Jaundica

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Definition
Jaundice is a yellow color in the skin, the mucous membranes, or the eyes. The yellow pigment is from bilirubin, a byproduct of old red blood cells.

Symptoms
Certain chemicals in bile may cause itching in jaundiced patients. Fatigue is a very common symptom in people with liver disease. In more severe illness, nausea may occur. Poor appetite and weight loss can be a problem for some patients, usually those with acute infection or advanced scarring of the liver (cirrhosis). Depending on the cause of jaundice, patients may or may not have pain over the liver (upper right quadrant). Liver pain is common if there are gallstones, and may also occur in acute hepatitis. Patients whose bile does not drain into the small intestine adequately will have clay-colored stools. The conjugated form of bilirubin may be excreted by the kidneys and result in dark urine. Long-standing jaundice may upset the balance of chemicals in the bile and cause stones to form in the gallbladder or in the ducts.
In newborns, the concern about jaundice is that insoluble or unconjugated bilirubin may get into the brain and do permanent damage to the central nervous system. This serious condition is called kernicterus. It becomes a concern as bilirubin levels approach 20 mg/dL. Newborns are more likely to have problems with jaundice if they are premature, Asian or Native American, or bruised significantly during the birth process. Jaundice is also more common if a newborn was born after an induced labor, has lost too much weight during the first few days of life, was born at high altitude, or was born to a diabetic mother.

Causes & Risks
Causes in children include:

Autoimmune hepatitis
Biliary atresia
Breastfeeding jaundice
Breast milk jaundice
Disorders present since birth that cause problems processing bilirubin (Gilbert syndrome, Dubin-Johnson syndrome, Rotor syndrome, or Crigler-Najjar syndrome)
Hemolytic anemia
Malaria
Newborn jaundice (physiologic jaundice)
Viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E)

Breastfeeding jaundice may occur in the first week of life in more than 1 in 10 breastfed infants. The cause is thought to be inadequate milk intake, leading to dehydration or low caloric intake. It is a type of physiologic or exaggerated physiologic jaundice.
Breast milk jaundice is far less common and occurs in about 1 in 200 babies. Here the jaundice isn’t usually visible until the baby is a week old. It often reaches its peak during the second or third week. Breast milk jaundice can be caused by substances in mom's milk that decrease the infant’s liver’s ability to deal with bilirubin. Breast milk jaundice rarely causes any problems, whether it is treated or not. It is usually not a reason to stop nursing.
Causes in adults include:

Alcoholic liver disease (alcoholic cirrhosis)
Autoimmune hepatitis
Biliary stricture
Blocked bile ducts (by infection, tumor or gallstones)
Cancer of the pancreas
Chronic active hepatitis
Disorders present since birth that cause problems processing bilirubin (Gilbert syndrome, Dubin-Johnson syndrome, Rotor syndrome, or Crigler-Najjar syndrome)
Drug-induced cholestasis
Drug-induced hepatitis
Hemolytic anemia
Ischemic hepatocellular jaundice (jaundice caused by not enough oxygen or blood to the liver)
Intrahepatic cholestasis of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy)
Malaria
Primary biliary cirrhosis
Viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E)

JaundicaOriginally from: http://www.nursinglink.monster.com/news/articles/13147-jaundica

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