Jaundice is a yellow coloring of the skin and the whites of the eyes. It is not a disease in itself, but a symptom which may occur in several diseases. It appears when an excessive amount of the yellow-green pigment bilirubin is present in the blood. Inevitably some of the pigment escapes from the blood into the skin, where it causes the characteristic yellow appearance. In some cases of jaundice it is possible to observe yellow coloration of the eyes in the early stages of the illness, before the color appears in the skin.

 

Jaundice is classified into three types:

 

Obstructive jaundice occurs when bile, made in the liver, fails to reach the intestine due to due obstruction of the bile ducts (e.g., by gallstones) or to cholestasis. The urine is dark, the feces pale, and the patient may itch.

Hepatocellular jaundice is due to disease of the liver cells, such as hepatitis, when the liver is unable to utilize the bilirubin, which accumulates in the blood. The urine may be dark but the feces retain their color.

Hemolytic jaundice occurs when there is excessive destruction of red cells in the blood (see hemolysis). Urine and feces retain their normal color.

 

Breast-milk jaundice is a prolonged jaundice lasting several weeks after birth in breast-fed babies for which no other cause can be found. It improves with time and is not an indication to stop breast-feeding.