Jaundice history & symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Common symptoms associated with jaundice are yellowing of the skin, nausea, and vomiting. Specific symptoms will depend on the underlying cause of jaundice. Patients may present with fever, anorexia, dark urine, fatigue, pruritis, right upper quadrant pain. A detailed history of alcohol use, blood transfusions, history of viral hepatitis and family history of liver disease is recommended for all the patients.
History and Symptoms
- Jaundice typically progress in "top to bottom" manner, from face to feet.
- Specific history should be focused on alcohol or hepatotoxic medication use.
History
Patients with jaundice may have a positive history of:
Social history
- History of alcohol use:
- Amount
- Duration
- History of illicit drug use
- History of unprotected sexual intercourse
Past Medical history
- History of infections:[1]
- Hepatitis B
- Hepatitis C
- History of autoimmune disorders:
- History of blood transfusions
Family history
- Family history of liver disease:
Medication history
- History of use of any hepatotoxic drugs
Common Symptoms
Common symptoms of jaundice depends on the underlying factor that causes jaundice and include:
- Viral Hepatitis[2][3]
- Anorexia
- Dark urine
- Fatigue
- Light-colored stools (acholic stools)
- Pruritis
- Right upper quadrant (RUQ) pain
- Nausea and vomiting
- Cirrhosis[4][5]
- Right upper quadrant abdominal pain
- Fever
- Anorexia
- Fatigue and weakness
- Nausea and vomiting
- Weight loss
- Abdominal pain and bloating
- Menstrual irregularities
- Symptoms of hypogonadism:
- Impotence
- Infertility
- Testicular atrophy
- Loss of libido
- Easy bruising
- Symptoms due to hepatic encephalopathy:
- Altered mental status
- Confusion
- Sleep disturbances
- Muscle cramps due to reduction in effective circulating plasma volume
- Lower extremity edema
- Primary biliary cirrhosis[6]
- Fatigue out of proportion to the severity of the disease
- Pruritis:
- May be intermittent
- Worse at night
- May present in the last trimester of pregnancy and may be mis-diagnosed as cholestasis of pregnancy
- Pancreatic cancer[7]
- Weight Loss (significant)
- Midepigastric pain which may also radiate either to the lower back region and mid-back region
- Nausea and vomiting
- Malaise
- Fatigue
- Loss of appetite
- Anorexia
- Dyspepsia
- Ascites
- Dark urine
- Light-colored or greasy stools
- Cholestasis[8]
- Clay-colored or white stools
- Dark urine
- Inability to digest certain foods
- Itching
- Nausea or vomiting
- Right upper quadrant abdominal pain
- Cholangiocarcinoma [9]
Less Common Symptoms
Less common symptoms of jaundice include
- Primary sclerosing cholangitis[10]
- Fatigue
- Pruritis
- Steatorrhea
- Abdominal pain, mainly in the right upper quadrant (RUQ)
- Fever
- Weight loss
- Decompensated cirrhosis[11]
- Increase in abdominal girth due to ascites
- Pruritus
- Signs of upper gastrointestinal bleeding:
References
- ↑ Flores YN, Lang CM, Salmerón J, Bastani R (2012). "Risk factors for liver disease and associated knowledge and practices among Mexican adults in the US and Mexico". J Community Health. 37 (2): 403–11. doi:10.1007/s10900-011-9457-4. PMID 21877109.
- ↑ Krugman S, Giles JP (1970). "Viral hepatitis. New light on an old disease". JAMA. 212 (6): 1019–29. PMID 4191502.
- ↑ Singal AK, Bataller R, Ahn J, Kamath PS, Shah VH (2018). "ACG Clinical Guideline: Alcoholic Liver Disease". Am. J. Gastroenterol. doi:10.1038/ajg.2017.469. PMID 29336434.
- ↑ Williams EJ, Iredale JP (1998). "Liver cirrhosis". Postgrad Med J. 74 (870): 193–202. PMC 2360862. PMID 9683971.
- ↑ Schuppan D, Afdhal NH (2008). "Liver cirrhosis". Lancet. 371 (9615): 838–51. doi:10.1016/S0140-6736(08)60383-9. PMC 2271178. PMID 18328931.
- ↑ Talwalkar JA, Lindor KD (July 2003). "Primary biliary cirrhosis". Lancet. 362 (9377): 53–61. doi:10.1016/S0140-6736(03)13808-1. PMID 12853201.
- ↑ Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX (2005). "Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage". Clin Transl Oncol. 7 (5): 189–97. PMID 15960930.
- ↑ Bunchorntavakul C, Reddy KR (2012). "Pruritus in chronic cholestatic liver disease". Clin Liver Dis. 16 (2): 331–46. doi:10.1016/j.cld.2012.03.010. PMID 22541702.
- ↑ Patel T (2011). "Cholangiocarcinoma--controversies and challenges". Nat Rev Gastroenterol Hepatol. 8 (4): 189–200. doi:10.1038/nrgastro.2011.20. PMC 3888819. PMID 21460876.
- ↑ Lazaridis KN, LaRusso NF (September 2016). "Primary Sclerosing Cholangitis". N. Engl. J. Med. 375 (12): 1161–70. doi:10.1056/NEJMra1506330. PMC 5553912. PMID 27653566.
- ↑ Bloom S, Kemp W, Lubel J (2015). "Portal hypertension: pathophysiology, diagnosis and management". Intern Med J. 45 (1): 16–26. doi:10.1111/imj.12590. PMID 25230084.