Jaundice Treatment in Delhi, India

Jaundice is a common medical condition characterised by yellowing of the skin, eyes, and mucous membranes. It develops when there is an imbalance in the production and elimination of bilirubin. The liver processes bilirubin and excretes it through bile into the digestive system. When the liver cannot perform this function properly, bilirubin accumulates in the blood, leading to the yellow discolouration seen in jaundice.

The severity of jaundice varies. In some cases, it may be mild and resolve on its own, while in others, it can indicate a serious health issue requiring medical intervention.

How is Jaundice Related to Hepatitis?

Hepatitis, an inflammation of the liver, is one of the leading causes of jaundice. Viral hepatitis A, hepatitis B, and hepatitis C directly affects liver function, impairing its ability to process bilirubin efficiently. Chronic hepatitis infections can cause severe liver damage, increasing the risk of long-term jaundice. Autoimmune hepatitis, alcoholic hepatitis, and drug-induced hepatitis can also contribute to jaundice by damaging liver cells.

Types of Jaundice

Jaundice is classified into three main types based on its underlying cause:

1. Hepatocellular Jaundice

This type occurs due to liver diseases such as hepatitis, cirrhosis, or liver cancer. When liver cells are damaged, they lose their ability to process bilirubin, leading to its accumulation in the blood.

2. Cholestatic Jaundice

Also known as obstructive jaundice, this occurs when bile flow is blocked due to gallstones, tumours, or bile duct infections. Since bile flow to the intestines is blocked, bilirubin accumulates in the liver and eventually enters the bloodstream.

3. Hemolytic Jaundice

This type results from the excessive breakdown of red blood cells, causing a rise in bilirubin levels. Conditions like sickle cell anaemia, malaria, or G6PD deficiency can cause hemolytic jaundice by accelerating red blood cell destruction.

Causes of Jaundice

Jaundice can result from various underlying conditions, including:

• Hepatitis A, B, and C: Viral infections that cause liver inflammation, impairing bilirubin metabolism.
• Alcoholic Hepatitis: Excessive alcohol consumption damages liver cells, reducing their ability to process bilirubin.
• Autoimmune Hepatitis: The immune system mistakenly attacks liver cells, leading to liver dysfunction and jaundice.
• Drug-Induced Liver Injury: Certain medications, such as acetaminophen (paracetamol), antibiotics, and steroids, can damage the liver and cause jaundice.
• Bile Duct Obstruction: Gallstones, bile duct cancer, or strictures can block bile flow, leading to bilirubin buildup.
• Pancreatitis: Inflammation of the pancreas can obstruct bile ducts, causing jaundice.
• Sickle Cell Anemia: A genetic blood disorder that increases red blood cell breakdown, resulting in excessive bilirubin production.
• G6PD Deficiency: A genetic enzyme disorder that causes red blood cells to break down more rapidly, leading to jaundice.
• Newborn Jaundice: A common condition in newborns due to immature liver function. Most cases resolve on their own within a few weeks.

Symptoms of Jaundice

Jaundice symptoms vary depending on its cause and severity. Common symptoms include:

• Yellowing of the skin and eyes (sclerae): The most noticeable sign of jaundice.
• Dark Urine: Bilirubin excretion in urine makes it appear darker than usual.
• Pale Stools: Lack of bile in the intestines leads to light-coloured stools.
• Itchy Skin: Excess bilirubin can cause irritation and itching.
• Fatigue: Liver dysfunction can result in persistent tiredness.
• Abdominal Pain: Inflammation or bile duct obstruction may cause discomfort or pain in the upper abdomen.
• Nausea and Vomiting: Digestive disturbances often accompany jaundice.
• Loss of Appetite: Affected individuals may experience a reduced desire to eat.

Stages of Jaundice

Jaundice progresses through three stages based on where the problem occurs in bilirubin metabolism:

1. Prehepatic Jaundice

Occurs when excessive red blood cell breakdown leads to high bilirubin levels. The liver cannot process the excess bilirubin quickly enough, resulting in jaundice. Conditions like hemolytic anaemia and malaria can cause prehepatic jaundice.

2. Hepatic Jaundice

Caused by liver diseases, such as hepatitis or cirrhosis, which impair bilirubin processing. This type is the most common and directly related to liver damage.

3. Posthepatic Jaundice

Also known as obstructive jaundice, this occurs when bile flow is blocked after it leaves the liver. Causes include gallstones, bile duct tumours, or pancreatic disorders.

Diagnosis of Jaundice

To diagnose jaundice and determine its cause, doctors may perform:

Physical Examination

Checking for yellowing of the skin and eyes, abdominal swelling, and liver tenderness.

Blood Tests

Measuring bilirubin levels, liver enzymes, and markers for hepatitis or hemolytic disorders.

Imaging Tests

Ultrasound, CT, or MRI scans help identify liver damage, bile duct obstructions, or tumours.

Treatment for Jaundice

The treatment of jaundice depends on its underlying cause:

Treating the Primary Condition

Managing hepatitis, infections, or liver disease to restore normal bilirubin levels.

Medications

Antiviral drugs for hepatitis, antibiotics for infections, or steroids for autoimmune conditions.

Bile Duct Surgery

Removing gallstones or tumours (cholecystectomy surgery) to restore normal bile flow.

Supportive Care

Hydration, balanced nutrition, and avoiding alcohol to aid liver recovery.

In newborns, phototherapy (light treatment) helps break down excess bilirubin, while severe cases may require an exchange transfusion (blood replacement).

Risks and Complications of Jaundice

If left untreated, jaundice may result in severe complications such as:

• Liver Damage or Liver Failure: Chronic jaundice may indicate progressive liver disease.
• Encephalopathy: High bilirubin levels can affect brain function, leading to confusion or coma.
• Hemorrhage: Liver dysfunction can cause clotting disorders, increasing the risk of internal bleeding.
• Kidney Failure: Liver disease can impact kidney function, leading to organ failure.

Prevention of Jaundice

Jaundice prevention involves maintaining liver health and reducing risk factors:

• Get Vaccinated: Vaccines for hepatitis A and B protect against viral liver infections.
• Limit Alcohol Consumption: Excessive drinking can lead to liver damage.
• Practice Safe Sex: Hepatitis B and C can spread through unprotected sex.
• Eat a Balanced Diet: A nutrient-rich diet supports liver function.
• Get Regular Health Checkups: Early detection of liver conditions can prevent severe jaundice.

Outlook

The prognosis for jaundice depends on its cause and severity. Mild cases, such as newborn jaundice or short-term infections, often resolve with minimal treatment. However, jaundice due to chronic liver disease requires long-term medical management. If untreated, severe jaundice can lead to life-threatening complications, including liver failure.

Frequently Asked Questions

1. Is jaundice contagious?

Jaundice itself is not contagious, but viral infections like hepatitis that cause jaundice can spread.

2. Is newborn jaundice common?

Yes, newborn jaundice is common and usually resolves within a few weeks as the baby’s liver matures.

3. What are the long-term effects of jaundice?

Chronic jaundice can lead to liver disease, organ failure, or neurological issues if bilirubin levels remain high for long periods.

4. How is jaundice treated?

Treatment focuses on addressing the underlying cause. Newborn jaundice may be treated with phototherapy, while adult jaundice requires medication or lifestyle changes.

5. Is jaundice easy to cure?

Mild jaundice often resolves on its own, but severe cases require medical treatment. Early intervention improves outcomes.

6. What deficiency causes jaundice?

G6PD deficiency and vitamin B12 deficiency can contribute to jaundice by increasing red blood cell breakdown.

7. What is the danger stage of jaundice?

If jaundice progresses to liver failure, it becomes life-threatening and requires urgent medical attention and consultation with a gastroenterologist.

8. How long can jaundice affect adults?

The duration depends on the cause. Acute jaundice may last a few weeks, while chronic liver disease can cause prolonged jaundice.

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