Yellow eyes: what causes? When to consult?

Yellow eyes, a symptom of jaundice (jaundice)

Contrary to what we might believe, yellow eyes are not a trivial symptom nor a sign of simple fatigue. They are part of the common manifestations of jaundicemedically called “ jaundice “. Jaundice is the result of an excess of a yellow pigment in the blood called “ bilirubin “. “Such an anomaly comes from a disturbance in the liver, bile ducts or pancreas. It is therefore on this side that we must investigate in the event of yellowing of the eyes”, according to Doctor Olivier Spatzierer, gastroenterologist and hepatologist.

What is bilirubin? When is it raised?

Bilirubin is a yellowish pigment, product of the breakdown of red blood cells and more precisely of a part of these called “ hemoglobin “.

Bilirubin is carried by the blood to the liver. This last organ excretes bilirubin in a juice that it produces: bile. Finally, the bile (and therefore the bilirubin it contains) is evacuated into the digestive tract by the bile ducts Then eliminated in the stool and in smaller quantities in the urine.

A high level of bilirubin in the blood (Or hyperbilirubinemia) can be the consequence of:

excessive destruction of red blood cells (in this case we are talking about a high level of “free bilirubin”);
a dysfunction in the liver, bile ducts or pancreas (in this case we are talking about an excess of “conjugated bilirubin”).

What causes yellow eyes?

Yellow eyes can be the result of liver diseaseof the Biliary or pancreas.

Most often liver disease

A hepatitis of viral, autoimmune or drug-related origin (paracetamol, certain antibiotics, certain anti-inflammatories or painkillers, psychotropic drugs and anti-epileptics). This option should be considered if you have signs of jaundice even though you are young and in good health. Viral hepatitis can be acute or chronic.
A alcohol-related liver disease. The most advanced and irreversible stage being theliver cirrhosis. Consuming a large quantity of alcohol daily and over time (at least 8 years) can damage the liver.
A non-alcoholic fatty liver disease (Or foie gras) often associated with metabolic syndrome in cases of obesity.

What if it was hereditary liver disease?

Sometimes yellow eyes are explained by:

THE Gilbert syndrome : this chronic disease of hereditary origin affects between 3 and 7% of the population. It is usually detected in young subjects. It is linked to the deficiency of a bilirubin degradation enzyme. It is characterized by a yellow coloring of the eyes, skin and mucous membranes;
another rare hereditary liver disease causing excess bilirubin such as Dubin syndrome–Johnson.

Sometimes obstruction of the bile ducts

Yellow eyes can be explained by bile duct obstruction as :

“Pancreatic cancer is a serious illness. The tumor can cause an obstruction in the bile ducts. When symptoms are present (as is the case with jaundice) then the cancer is unfortunately at an advanced stage,” according to Doctor Olivier Spatzierer, gastroenterologist and hepatologist.

A possible hematological disease

Note that certain hematological disorders causing excessive breakdown of hemoglobin and therefore excess bilirubin can lead to jaundice and yellow eyes. This is the case, for example, of diseases that cause hemolytic anemia (such as autoimmune hemolytic anemia, sickle cell anemia…).

Having the whites of your eyes yellow is not trivial. Whatever your state of health, it is best to consult a doctor. It may be Gilbert’s syndrome which is annoying but not serious. However, this may reflect more serious liver disease. Olivier Spatzierer, gastroenterologist and hepatologist at the American Hospital of Paris.

Yellowish eyes: what signs are associated?

Depending on the cause of yellow eyes, certain symptoms could also bother you:

A yellowish skin which gives the impression that you have unwell ;
Of the itching ;
Of the dark urine ;
Of the light stools ;
Of the nausea and vomiting ;
Of the abdominal pain ;
Small star-shaped vessels called “ stellar angiomas » ;
In men: breast enlargement and reduction in the volume of the testicles;
An increase in the volume of pubic hair;
A loss of appetite ;
Sometimes fever : in this case, it could well be viral hepatitis.

Yellow eyes are often associated with yellowish skin, dark urine, white stools and more or less intense itching. Doctor Olivier Spatzierer, gastroenterologist and hepatologist.

Other signs could suggest a severe liver disorder :

A bleeding tendency and bruises;
Of the neurological disorders or psychiatric conditions linked to encephalopathy of hepatic origin (since the liver malfunctions, toxins accumulate which can impair brain function);
A hard and swollen belly Or ascites. This is often the case with alcohol-related liver disease.
Of the coughing up blood coming from the esophagus or stomach (they are the consequence of increased pressure in the portal vein)…

I have yellow whites of my eyes: When to consult?

If you have yellow eyes, you should consult a general practitioner or a gastroenterologist and hepatologist. The latter will perform a clinical examination. Sometimes, he will have to order other tests to determine the cause of this anomaly: blood tests, imaging (ultrasound, CT, MRI, etc.), biopsy, etc.

What are the treatments for yellow eyes?

THE yellow eye treatment and jaundice requires treatment of their cause.

In the event of an obstructed bile or pancreatic duct, it is possible to perform a ERCP (endoscopic retrograde cholangiopancreatography) in order to open the channels.
In case of viral hepatitis, there is nothing to do. The virus should gradually and spontaneously weaken. Support may be necessary, especially if hepatitis becomes chronic.
In the event of liver damage (alcoholic, toxic, etc.), removal of the causal factor is essential in order to hope for improvement.
Finally, if you have Gilbert’s syndrome, there is no solution to get rid of it permanently. It is advisable to avoid dehydration, consumption of alcohol, tobacco and fasting as much as possible.

If itching is associated with jaundice, the cholestyramine is effective.

Note that treatment by phototherapy helps slow the progression of jaundice and reduce the baby’s bilirubin levels. When phototherapy is not sufficient, blood exchange by transfusion can quickly remove bilirubin from the bloodstream.