Jaundice - Symptoms, Treatment And Causes

Jaundice is a condition that occurs when your skin and eyes turn yellow. It can be a sign of some serious problems like liver disease, therefore, you must take medical help. It is caused by the build-up in your body of a yellow substance called bilirubin. Bilirubin is formed in the body when the parts of the red blood cells break down.

The liver takes the bilirubin as waste material from the blood and changes its chemical makeup so that most of it is passed through the stools as bile. An inflamed liver or obstructed bile duct can lead to excessive bilirubin leading to jaundice. The symptoms of the disease include a yellow color to the skin and eyes, dark urine, and itchiness.

There are lots of possible reasons for this and some of them are serious. They include:

• Gallstones
• Alcoholic liver disease
• Pancreatitis
• Hepatitis
• Sickle cell disease

Jaundice is more common in newborn but may occur in adults too. Bilirubin, a yellow-orange substance, is found in your red blood cells and when these cells die, the liver filters it from the bloodstream. But if something is wrong and your liver can't keep up, bilirubin builds up and can cause your skin to look yellow.

A person suffering from jaundice may see changes in the skin color. The colour of the skin and eyes will vary depending on the level of bilirubin. Moderate levels lead to a yellow colour, while very high levels will appear brown. One may also have dark urine and itchiness, pale stools. Accompanying symptoms include:

• Fatigue
• Abdominal pain and some may have pain in upper abdomen due to inflammation of liver.
• Weight loss
• Vomiting and nausea
• Fever
• Pale stools
• Dark urine
• The itchiness due to jaundice is sometimes so severe that patients scratch their own skin or experience insomnia.

Jaundice occurs when there is too much bilirubin, a yellow-orange substance in your blood. It’s found in your red blood cells and when these cells die, the liver filters it from the bloodstream and accumulates them so that they can pass through bile from the stools. But if something’s wrong and your liver can't keep up, bilirubin builds up and can cause your skin to look yellow. This is caused due to liver infection.

Some of the reasons for jaundice in adults are:

• Hepatitis : Mostly viral, it may be short-lived or chronic. Drugs or autoimmune disorders can cause hepatitis. Over time, it can damage the liver and lead to jaundice.
• Acute inflammation of the liver: Due to the inflammation the ability of the liver to conjugate and secrete bilirubin, decreases and thus bilirubin quantity builds up. Inflammation is caused due to contaminated water or foods.
• Alcohol-related liver disease: If you drink too much over a long period of time-typically over 8-10 years-you could damage your liver. Two diseases, in particular, Alcoholic hepatitis and alcoholic cirrhosis harm the liver.
• Hemolytic anemia: Due to this condition the production of the bilirubin increases in the body as large quantities of red blood cells get broken down.
• Gilbert's syndrome: In this condition the ability of the enzymes to process the bile excretion decreases. This is an inherited condition.
• Blocked bile ducts: These are thin tubes that carry a fluid called bile from the liver and gallbladder to the small intestine. Sometimes; they get blocked by gallstones, cancer, or rare liver diseases. If they do, they cause jaundice.
• Pancreatic Cancer: This is 10th most common cancer in men and 9th in women. It can block the bile duct and cause jaundice.
• Certain Medicines: Drugs like Acetaminophen, penicillin, birth control pills and steroids have been linked to liver disease.

The symptoms of jaundice are managed and controlled spontaneously in most cases such as Acute viral hepatitis, and need not be treated. In this case, the symptoms fade away gradually due to the self-healing tendency of the liver and certain medications.

While anemia-induced jaundice can be controlled at home by incorporating iron-rich foods in one’s diet, hepatitis-related jaundice can undergo self-treatment by the application of medicines such as antivirals and steroids. In these cases, the symptoms may get resolved in a time period of around two weeks and there is no need for medical treatment.

The itching in jaundice might get very intense and the patients might suffer from insomnia. The complications in jaundice are mostly not due to the jaundice itself, but the underlying causes. For example, a bile-duct obstruction jaundice might result in continuous bleeding due to vitamin deficiency.

Precautions for jaundice:

• Ensure safe and healthy eating and drinking habits.
• During infection avoid fatty and oil rich foods.
• Consume fluids and water so as to keep well hydrated.
• Eat foods like carbohydrates, fruits like mango and papaya that are digestive friendly and are causing no harm to liver.

Some preventive measures against jaundice are as follows:

• Avoid heavy alcohol use .
• Get vaccines for hepatitis.
• Take medications to prevent malaria before travelling to high risk areas.
• Avoid high risk behaviours like intravenous drug use or unprotected sex.
• Avoid potentially contaminated water/food and maintain good hygiene.
• Avoid medications that cause hemolysis in susceptible individuals.
• Consult the doctor immediately if one faces the symptoms of the jaundice.

The correct diagnosis requires examinations and lab tests. Diagnosis includes history and physical exam and close attention to the abdomen, feeling for tumors, and checking the firmness of the liver. A firm liver indicates cirrhosis or scarring of the liver. A rock-hard liver suggests cancer. Several tests can confirm jaundice. First is a liver function test to find out whether the liver is functioning well or not.

Other supporting tests needed for diagnosis are:

• Bilirubin tests - A high level of unconjugated bilirubin compared to levels of conjugated bilirubin suggest hemolytic jaundice.
• Full blood count - This measures levels of red blood cells, white blood cells and platelets.
• Hepatitis A, B and C tests - This test for a range of liver infections.

The doctor will examine the structure of the liver if they suspect an obstruction. In these cases, they will use imaging tests, including MRI, CT, and ultrasound procedures. They may also carry out an Endoscopic retrograde cholangiopancreatography. This is a procedure combining endoscopy and X-ray imaging. Liver biopsy can check for inflammation, cirrhosis, cancer, and fatty liver.

The methods of jaundice treatments usually include phototherapy in infants, intravenous immunoglobulin therapy, blood transfusion, certain medications, and surgical correction of the blocked bile duct. These methods are associated with some side effects and complications which generally include constipation, bloating, gas, stomach pain, diarrhoea, nausea and vomiting, upset stomach, and abdominal pain.

Some of the fastest ways to cure jaundice are as follows:

• Drink at least 8 glasses of water.
• Consider adding milk to your routine.
• Opt for fruits like papaya and mango which are high in digestive enzymes.
• Eat at least 2 and ½ cups of vegetables and 2 cups of fruits daily.
• Look for high-fibre foods like oatmeal, berries and almonds.

Treatment of adult jaundice is not about treating jaundice by itself, rather treating its cause. For example, if you have acute viral hepatitis, jaundice will go away on its own as the liver begins to heal. If a blocked bile duct is to be blamed, the doctor may suggest surgery to open it.

The results of the treatment are not necessarily permanent. It depends upon the causes. Most of the cases which are associated with the conditions like gallstones disease or viral hepatitis are amenable to treatment, however, if it is due to conditions like cancer of the gallbladder or liver or due to cirrhosis of the liver then permanent treatment is not possible.

Some of the home remedies are as follows:

• Sunlight: One of the most widely used therapies to treat Jaundice in children or newborns is phototherapy. Although there are studies proving sunlight is far effective than phototherapy, there are many more suggesting that scientifically it is not proven that sunlight is effective.
• Sugarcane Juice: Drinking 1-2 glasses of sugarcane juice daily until your condition improves helps in strengthening your liver and hence is a great cure for jaundice.
• Essential Oils:
• a) Rosemary: Apply it topically on the abdomen and liver area and massage gently by combining 12 drops of rosemary with 30 ml of carrier oil. It has detoxifying and hepatoprotective effects.
• b) Lemon essential oil: It has detoxifying and hepatoprotective effects when mixed in same proportions and applied in same regions as the rosemary oil.
• Goat Milk : It has many antibodies against hepatitis and so is a great substitute to cow’s milk and should be consumed as one cup daily.
• Green Grape Juice : One cup of this consumed daily is believed to absorb the yellowness by enhancing the functioning of liver. This can improve the serum bilirubin levels and cure jaundice.
• Garlic : 3-4 cloves of minced garlic if added to daily diet can help in detoxifying your liver, speeding up your recovery from jaundice because of a substance called allicin present in it.
• Ginger : 1-2 inches of minced ginger when boiled and consumed daily as a drink has antioxidant and hypolipidemic effects which boost liver function.
• Lemon juice : 1/2 a lemon when mixed in a glass of water with some honey and consumed as a drink 3-4 times daily helps in unblocking your bile ducts because of its antioxidant properties. This protects the health of liver.
• Vitamin D: Vitamin D supplements and enriched foods like eggs, fish and cheese prove beneficial in jaundice.
• Yogurt: One bowl of plain probiotic yogurt if consumed daily, helps in bringing down the serum bilirubin levels by enhancing your immunity and regulating the bacterial colonies in your body.
• Tomatoes: Boiling 2-3 tomatoes and straining them and consuming as juice daily has an antioxidant effect and hence heals because of a component named lycopene.
• Amla: Boiling 2-3 almas and adding honey and consuming 2-3 glasses of this drink enhances the life of liver due to the antioxidant properties of vitamin C and other nutrients present in it.
• Barley water: One teaspoon of barley seeds mixed with water and honey when consumed daily has diuretic and antioxidant properties, thus flushing out toxins and even bilirubin.
• Basil: Chewing few fresh basil leaves or grinding them and adding to your favourite juice have hepatoprotective effects.
• Oregano: 1-2 teaspoons of oregano boiled in water and consumed as a tea with honey thrice daily, has antioxidant properties helping in breaking down bilirubin molecules.
• Papaya: Papaya leaves ground and mixed with honey consumed 2-3 times daily are a rich source of enzymes like papain and chymopapain. These enzymes support your digestive health and also treat liver problems like jaundice.

Read More: Home Remedies For Jaundice

Foods to avoid:

• Sugar
• Meat
• Dairy Products
• Salt

The diet during jaundice is as follows:

1) Water : Drink at least 8 glasses of water which helps the liver to flush out toxins. Also helps maintain a healthy weight and keeps the blood thin which helps to filter.

2) Coffee or Herbal Tea : Moderate coffee consumption helps improve liver health by reducing-

• Your risk of cirrhosis
• Levels of harmful liver enzymes
• Inflammation

3) Milk: High in antioxidants and also contains silymarin which helps repair damaged liver cells.

4) Digestive Enzymes: Naturally occurring digestive enzymes may help reduce bilirubin. These are found in-

• Honey
• Orange peels
• Papaya
• Pineapple
• Mango

5) Fruits and Vegetables: USDA recommends daily consumption of at least 2n ½ cups of vegetables and 2 cups of fruits. Healthy choices in jaundice include-

• Grapefruit
• Avocado
• Brussels sprouts
• Grapes
• Mustard greens

6) Fibre : Especially soluble fibre helps move bile out of the liver, they can reduce toxicity. It is found in-

• Fruits
• Vegetables
• Legumes
• Nuts
• Whole grains

High fibre foods include -

• Cruciferous vegetables like kale and broccoli.
• Berries
• Oatmeal
• Almonds
• Brown rice
• Quinoa

Cut back or avoid on:

• Alcohol
• Opt for lean proteins
• Saturated fats
• Refined sugar

Newborn babies usually are subjected to jaundice and it is not much to worry about. The baby is exposed to the phototherapy and treated. Usually if the baby is a breastfed baby then it takes about a month to complete the treatment and the baby to heal.

If the baby is formula fed the jaundice takes a much lesser time of 2 weeks to go away. However it is a matter of concern if the baby takes more than 3 weeks to recover from the jaundice.

There is a rare case that the person suffering from jaundice dies within the first few weeks after getting it. However, in a time span of 4-6 months, if the person experiences the blockage of common bile duct, then he/she might face deterioration of health on a high pace and eventually die.

Jaundice is a disease associated with abnormal conditions of the liver, gallbladder, and blood. It needs to undergo treatment under the supervision of a doctor and the treatment totally depends upon the conditions responsible for it and also the symptoms being shown.

The cost of the treatment usually depends on the treatment plan which may include surgery of the bile duct, blood transfusion or phototherapy, or certain medications. The expense related to the jaundice treatment may vary between rupees 2000 up to 15000 excluding the expenditure due to the changes in the diet post jaundice treatment care.

Summary: Jaundice is a disease associated with abnormal conditions of the liver, gallbladder, and blood. It is related to some risks which include systemic or physiological conditions such as hemolytic anemia, chronic liver hepatitis, and viral hepatitis. The methods of jaundice treatments include phototherapy in infants, intravenous immunoglobulin therapy, blood transfusion, certain medications, and surgical correction of the blocked bile duct.