Jaundice Vitamin D production. Bilirubin count is lowered through bowel movements and urination, so frequent and effective feedings are especially important. Yellow discoloration of the skin, especially on the palms and the soles, but not of the sclera or inside the mouth is due to carotenemia—a harmless condition. Jaundice itself is not a disease, but rather a sign of one of many possible underlying pathological processes that occur at some point along the normal physiological pathway of the metabolism of bilirubin in blood. When red blood cells have completed their life span of approximately 120 days, or when they are damaged,
Jaundice may be impaired at any point between the uptake of unconjugated bilirubin into the cell and transport of conjugated bilirubin into biliary canaliculi. In addition, swelling of cells and oedema due to inflammation cause mechanical obstruction of intrahepatic biliary tree. Hence in hepatocellular jaundice, concentration of both unconjugated and conjugated bilirubin rises in the blood. In hepatocellular disease, there is usually interference in all major steps of bilirubin metabolism—uptake, conjugation and excretion. Excretion is the rate-limiting step, however, and usually impaired to the greatest extent. As a result, conjugated hyperbilirubinaemia predominates. The unconjugated bilirubin still enters the liver cells and