Jaundice is characterized by the yellowish discoloration of the skin, conjunctival membranes and mucous membranes. This is caused by an elevated level of bilirubin in the blood. Bilirubin is the by-product of the breakdown of red blood cells (RBC).
Jaundice in itself is not a disease. It is usually an indicator of an underlying disease. The body produces millions of new RBC every day as the old ones break down and are processed by the liver. These are then excreted through urine and bile. If the liver is unable to break the bilirubin down, its level increases and reaches a point where it can cause jaundice. Jaundice is symptomized by:
- Yellow pigmentation in the whites of the eyes
- Yellow discoloration of the skin
- Elevated bilirubin levels found in liver function tests
Types of Jaundice
Since jaundice is considered an indicator of an underlying disease, the root must be diagnosed for effective treatment. There are three major types of jaundice:
This type of jaundice is caused by the breakdown of RBC. This leads to an elevated level of unconjugated bilirubin, which in turn can cause jaundice. Diseases that can cause pre-hepatic jaundice are:
- Severe Malaria
- Sickle Cell Anemia
Pre-hepatic jaundice is always secondary to hemolysis (the breakdown of RBC), so there is no increased count of bilirubin in the urine and can be diagnosed by checking the level of bilirubin in the serum.
Hepatic jaundice is caused by an increased level of bilirubin in the blood arising from the liver’s inability to process it. When the liver’s functioning is disturbed due to the disease, necrosis kills these cells, thereby reducing the liver’s ability to process bilirubin. Diseases that cause hepatic jaundice include:
- Hepatitis (acute or chronic)
- Liver cirrhosis
- Liver damage due to hepatotoxicity
- Alcoholic liver disease
- Drug-induced hepatitis
In hepatic jaundice, there is a significant increase in the count of bilirubin in the urine along with an increase in the levels of plasma protein and plasma globulins.
Also known as obstructive jaundice, post-hepatic jaundice is caused by an obstruction to the drainage of bile. Because the drainage is blocked, the bile does not flow into the intestine, causing pale colored stools. Post-hepatic jaundice is caused by:
- Pancreatic cancer
- Liver flukes (parasites)
- Biliary atresia
An enzyme called glucuronosyltransferase is responsible for converting unconjugated bilirubin into conjugated bilirubin, which can be excreted. In newborns, this enzyme can takes time to function, thereby causing jaundice.
In most cases, it is a harmless condition that lasts from the second to about the eighth day after birth. In premature births, it can last up to 18 days.
Diagnosis and Treatment of Jaundice
The diagnosis of jaundice usually involves the following:
- A physical examination to identify inflammation of the liver.
- Blood and urine tests to find bilirubin levels.
- A liver biopsy to rule out liver cirrhosis and cancer.
- Scans to identify any biliary obstruction.
The condition is usually treated based on the underlying issue and a surgery may be required in the case of obstructive jaundice. A transplant is considered when there is significant damage to the liver.
Herbal and Ayurvedic treatments are available for jaundice, however, a complete diagnosis from a doctor is essential before trying any medications.
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