Jaundice is a yellowing of the skin, whites of the eyes, and mucous membranes. The discoloration results from a buildup in the blood of bilirubin, a pigment produced when the hemoglobin in wornout red blood cells is broken down so that its iron can be recycled to make new blood cells. Normally, the liver metabolizes and converts bilirubin into substances that are transported with bile into the intestinal tract to be eliminated. These byproducts give feces its brown color. Thus, jaundice is typically accompanied by light stools and dark urine, resulting from the kidneys’ attempt to eliminate excess bilirubin from the body. Various conditions can cause the buildup of bilirubin and different types of jaundice, including the following: Hemolytic jaundice develops when an unusually large number of red blood cells are destroyed at the same time and the liver is unable to metabolize all of the resulting bilirubin. Obstructive jaundice, or cholestasis, occurs when the bile ducts to the intestine are blocked, causing the bilirubin to be reabsorbed into the bloodstream. Hepatic jaundice is caused by hepatitis and other disorders that not only reduce the liver’s ability to process bilirubin, but also produce inflammation, which blocks bile channels and prevents the exit of bile that is processed. Neonatal jaundice often develops in the first few days of life because of the liver’s immaturity. About half of all newborns develop this type of jaundice. It usually clears up by the time a baby is 7 to 10 days old but may linger in premature infants. Mild jaundice is not serious, but very high bilirubin levels may require treatment.
Diagnostic Studies And Procedures
This condition should always receive prompt attention by a doctor, who will begin by noting skin color and asking questions about lifestyle, chronic ill ness, medications, alcohol consumption, and possible exposure to harmful chemicals. The doctor will also inquire about itchiness, the color of urine and stools, and digestive problems-all of which are common aspects of jaundice. Urine, stool, and blood samples may be sent to a laboratory for special tests, which can be used to diagnose many liver disorders, including hepatitis and damage from drugs, chemicals, and other toxic substances. However, a liver biopsy may be needed to diagnose liver cancer and other conditions. If obstructive jaundice is suspected, further diagnostic procedures may include abdominal X-rays, sonography, and CT scans or MRI. In some cases, laparoscopy, an examination in which a viewing tube is inserted into the abdominal cavity through a small incision’ is necessary to make a diagnosis.
Medical Treatments
Medical treatments for jaundice are determined by the underlying cause. Obstructive jaundice usually requires some sort of intervention surgery, endoscopy, or the insertion of drainage tubes to unblock the bile ducts. Rest and avoidance of alcohol and other toxic substances are the main treatments for many types of liver disease. The liver has remarkable regenerative capabilities and often heals itself, at which time the jaundice disappears. Mild neonatal jaundice can usually be minimized by frequent feedings to increase excretion of bilirubin in the stools. In more severe cases, exchange transfusions of blood may be necessary.
Alternative Therapies
After a medical diagnosis has been established, various alternative therapies may be useful.
Herbal Medicine
Herbalists recommend milk thistle extract, dandelion extract or tea, and black radish extract to strengthen and rebuild the liver. Tea made from dried wild Oregon grape is also said to help overcome jaundice.
Light Therapy
Exposing a jaundiced newborn to ultraviolet light speeds clearance of bilirubin from the blood.
Nutrition Therapy
Consult a clinical nutritionist if jaundice is the result of liver disease, which often causes loss of appetite. Try frequent small meals, with emphasis on complex carbohydrates and a moderate amount of fat and protein . A proper balance of the amino acids that make up protein is especially important. Generally, protein from plants and milk is better tolerated than that from meat. Severe cases may require tube feeding or enriched liquid supplements.
Self Treatment
Self treatment usually involves easing the liver’s workload by reducing the amount of chemicals it must process. Abstain from alcohol and take only those nutritional supplements and medications specified by your doctor. Avoid exposure to potentially harmful chemicals and gases, especially carbon tetrachloride, benzene, paint strippers, and cleaning fluids. Women should not use birth control pills.
Other Causes of Jaundice
Gallbladder disease, yellow fever, and pancreatic or liver cancer may cause yellow skin. Some women develop jaundice during pregnancy. Some 3 to 5 percent of the population may develop mild, asymptomatic jaundice. If liver function and other laboratory tests turn out to be normal, the jaundice is probably due to slower than usual processing of bilirubin.