Ganiv is just shy of fifty. She was barely ten when she first contracted jaundice. The symptoms showed up during a road trip she took with her family. What was supposed to be a fun road trip turned into a nightmare when she threw up multiple times along the way. They stopped at a hospital en route and the doctor brushed it aside as food poisoning. The happy family continued to their destination.
“It was night by the time we reached home. Immediately after reaching home, my father took me to the doctor. He took one look at me and said that I had jaundice. My eyes were yellow,” she recalls.
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Sure enough, the blood and urine test confirmed the visual examination and Ganiv was put on complete bed rest for around 45 days.
“What I remember from that time was that I was not allowed to get off the bed even for a minute. My mom would carry me to the washroom and carry me back,” Ganiv remembers. And of course, there was the bland food. “It was all boiled lauki (bottle gourd), no masala, no ghee or butter for 45 days. Just once, towards the time that I had almost recovered, I got to have a small bowl of rajma,” she says.
The upside is that Ganiv recovered completely and she has never had any liver issues.
This is the jaundice most of us are familiar with. And most doctors also agree that jaundice in its acute form (an acute condition develops quickly, is intense and last for a short duration) is easily treatable. Still, there is much more to jaundice than just the yellowing of the skin, nails and eyes.
What is jaundice?
“Jaundice is a symptom of a liver-related disease,” says Prof (Dr) Anil Arora, chairman and head of department of liver, gastroenterology and pancreatobiliary sciences, Sir Ganga Ram Hospital, New Delhi. “We treat the underlying cause of the symptoms of jaundice,” he explains.
People typically come to the doctor with a fever, abdominal pain, vomiting, yellowing skin pallor, dark-coloured urine or clay-coloured stool.
What causes yellow skin?
When the liver is not functioning properly, it does not filter out the bilirubin (a by-product of the breakdown of red blood cells). In the normal course, the bilirubin is filtered out by the liver and excreted from the system through urine and stool. As bilirubin builds up in the blood, it imparts a yellow pallor to the skin and the whites of the eyes.
Doctors conduct blood, urine and liver function tests (LFT) to figure out why the liver is not functioning properly.
What’s up with the liver?
Apart from reasons like hepatitis B or C, liver function may be compromised because of certain medications. “The long-term use of steroids like those prescribed for rheumatoid arthritis may have an impact on the liver,” says Prof Arora.
Certain kinds of nonsteroidal anti-inflammatory drugs, painkillers, statins or anabolic steroids can lead to drug-induced liver injury. So, the long-term use of any medication should be monitored. Even certain kinds of birth control pills can cause liver damage.
Since the liver breaks down alcohol, over-consumption of alcohol can lead to liver damage or fatty liver. Uncontrolled diabetes and obesity are the other reasons that can put pressure on the liver and cause it to break down. Autoimmune diseases can also affect the liver.
What is the treatment?
The doctors treat the underlying cause of jaundice. In case it is not related directly to the liver, but to the gall bladder or pancreas, then the treatment will be directed there.
“However, if the jaundice is acute, it is self-limiting and patients recover well,” says Prof Arora. Most patients recover with good home care and proper treatment. But care needs to be taken and the doctor needs to be kept informed of any changes in the condition of the patient.
Babies and jaundice
We have often heard of newborn babies getting jaundice. This happens because babies are born with a lot of red blood cells and the newborn liver may not be mature enough to handle the breakdown of the red blood cells and the excess bilirubin.
Most such babies recover well with phototherapy. Here the baby is placed under a lamp which helps increase the oxygen level in the bilirubin, making it water soluble and easily excretable through the urine. There may, however, also be more serious reasons for infantile jaundice which the doctors will diagnose through various tests.
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