Jaundice

neonatal jaundice

Last Updated December 20th, 2021

Overview of jaundice

Environmental pollution, combined with lack of hygiene, predispose an individual to different diseases. Liver diseases are becoming very common in low and middle-income countries where awareness related to the importance of hygiene is lacking. Among innumerable liver disorders, jaundice is the leading cause of illness in infants and adults. It is a very common occurrence in newborns. Nearly 60% new-borns around the world acquire the disease annually. This has triggered American Liver Foundation to organize health campaigns to educate the mass about relevant vaccinations which can prevent future risks of hepatic diseases.

What is jaundice?

Jaundice is the yellowish discoloration of the skin, sclera (white membrane covering the eye-ball) and mucous membranes. Abnormalities in bilirubin secretion by the liver or obstruction of bile duct are the prime factors behind the disease. Bilirubin is a yellowish pigment present in hemoglobin (responsible for carrying oxygen in Red Blood Cells). An increase in the concentration of bilirubin above 3 mg per dL of blood leads to hepatic diseases.

What causes jaundice?

jaundice symptomsHepatic diseases are caused by an elevation in the level of bilirubin in the blood, which is clinically termed as “hyperbilirubinemia”. This condition results due to three distinct phases of bilirubin metabolism namely – Prehepatic Phase, Intrahepatic Phase, and Posthepatic phase. The contributions of these phases are as follows-

    • Pre-hepatic causes: In the prehepatic phase, excessive heme (non-protein, an insoluble element of hemoglobin) metabolism can lead to increased level of bilirubin in the blood. This condition can arise due to hemolytic anemia in which membrane abnormalities of RBC membrane or enzyme functions occur, causing a rise in bilirubin content to about 5 mg per dL of blood.
    • Intrahepatic causes: Aberrations in enzyme metabolism in the Intrahepatic phase causes excessive bilirubin in the bloodstream. These enzyme metabolism abnormalities may result from Gilbert syndrome or Autoimmune hepatitis.
  • Posthepatic causes: The disease can occur in the post-hepatic phase due to the obstruction of the bile duct due to internal or external agents. This condition might arise due to Cholelithiasis (gallstones), Cholecystitis (gallbladder inflammation) or biliary tract tumors.

Here is a list of the more general causes of hepatic diseases-

  • Viral hepatitis (pathogens: Hepatitis A, B, C, D or E virus)
  • Infections of gallbladder, liver or pancreas (pancreatitis) which interferes with the body’s capacity to break down bilirubin
  • Accidental consumption of poison, for example, poisonous mushrooms or expired milk
  • Certain medications such as Acetaminophen or Tylenol
  • Hormonal changes during pregnancy can cause jaundice in women
  • Excess consumption of tobacco or alcohol
  • Past occurrence of jaundice

What are the warning signs?

The signs and symptoms of hepatic diseases are not so prominent in the initial stages. With the slow progress of the disease, a few distinct symptoms appear-

  • Yellowish discoloration of skin
  • Sclera, conjunctiva, and mucosa turns pale yellow (in advanced stages)
  • Dark yellow or brownish discoloration of urine
  • Dark stool
  • Irritation of skin
  • Severe loss of appetite
  • Abnormal weight loss in advanced stages
  • Extreme fatigue
  • Occasional pain in the upper right portion of stomach
  • Nausea and vomiting
  • Occasional headaches
  • Fever (occasional)

 Types of jaundice

Jaundice, clinically termed as “icterus” may be classified into different categories based on the etiology and the degree of infection. The main categories are listed below-

  • Physiological jaundice: It is caused by excessive destruction of Red Blood Cells, especially in infants. It is often characterized by severe infarction of lungs and tissues. It usually occurs as mild infection and disappears after a few days.
  • Obstructive jaundice: Obstruction of the biliary ducts due to tumor formation (intrinsic or extrinsic carcinoma), clustered tissues or stone formation causes abnormalities in the normal mechanism of bile flow. This leads to hepatic syndromes. This is accompanied by the enlarged liver with metastatic nodules.
  • Toxic/infective jaundice: In this condition, acute viral infection of liver cells occurs, leading to inflammation and abnormal functioning of the liver. Yellow atrophy and enlargement of the liver occur. Infective jaundice may also occur during other infectious diseases like Weil’s disease, Glandular fever, Pneumonia or Yellow fever. In these conditions, the urine contains bile pigments, bile salts and a trace amount of urobilinogen.
  • Haemolytic jaundice: This occurs due to excessive destruction of hemoglobin due to intrinsic (congenital infections) or extrinsic (incompatible blood transfusion) Haemolytic jaundice is usually accompanied by elevated body temperature and abnormally enlarged spleen. It is normally accompanied by Reticulocytosis (abnormal increase in the count of immature RBCs).

Congenital jaundice

congenital jaundiceIn many cases, infants are born with hepatic diseases. This is called neonatal jaundice and is usually of the following types-

  • Physiological jaundice: It reaches its peak within 4-5 days of birth and is characterized by shortening of RBC life span (70-90 days instead of the usual 120 days).
  • Pathological jaundice: It appears within 24 hours of birth and bilirubin level rises above 5 mg per dL of blood. It usually stays even after 14 days and is characterized by dark-colored stool and brownish urine.
  • Breast-milk jaundice: Breast milk might contain a bilirubin conjugation inhibitor or bilirubin recirculation enhancer (beta-glucuronidase) which when passed on to the infant can cause neonatal jaundice.

Diagnosis

The first step to the diagnosis of hepatic diseases involves an ultrasonography of gallbladder and liver to determine the exact cause of jaundice. A CT scan of the organs of the abdomen and an Endoscopic Retrograde Cholangiopancreatography (ERCP) to study the bile and pancreatic ducts is very essential. A liver biopsy can be carried out in few extreme cases.Blood tests to measure bilirubin levels are also precribed.

Treatment & Prevention

Since there can be many reasons for the onset of jaundice, the treatment methodology depends upon the actual cause. Jaundice caused by anemia can be treated by consuming iron-rich foods and taking additional iron supplements. Hepatitis-induced jaundice is treated with the help of antiviral or steroidal drugs. The most effective way to prevent jaundice is vaccination. One must completely cut down on alcohol and use of illicit drugs, in order to keep the liver healthy.  Stress and high BMI are also responsible in weakening the liver. Easy to digest food should be consumed that put negligible strain on the liver. Foods such as boiled rice, yogurt, turmeric, ginger, fresh fruit juice, and almonds are help greatly in recuperation from the disease. It is important to maintain adequate sanitation and stay away from contaminated food and water. Removing excess cholesterol from body can also reduce your chances of acquiring jaundice.

Center for Disease Control and Prevention (CDC) has estimated that nearly 200 million people worldwide are suffering from jaundice at present. Majority of these cases are observed in the undeveloped countries. Health Organizations all around the world are recommending a hygienic lifestyle, combined with healthy food habits to prevent the occurrence of the disease. These organizations are also spreading awareness related to hepatic diseases in new-born children to reduce the mortality rates on a global scale.

 

Dos and Don'ts

Dos
  • Opt for more fruits, nuts, black soybeans, lemons, bitter-gourd, and tomatoes in the diet.
  • Basil leaf decoction/paste, when taken with radish juice, is an excellent home remedy for jaundice.
  • Jaundice causes a severe deficiency of calories and sudden weight-loss. To make up for the loss, add healthy and easily digestible carbs such as soft bread and rice.
Don'ts
  • Consume pulses, legumes, and peas as they are complex sources of proteins and difficult to digest.
  • Consume meat, eggs, and poultry for at least a month.
  • Have a salty diet since it contains minerals which are difficult to digest.

 

 

 

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Poop chart: Top things you didn’t you your poop could reveal about you Bristol poop chart was designed during the 1990s in order to help doctors identify various types of poops…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
ASTtest-liver
AST- Aspartate Aminotransferase Test AST test is a blood test that is used to measure the level of a particular liver enzyme…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
The complete “what to eat” guide for gluten intolerance Does eating breads and pastas often makes you nauseous? Gluten intolerance is a common reason why you might…
How can Kegels help you overcome weak pelvic muscles & incontinence? Kegel exercises are pelvic floor strengthening exercises that can help you overcome incontinence issues that rise out of…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
gout diet purines
Gout Diet : Get relief from painful joints by eating these foods Are you a victim of this painful condition? Are medications providing only short relief? Find a list of…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
rosacea-treatment--before-_-after
The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Gua sha: Scraping away layers of pain with this ancient healing tool Gua sha is an ancient oriental healing method which focuses on scraping the body with specific tools to…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Burpees: World’s most challenging fitness routine now made simple for you The majority of the fitness regimens mainly concentrate on a particular muscle group whereas Burpees is s whole…
Beginner to Tai Chi? Find the right way to perform this exercise for best results According to the Chinese tradition, it is believed that practicing Tai chi helps in promoting self awareness and…
CT-scan-machine
CT – Computed Tomography Scan CT scan or computed tomography scan is an diagnostic imaging technique where cross-sectional images of body are obtained…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
cardioliin antibody iga
Cardiolipin Antibody (ACL) – IgA test Cardiolipins are phospholipids that are constituents of the platelets and the cell membranes. The IgA test detects the…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…

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