What is jaundice?
Jaundice is not a disease but rather a sign that can occur in many different
diseases. Jaundice is the yellowish staining of the skin and sclerae (the
whites of the eyes) that is
caused by high levels of the chemical bilirubin in
blood. The color of the skin and sclerae vary depending on the level of
bilirubin. When the bilirubin level is mildly elevated, they are yellowish.
When the bilirubin level is high, they tend to be brown.
What causes jaundice?
Bilirubin comes from red blood cells. When red blood cells get old, they are
destroyed. Hemoglobin, the iron-containing chemical in red blood cells that
carries oxygen, is released from the destroyed red blood cells after the iron
it contains is removed. The chemical that remains in the blood after the iron
is removed becomes bilirubin.
The liver has many functions. One of the liver's functions is to produce and
secrete bile into the intestines to help digest dietary fat. Another is to remove
toxic chemicals or waste products from the blood, and bilirubin is a waste
product. The liver removes bilirubin from the blood. After the bilirubin has
entered the liver cells, the cells conjugate (attaching other chemicals,
primarily glucuronic acid) to the bilirubin, and then secrete the
bilirubin/glucuronic acid complex into bile. The complex that is secreted in
bile is called conjugated bilirubin. The conjugated bilirubin is eliminated in
the feces. (Bilirubin is what gives feces its brown color.) Conjugated
bilirubin is distinguished from the bilirubin that is released from the red
blood cells and not yet removed from the blood which is termed unconjugated
bilirubin.
Jaundice occurs when there is
1) too much bilirubin being produced
for the liver to remove from the blood. (For example, patients with hemolytic anmeia
have an abnormally rapid rate of destruction of their red blood cells that
releases large amounts of bilirubin into the blood),
2) a defect in the liver that prevents bilirubin from being removed from the
blood, converted to bilirubin/glucuronic acid (conjugated) or secreted in bile,
or
3) blockage of the bile ducts that decreases the flow of bile and bilirubin
from the liver into the intestines. (For example, the bile ducts can be blocked
by cancers, gallstones, or inflammation of the bile ducts). The decreased
conjugation, secretion, or flow of bile that can result in jaundice is referred
to as cholestasis: however, cholestasis does not always result in jaundice.
Jaundice can turn the skin and sclerae yellow. In addition,
stool can become light in color, even clay-colored because of the absence of
bilirubin that normally gives stool its brown color. The urine may turn dark or
brownish in color. This occurs when the bilirubin that is building up in the
blood begins to be excreted from the body in the urine. Just as in feces, the
bilirubin turns the urine brown.
The itching associated with jaundice and cholestasis can
sometimes be so severe that it causes patients to scratch their skin
"raw," have trouble sleeping
Possible reasons for the jaundice. For example, heavy use of
alcohol suggests alcoholic liver disease, whereas use of illegal, injectable
drugs suggests viral hepatitis. Recent initiation of a new drug suggests
drug-induced jaundice.
Diagnosis/ Detection
Physical examination
The most important part of the physical examination in a patient who is
jaundiced is examination of the abdomen. Masses (tumors) in the abdomen suggest
cancer infiltrating the liver (metastatic cancer) as the cause of the jaundice.
An enlarged, firm liver suggests cirrhosis. A rock-hard, nodular liver suggests
cancer within the liver.
Blood tests
Measurement of bilirubin can be helpful in determining the causes of jaundice. Markedly
greater elevations of unconjugated bilirubin relative to elevations of
conjugated bilirubin in the blood suggest hemolysis (destruction of red blood
cells). Marked elevations of liver tests (aspartate amino transferase or AST
and alanine amino transferase or ALT) suggest inflammation of the liver (such
as viral hepatitis). Elevations of other liver tests, e.g., alkaline
phosphatase, suggest diseases or obstruction of the bile ducts.
Ultrasonography
Ultrasonography is a simple, safe, and readily-available test that uses sound
waves to examine the organs within the abdomen.
Computerized tomography (CT or CAT scans)
Computerized tomography or CT scans are scans that use x-rays to examine the
soft tissues of the abdomen. They are particularly good for identifying tumors
in the liver and the pancreas and dilated bile ducts, though they are not as
good as ultrasonography for identifying gallstones.
Magnetic resonance imaging (MRI)
Like CT scans, they are good for identifying tumors and
studying bile ducts. MRI scans can be modified to visualize the bile ducts
better than CT scans (a procedure referred to as MR cholangiography), and,
therefore, are better than CT for identifying the cause and location of bile
duct obstruction.
Endoscopic retrograde cholangiopancreatography (ERCP) and
endoscopic ultrasound
Endoscopic retrograde cholangiopancreatography (ERCP) provides the best means
for examining the bile duct. For ERCP an endoscope is swallowed by the patient
after he or she has been sedated. The endoscope is a flexible, fiberoptic tube
approximately four feet in length with a light and camera on its tip. The tip
of the endoscope is passed down the esophagus, through the stomach, and into
the duodenum where the main bile duct enters the intestine. A thin tube then is
passed through the endoscope and into the bile duct, and the duct is filled
with x-ray contrast solution. An x-ray is taken that clearly demonstrates the
contrast-filled bile ducts.
Liver biopsy
Biopsy of liver provides a small piece of tissue from the liver for examination
under the microscope. The biopsy most commonly is done with a long needle after
local injection of the skin of the abdomen overlying the liver with anesthetic.
The needle passes through the skin and into the liver, cutting off a small
piece of liver tissue. When the needle is withdrawn, the piece of liver comes
with it. Liver biopsy is particularly good for diagnosing inflammation of the
liver and bile ducts, cirrhosis, cancer, and fatty liver.
Home Remedy For Jaundice
- The
patient should rest till acute symptoms subside.
- Water
Treatment – Drink lots of water with lemon juice to protect damaged liver
cells. A hot immersion bath for 10 minutes at 104 degree Fahrenheit daily
eliminates bile pigment through skin and kidneys.
- The
patient should be put on a juice fast for a week. After the juice fast, he
may adopt an all-fruit diet for a further three to five days, taking three
meals a day of fresh Juicy fruits at five-hourly intervals.
- The
green leaves of the radish (muli) are also an effective home remedy. Pound
the leaves and extract the juice from them. Intake at least one pound of
this juice daily.
- Another
effective remedy would be to mash a banana and add to it a tablespoon of
honey. Have this mixture two times a day.
- In a
glass of buttermilk, mix a pinch of black pepper. Intake this for about a
week.
- In a
cup of boiling water, add 8-10 lemon leaves. Cover it with a lid for about
5 minutes. Now, strain the liquid and drink it. Repeat this for 4-5 days.
- Mix 1/4
tsp of turmeric powder in a glass of hot water. Have this 2 to 3 times a
day.
- Take
tender papaya leaves and make a paste out of it. Consume ½ tsp of this
paste with 1 tsp honey.
- Consuming
lots of lime juice is beneficial for a person suffering from jaundice.
- Mix 1/2
tsp ginger juice and 1 tsp each of mint juice and lime juice. have this
mixture after a span of few hours.
- Have a
glass of tomato juice early in the morning. Add some salt and pepper to
it, before drinking.
- Squeeze
half a lemon in half a cup of beetroot juice. This is an effective remedy
for treating jaundice.
- Consuming
a glass of carrot juice every day is also beneficial.
- Avoid
having oils, fried foods, butter, turmeric, spicy food, pickles , cream and
sour products.
