilirubin is excreted from your body by the body’s waste disposal system when it is transported from your blood into your liver. This bilirubin combines with bile from your gallbladder, and the mixture exits the body through your urine and faeces. Usually, if this process has been completed, your urine will be light yellow and faeces brown. Infections or damage may interfere with this process, resulting in jaundice.
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What Causes Jaundice?
There are three main types: Hepatocellular, Haemolytic and Obstructive (which is our primary concern).
Hepatocellular jaundice develops when your liver is injured or diseased.
Haemolytic jaundice develops when haemolysis, an accelerated breakdown of red blood cells, occurs. This leads to increased bilirubin production in your body.
Obstructive jaundice develops when a gallstone passes from your gallbladder via the cystic duct into the bile duct. This stone blocks the bile duct and the passage of bile into the intestine. The bile will then be absorbed into your bloodstream instead. Without the necessary bile secreted into your liver to combine with bilirubin, bilirubin is unable to be excreted by the body and thus remains in the body.
Excess bilirubin in the body causes patients to have a yellow discolouration of the whites of their eyes and skin which is associated with severe itchiness. In most cases, it requires an emergency procedure by your surgeon to surgically remove the gallstones from your bile duct. In some cases, the gallstone eventually passes into their intestine.
How Do I Know If I Have Jaundice?
Common signs and symptoms include:
Yellowing of the whites of your eyes and skin
Itchiness
Fatigue
Dark urine and light stools
Fever
Vomiting
Abdominal pain, which may indicate blockage of bile duct
Unexplained weight loss
Do seek medical attention immediately should you present the symptoms mentioned above.
How Is It Diagnosed?
Your doctor will perform a physical examination to diagnose you with jaundice. Besides the yellowing of your skin and whites of the eyes, your doctor will look for other symptoms such as lumps in your abdomen and the firmness of your liver. You may also be asked about things that may heighten your risk of jaundice, such as having travelled to another country recently or having a history of drug or alcohol misuse.
You may also have to undergo liver function test, a type of blood test that helps your doctor determine if the cause of jaundice is a liver malfunction or a blocked bile duct. Other blood tests include bilirubin test, full blood count (FBC) or complete blood count (CBC) test and hepatitis A, B and C test to test for liver functioning. Urine tests to check the amount of urobilinogen in your urine can indicate the type of jaundice you have.
Imaging tests can be used to check for abnormalities in your liver or bile duct. These include ultrasound scan, CT scan, MRI scan and ERCP, which combines endoscopy and X-ray imaging. These give your doctor clearer pictures of your internal organs for him or her to make a more accurate diagnosis.
A liver biopsy, which is the removal of a small tissue sample, may sometimes be needed to confirm or rule out conditions associated with liver diseases. These include inflammation, cirrhosis, cancer, and fatty liver.
Why Surgery For Jaundice Is Associated With Gallstones
The treatment of jaundice typically involves addressing the underlying cause that has been diagnosed instead of jaundice itself.
In most cases of obstructive jaundice, surgery to unblock the blocked bile duct system is recommended. It may be necessary to a section of the bile duct system or a section of the pancreas to prevent further blockages from occurring. These measures may be taken to prevent further problems which may lead to removal of your gallbladder.
Frequently Asked Questions
How Can Jaundice Be Cured?
Jaundice usually occurs because of a problem in the liver, gallbladder or pancreas. The issue must first be identified and treated in order to recover from jaundice. If jaundice is caused by a blockage in the bile duct, a surgery to remove the gallstone blockage must be done to recover from jaundice.
Will Jaundice Go Away On Its Own?
Jaundice in adults is quite rare and is caused because of a separate issue in the liver, gallbladder or pancreas. Therefore, it usually does not go away on its own until the condition is treated.
When Should I Be Worried About Jaundice?
If jaundice is accompanied by symptoms of fever, severe abdominal pain, confusion and blood in stool, you should seek immediate medical care.
Dr. Ganesh Ramalingam
Specialist in General Surgery
As a strong proponent of treating the patient holistically instead of just their condition, Dr Ganesh Ramalingam advises patients as to how they can manage their daily habits and diets to lead healthier lifestyles. As a consultant with G&L Surgical Clinic specialising in General Surgery, he sees many patients with conditions related to the stomach and is skilled in bariatric surgery, upper GI and hernia surgery, advanced laparoscopic surgery, endoscopies, and trauma.