Jaundice

Jaundice is caused by an increase in bilirubin in the blood. This can occur before the bilirubin is conjugated by the liver, or after the bilirubin has been conjugated. If the bilirubin has not yet ben conjugated, it will not be able to pass through lipid membranes and will not be soluble in water. Therefore it will not be present in urine. Increases in conjugated bilirubin by the liver, or problems in the conjugation itself. If the increase is conjugated bilirubin, the disorder lies within the outlet channels of the hepatocyte, or there is some kind of obstruction in the biliary outlet system. Within the liver itself, the most common causes of difficulty are acute and chronic hepatitis, alcoholic cirrhosis and drug-induced liver dysfunction. Extra-hepatic obstructions are usually associated with the gall bladder, but may result from tumors of sclerosing secondary to chronic bowel disease.