Jaundice means yellow discoloration of the skin, mucous membrane and sclera (the white of an eye) that occurs when the blood contains an excess amount of the pigment called bilirubin.Bilirubin is a yellow pigment produced when red blood cell breaks down. Bilirubin enters the liver though bloodstream and then passes into the intestine with bile.Finally, it is excreted in the stool. A very little amount of bilirubin remains in the blood.
Basics: The liver is the largest gland in the body. It has three surfaces (superior, inferior and posterior and two lobes (right and left). It is situated in the upper and right parts of the abdominal cavity, occupying almost the whole of the right hypochondrium. It weighs 1.4 to 1.6 kg in males and 1.2 to 1.4 kg in females. It is much larger in the fetus as compared to the adults. Conjugated hyperbilirubinemia occurs when there is reduced secretion of conjugated bilirubin into the bile. This condition occurs in cases of hepatitis or biliary obstruction. Unconjugated bilirubin elevates secondary to high level of conjugated bilirubin.Classification of Jaundice
• Hemolytic jaundice: It occurs because of excessive breakdown of red blood cells.
• Obstructive jaundice. It occurs because of functional obstruction of liver.
• Hepato-cellular jaundice. The liver becomes dysfunctional because metabolic disease.
• Neonatal jaundice. It occurs in new-born babies.
Conjugated bilirubinemia affects population in midlife. Unconjugated bilirubinemia affects most commonly women. It may occur in infants in first days of life and in midlife.
Jaundice can occur as a result of any of the following three conditions:
1. An excessive breakdown of red blood cells (Haemolysis):- It occurs as a result of
• Incompatibility of Rhesus blood group of fetus and mother.
• Auto-immune hemolytic anemia.
• Side-effect of some drugs.
2. Impaired function of liver cells:- This happens due to one of the following reasons:-
• Viral hepatitis.
• Glandular infection.
• Alcohol abuse.
• Liver cirrhosis.
• Tumors of the liver.
• Disorders present since birth such as Gilbert syndrome, Dubin- Johnson syndrome, Rotor syndrome, or Crigler-Najjar syndrome.
• Reduced oxygen or blood flow to the liver.
3. Blockage of the bile ducts:- This can occur due to abnormality inside or outside the ducts.
• Cancer of the pancreas.
• Pressure on the bile duct by external enlarged organ.
The common Signs and symptoms of jaundice include:
• Yellow color of the skin and whites of the eyes.
• Clay-colored stools.
• Dark or brown-colored urine. Jaundice in new born is marked by – yellowish skin, the white part of eyes, the inside of the mouth.
• Breast-feeding jaundice is due to dehydration. Dehydration contributes to jaundice because it makes removing bilirubin from the body even harder for babies’ immature systems.
• Breast milk jaundice is a rise in bilirubin levels that occurs about 10 to 14 days after birth. It is likely related to how certain components of breast milk affect bilirubin elimination in the infant.
• Brain damage can develop if a baby with a high bilirubin blood level is not treated. Signs of a very high level of bilirubin include:
• Periods of not breathing (apnea) or difficulty in breathing (dyspnea).
• Serum bilirubin level.
• Liver function tests.
• Complete blood count.
• Ultrasound and CT scan of abdomen.
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Liver biopsy.
• Prothrombin time.
• Acute Liver Failure.
• Alcoholic Hepatitis.
• Biliary Obstruction.
• Acute Pancreatitis.
Treatment depends on the underlying cause of the jaundice.
Treating with intravenous fluids , medications and antibiotics or blood transfusion.
In new born jaundice -exposing babies to special coloured light ( phototherapy ).
Prognosis of the jaundice depend on the severity of the bilirubin levels in the blood and also on the course of treatment.In cases of jaundice due to obstruction of bile duct than removing the obstruction treat the jaundice early. Proper diet with nutritional supplements and taking care of diet to be avoided will help a lot in treating jaundice in shorter time period.
• Pressure in right hypochondrium
• Patient is anxious and restless.
• Thirst for small quantity of water.
• Duodenal catarrh causes jaundice.
• Stitching pain under right scapula.
• Thick white coated tongue with red tip and edges.
• Vomiting of acidic green fluid.
• Yellowish urine and clay colored stool.
• Chronic complaints of liver.
• Nutmeg liver.
• Obstinate constipation.
• Bitter taste of mouth with loss of taste.
• Nausea and vomiting.
• Pressure in stomach.
• Constipation with yellowish complexion.
• Stitching pain in the region of gall bladder extending to stomach.
• Worse on pressure.
• Jaundice due to hepatic and gall bladder obstruction.
• Clay colored stool, floats in water.
• Enlarged liver.
• Congested liver.
• Large yellow spots on abdomen.
• A weak, empty, gone sensation is felt in the abdomen.
• Sensation of weakness and sinking.
• Liver region is painful, better rubbing apart.
• Rumbling and shifting of flatus in ascending colon.
• Liver region is tender.
• Dull dragging in right groin with cutting sensation into right testicle.
• Vegetable broth, which contains adequate minerals and trace minerals, and is easy to digest.
• Fresh vegetable juices are also an excellent dietary supplement.
• Avoid processed food products containing preservatives, artificial flavors and colorings, and other additives.
• Avoid saturated animal fats, fried foods, and large meals.
• Avoid alcohol.
• Avoid refined sugar and anything containing caffeine in diet.
Why not ask your query directly to Dr. Thind’s team? Get an expert opinion FOR FREE!