Jaundice: Is it deadly?

Jaundice refers to the yellow pigmentation of the skin or sclera by bilirubin.

As a Pharmacist, I want to share with you some information about Jaundice, which is a fatal one and common in human beings .I want to enlighten you about the seriousness of this disease.

"Jaundice is also known as Icterus .It is a disorder caused by abnormally high levels of the bile pigment, bilirubin in the blood stream. Yellow discoloration of the skin and the whites of the eyes are the most important features."

Classification and features of Jaundice

Based on pathophysiology ,Jaundice may result from one or more of the following mechanisms

• Increased bilirubin production

• Decreased hepatic uptake

• Decreased hepatic conjugation

• Decreased excretion of bilirubin into bile.

Accordingly, a simple age old classification of Jaundice was to divide it into three predominant types

1. Pre-hepatic (haemolytic)

2. Hepatic

3. Post hepatic cholestatic

"In pre-hepatic and hepatic Jaundice, unconjugated hyperbilirubinaemia occurs. The various causes include excessive red cell destruction, decreased hepatic uptake of bilirubin for dissociation from albumin and cytoplasmic proteins."

Predominant conjugated hyperbilirubinaemianis usually seen in cholestasis .The cholestasis may be due to defect in biliary conaliculi of hepatocyte.

Pathiphysology classification of Jaundice-

Predominantly unconjugated hyperbilirubinaemia

"Increased Bilirubin production ( Haemolytic ,acholuric or prehapetic jaundice )"

• Intra and extravascular haemolysis

• Ineffective erythropoiesis

"Decreased hepatic uptake"

• Drugs

• Prolonged starvation

• Sepsis

"Decreased bilirubin conjugation"

• Hereditary disorders ( E.g. – Gilbert’s syndrome, Crigler-Najjar syndrome )

• Acquired defects ( E.g. –Drugs, Hepatitis, Cirrhosis)

• Neonatal Jaundice

Predominantly conjugated hyperbilirubinaemia (Cholestasis)

"Intrahepatic Cholestasis (Impaired hepatic excretion)"

• Hereditary disorders or Pure Cholestasis ( E.g. – Dubin-Johnson Syndrome, Rotor’s syndrome )

• Acquired disorders or Hepatocellular Cholestasis ( E.g.- Viral hepatitis, Drugs, Alcohol-induced injury, Sepsis, Cirrhosis)

"Extrahepatic Cholestasis (Extrahepatic biliary obstruction)"

• Mechanical Obstruction ( E.g. – Gallstones, Inflammatory strictures, Tumours of bile ducts)

The Diagnosis

• Bilirubin Test - This test measures the amount of the substance in your blood, a complete blood count (CBC). If you have Jaundice your level of bilirubin will be high.

• Imaging studies by the Physician

• Endoscopic studies

• Liver Biopsy

Treatment

• Symptomatic drug therapy

• Surgery

Clinical features

• Yellowish discoloration of the skin and the white of your eyes.

• Dark colored Urine

• Loss of Appetite

• Nausea and Vomiting

Home Remedies for treatment

• Sugarcane

• Tomato juice

• Radish leaves

• Lemon

• Papaya leaves

• Spinach

• Buttermilk

This is some of the information about Jaundice, I want to enlighten you. If you like my above blog ,keeping following it with utmost interest and do not forget to comment if you have some suggestions regarding my future blogs and also hit on some queries if you have any. I will try my level best to clarify them.