Jaundice

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.