Jaundice history & symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Farnaz Khalighinejad, MD [2]
Overview
Common symptoms of jaundice that the patient will notice, is yellowing of the skin, nausea, and vomiting. Specific symptoms will depend on the underlying factor that caused jaundice to occur.
History and Symptoms
Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner.
The caregiver should ask questions regarding
- Alcohol/hepatotoxic medication use
Various Symptoms
- Cirrhosis
the symptoms of liver cirrhosis are very non-specific: 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 bruisability Decompensated cirrhosis may present with[4] Jaundice Increase in abdominal girth due to ascites Pruritus Signs of upper gastrointestinal bleeding: Hematemesis Hematochezia Melena Symptoms due to hepatic encephalopathy: Altered mental status Confusion Sleep disturbances Muscle cramps due to reduction in effective circulating plasma volume Lower extremity edema Symptoms may vary depending on the underlying cause of cirrhosis: Primary biliary cirrhosis presents with the following symptoms: Fatigue out of proportion to the severity of the disease Pruritis May be intermittent Increases in the evening May present in the last trimester of pregnancy and may be mis-diagnosed as cholestasis of pregnancy Primary sclerosing cholangitis may present with the following in addition to the above symptoms of cirrhosis: Fatigue Pruritis Steatorrhea Abdominal pain, mainly in the right upper quadrant (RUQ) Yellowish discoloration of the skin and mucous membranes (jaundice) Fever Weight loss
- Primary biliary cirrhosis
- Choledocholithiasis
- Cholangiocarcinoma
- Primary sclerosing cholangitis
- Acute pancreatitis
- Chronic pancreatitis