Jaundice is perhaps one of the most alerting symptoms that anyone can experience. This yellowish tinge of the skin can indeed be a sign of a severe disease affecting the liver, the blood, the biliary tract or even the pancreas. Differentiating the different types and causes of jaundice is not always an easy task, and many doctors can struggle to know the reason behind it despite having various lab tests and imaging studies.
Jaundice occurs when a chemical called bilirubin rises in the blood. There are two types of bilirubin, conjugated and unconjugated. Conjugated bilirubin is that which has been processed by the liver, while the unconjugated one is the one arising directly from the breakdown of red blood cells which has not been processed by the liver. Each type of bilirubin rises in the blood when the stage of its processing is altered. Conjugated bilirubin level rises in diseases related to the biliary tract through which bile, the main excretory method for bilirubin, flows. On the other hand, unconjugated bilirubin level rises when there is a problem related to the blood rather than the liver or the biliary tract. Total bilirubin -both direct and indirect- level can rise if the liver is damaged, since it affects its processing capacity and the flow of bile in its microscopic canals.