Body itching during jaundice (jaundice), what is the cause?

Jaundice aka jaundice or jaundice is a condition of the skin color, the whites of the eyes, and the mucous tissue layer that turns yellow due to high levels of bilirubin due to liver damage. People who have jaundice also often complain of an itchy body as a symptom. What causes it, and how to solve it? Check out the details in this article.

What causes body itching when jaundice?

Most people who have jaundice will experience body itching in addition to other symptoms, especially in the evening and at night. In fact, itching is the most difficult symptom of jaundice to control and can hinder daily activities. Itching that appears at night can make it difficult for you to sleep well.

The itching feeling we feel is actually triggered by stimuli called pruritogens. Examples are insect bites or chemical irritants. The brain then translates it as an itchy sensation. In response to the itching sensation, we will scratch or rub the area to remove the irritant.

Well, bilirubin (yellow pigment) is one of the pruritogenic substances. Bilirubin is formed when hemoglobin (the part of red blood cells that carries oxygen) is broken down as part of the normal process of recycling old or damaged red blood cells. Bilirubin is carried in the bloodstream to the liver, where it binds with bile. Bilirubin is then transferred through the bile duct to the digestive tract, so that it can be excreted from the body. Most of the bilirubin is excreted through feces, while the rest is through urine.

If too much bilirubin builds up in the liver, bilirubin will then continue to accumulate in the blood and be deposited under the skin. The result is body itching, which is common in people with jaundice.

In addition, body itching as a symptom of jaundice may also be caused by bile salts. Bile salts are also pruritogenic substances. The difference is, complaints of itching due to bile salts appear before the skin turns yellow. Body itching due to bile salts also does not produce reddish skin that looks swollen.

Women are more prone to itching than men

Body itching due to jaundice is heavier and lasts longer in women than men.

In women who have cholestasis in the third trimester of pregnancy, when the steroid hormones are highest, the itching symptoms get worse. After childbirth, the symptoms of itching begin to lessen.

How do you deal with body itching due to jaundice?

There are many ways to deal with complaints of itching that accompanies jaundice (jaundice). Examples are SSRI drugs such as sertraline and paroxetine, or opioids such as naloxone and naltrexone.

Some other treatments that can be done to treat body itching in jaundice patients include:

1. Draining pruritogens from circulating blood and liver with resin or biliary drainage procedures (endoscopic, radiological and operative)
2. Altering the metabolism of pruritogens in the liver and intestines
3. Modulation of impulse travel in the central nervous system such as using antihistamines, SSRI drugs, and antidepressants.
4. Removes pruritogens from the systemic circulation.

European Association for the Study of Liver Disease (EASL) provides several drug recommendations for the management of jaundice-related itching, including:

• Initial: UDCA 10-15mg / kg / day orally
• First-line: cholestyramine 4-16g / day orally
• Second line: Rifampicin 300-600mg / day orally
• Third line: Naltrexone 50mg / day orally
• Fourth line: Setraline 100 mg / day orally

The patient needs to be evaluated for the cause of jaundice. If there is clear evidence of biliary obstruction then a procedure is necessary to remove the obstruction by surgery or radiology. If the itching is still being felt, the drugs above can be prescribed.

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