Jaundice is a disease caused due to an impaired liver functioning, leading to excessive bilirubin accumulation in the blood. This excessive accumulation of bilirubin cause the whites of the eyes, skin, and mucous membranes to appear yellow. Bilirubin is released into the bloodstream when red blood cells break down and can no longer carry oxygen. The orange-yellow hue of bilirubin makes the jaundice patient appear pale and tired.
It is the function of liver to breakdown this bilirubin and expel it out of the body, but when this process is hampered, it is the first indicator of an underlying liver disease.
Know more about liver diseases here: Liver Diseases
In India, every 2.76 per 1000 people are stated and confirmed cases of jaundice. Children under 5 years of age are at a greater risk of jaundice. Almost 60% of jaundice cases occur during the monsoon and summer months.
Jaundice is the most common condition requiring medical attention in new-borns. About 3 in 5 new-borns suffer from jaundice a few days after birth. About 50% of term babies and 80% of premature babies develop jaundice in the first week after birth. Jaundice is also a common cause of readmission to the hospital after early discharge of infants. Jaundice usually occurs two to four days after birth and eventually resolves with effective treatment.
The prevalence of jaundice in adults is rare compared to children. Therefore, it is often an indicator of an underlying problem related to haematopoiesis, liver dysfunction, and biliary obstruction. Men and smokers, are more likely to have high-risk serum bilirubin levels than women. People who have hepatitis and drink excessive alcohol are also at a greater risk.
What are the types of Jaundice?
Pre-hepatic jaundice: Pre-hepatic jaundice occurs when the rate of breakdown of red blood cells, called haemolysis increases. Malaria is one of the most common causes of pre-hepatic jaundice. Other causes include sickle cell anaemia and spherocytosis, genetic conditions responsible for red blood cells becoming crescent and spherical in shape, as opposed to the usual disc shape. Another underlying cause of increased haemolysis could be thalassemia, a deadly blood disorder that makes it harder for the body to produce healthy red blood cells. Patients suffering from Hepatitis A, chronic Hepatitis B and Hepatitis C, and Epstein-Barr virus infections are also at increased risk of being diagnosed with pre-hepatic jaundice.
Intrahepatic jaundice: Intrahepatic jaundice occurs when scar tissue in the liver interferes with the process of filtering bilirubin from the blood. One of the main causes of liver cirrhosis in adults is alcohol abuse. Long drinking damages the functions of the liver and slows down the filtration process. Know more about Fatty Liver and Liver Cirrhosis by clicking on the link. This is followed by viral hepatitis, which causes inflammation in the liver and reduced function due to viral bombardment. Liver cancer is one of the worst causes of jaundice because the rapid spread of cancer cells drastically impairs the liver's functions.
Post-hepatic jaundice: Post-hepatic jaundice is caused by blockages in the bile duct. This occurs mainly due to gallstones which are the hard calcium deposits in the ducts, and cancers of the gallbladder and pancreas. Pancreatitis, a condition in which inflammation of the pancreas causes complications, is also a major cause of blockages in the bile ducts. However, biliary atresia is one of the direct causes of this type of jaundice as it is genetic due to narrow and absent bile ducts.
Neonatal Jaundice: Neonatal jaundice is very common in new-born babies that have high levels of bilirubin. This is mainly due to the fact that the liver is not yet fully formed. Therefore, premature babies are at high risk for neonatal jaundice. Incorrect breastfeeding and different blood types of mother and child can also lead to this condition.
What are the symptoms of Jaundice?
Jaundice symptoms appear earlier in infants than in adults. These symptoms may not be very noticeable initially, so it is recommended that patients with mild jaundice symptoms see their doctor as early detection is key to speed recovery processes for all ages.
Before the bilirubin secretions starts the discoloration of the skin, one should be aware of these jaundice symptoms and seek medical attention as soon as possible:
- Abdominal pain
- Flu-like symptoms
- Change in skin colour
- Dark-coloured urine or clay coloured stools
- Weight loss
- Itchy skin
What causes Jaundice?
Jaundice can be caused by a problem in any of the three phases of bilirubin production:
Pre-hepatic: Haemolytic anaemias, CrigglerNajjar syndrome, Gilbert's syndrome.
Intrahepatic: Alcoholic liver disease, Iatrogenic, viral hepatitis, hereditary haemochromatosis, autoimmune hepatitis, primary biliary cirrhosis, hepatocellular carcinoma, alcohol, rare genetic metabolic defects.
Post-hepatic: Intraluminal causes (gallstones), wall-related causes, (cholangiocarcinoma, strictures, or drug-induced cholestasis), extramural causes, (pancreatic cancer or abdominal masses e.g., lymphoma).
What are the complications of Jaundice?
- Stomach pain
- Upset stomach
How to prevent Jaundice?
Because there are multiple causes of jaundice, there are not many specific precautions that can be taken to prevent it. However, the following measures can be considered:
- Stop drinking and smoking
- Maintain a healthy weight
- Control cholesterol levels
- Drink at least 8 glasses of water a day
- Opt for fruits and vegetables that are rich of digestive enzymes
- Eat high-fibre foods
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