Ask a doctor - What is the role of the liver in jaundice?

Q. What is the role of the liver in jaundice?

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Answered by Secondmedic Expert

The liver plays a central role in the development of jaundice, as it is responsible for the processing and elimination of bilirubin, a yellow pigment formed during the breakdown of red blood cells. Here is an overview of the liver's role in jaundice:

1. Breakdown of Red Blood Cells (RBCs): The process begins with the breakdown of aged or damaged red blood cells in the spleen and other parts of the body. This breakdown releases hemoglobin, which is further broken down into heme and globin.

2. Conversion of Heme to Biliverdin: Heme is converted into biliverdin by the enzyme heme oxygenase. Biliverdin is a green pigment.

3. Conversion of Biliverdin to Bilirubin: Biliverdin is then converted into bilirubin by the enzyme biliverdin reductase. Bilirubin is a yellow-orange pigment.

4. Binding to Albumin: Unconjugated (indirect) bilirubin, which is insoluble in water, binds to albumin in the blood and is transported to the liver.

5. Uptake by Liver Cells (Hepatocytes): In the liver, hepatocytes take up unconjugated bilirubin from the blood.

6. Conjugation of Bilirubin: Inside the hepatocytes, unconjugated bilirubin undergoes a chemical reaction called conjugation. This involves the addition of glucuronic acid, making bilirubin water-soluble.

7. Excretion into Bile: Conjugated (direct) bilirubin is then excreted into bile, a fluid produced by the liver that aids in digestion.

8. Transport to the Intestines: Bile, containing conjugated bilirubin, is transported to the small intestine.

9. Elimination from the Body: In the intestines, bilirubin undergoes further processing by bacteria, forming compounds that are eventually eliminated from the body in feces.

In jaundice, there is a disruption in this normal process, leading to an accumulation of bilirubin in the blood and tissues. This can occur due to liver dysfunction, bile duct obstructions, excessive breakdown of red blood cells, or other factors affecting bilirubin metabolism.

Understanding the liver's role in bilirubin processing is crucial in diagnosing and managing jaundice. The specific cause of jaundice can be identified through various diagnostic tests that assess liver function, bile flow, and bilirubin levels in the blood.