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What causes jaundice in adults?
Jaundice in adults is caused by various medical conditions that affect the normal metabolism or excretion of bilirubin. Bilirubin is mostly formed from the daily breakdown and destruction of red blood cells in the bloodstream, which release hemoglobin as they rupture. The heme portion of this hemoglobin molecule is then converted into bilirubin, which is transported in the bloodstream to the liver for further metabolism and excretion. In the liver, the bilirubin is conjugated (made more water soluble), and is excreted into the gallbladder (where it is stored) and then into the intestines. In the intestines, a portion of the bilirubin is excreted in the feces, while some is metabolized by the intestinal bacteria and excreted in the urine.
Jaundice occurs if there is a dysfunction of the normal metabolism or excretion of bilirubin. This disruption in the metabolism or excretion of bilirubin can occur at various stages, and it is therefore useful to classify the different causes of jaundice based on where the dysfunction occurs. The causes of jaundice are generally classified as pre-hepatic (the problem arises before secretion to the liver), hepatic (the problem arises within the liver), and post-hepatic (the problem arises after bilirubin is excreted from the liver).
Asymptomatic hyperbilirubinemia was found during my yearly physical examination. Total bilirubin 31.3 (normal range 3.0-22) mmol/L, unconjugated bilirubin 22.8 (normal range2.0-21) mmol/L, conjugated bilirubin 8.5 (normal range 0-7) mmol/L.