Jaundice

Jaundice is a medical condition characterized by yellowing of the skin, mucous membranes, and the whites of the eyes due to an increased level of bilirubin in the blood. Bilirubin is a yellow pigment formed during the breakdown of red blood cells.

Causes of Jaundice

Jaundice is generally classified based on its cause:

1. Pre-Hepatic (Hemolytic) Causes

These occur before bilirubin reaches the liver and are usually due to excessive breakdown of red blood cells, leading to an overwhelming amount of bilirubin. For e.g.

Malaria
Sickle cell anaemia
Haemolytic anaemia
Thalassemia

2. Hepatic Causes

These are due to liver dysfunction or damage, affecting the liver's ability to process bilirubin. For e.g.

Hepatitis (viral, alcoholic, autoimmune)
Cirrhosis
Liver cancer
Fatty liver disease
Gilbert's syndrome (a genetic disorder)

3. Post-Hepatic (Obstructive) Causes

These occur due to obstruction of bile flow from the liver to the intestine.

Gallstones
Pancreatic cancer
Biliary atresia
Strictures or scarring of bile ducts

Common Symptoms of Jaundice

Yellowing of the skin and eyes
Dark-coloured urine (due to increased bilirubin excretion)
Pale stools (indicating bile duct obstruction)
Fatigue and weakness
Itching (pruritus) due to bile salt accumulation
Loss of appetite
Nausea and vomiting

Complications of Jaundice

If left untreated, jaundice can lead to severe complications depending on the underlying cause:

Liver failure
Kidney damage (hepato-renal syndrome)
Chronic hepatitis leading to cirrhosis
Portal hypertension
Increased risk of infections
Neurological damage in new-borns (kernicterus)

Diagnosis of Jaundice

The diagnosis involves clinical examination and laboratory tests:

1. Clinical Examination

Checking for yellowing of the skin and sclera
Palpating the liver for enlargement

2. Laboratory Tests

Bilirubin levels: Total, direct (conjugated), and indirect (unconjugated) bilirubin
Liver function tests (LFTs): ALT, AST, alkaline phosphatase, albumin
Complete blood count (CBC): To detect anaemia or infection
Coagulation profile: To assess liver's synthetic function

3. Imaging Studies

Ultrasound: To detect gallstones or liver abnormalities
CT or MRI scans: For detailed imaging of liver and bile ducts
MRCP (Magnetic Resonance Cholangio-pancreatography): To visualize bile ducts

4. Specialized Tests

Liver biopsy: To assess for cirrhosis or liver cancer
Serology tests: To identify hepatitis viruses
Endoscopic retrograde cholangio-pancreatography (ERCP): To remove blockages in bile ducts

Ayurvedic Perspective of Jaundice (Kamala Roga)

In Ayurveda, jaundice is referred to as Kamala Roga, caused by an imbalance of the Pitta dosha (fire and water element). It often results from excessive heat and toxins (Ama) in the body, disrupting the liver and biliary system.

Types of Kamala (Jaundice)

Koshthashrita Kamala: Involves the liver and digestive tract.
Shakhasrita Kamala: Severe jaundice involving tissues and other organs.
Pittaja Halimaka: A rare, chronic form of jaundice.

Symptoms in Ayurvedic Context

Yellowish discoloration of skin and eyes (Peeta Netra, Peeta Twak)
Loss of appetite (Aruchi)
Bitter taste in the mouth (Tikta Asya)
Pale stools and dark urine (Krishna Mutra)
General fatigue (Daurbalya)

Causes of Jaundice as per Ayurveda

Excessive consumption of hot, spicy, or oily foods
Alcohol abuse
Suppression of natural urges
Mental stress or overexertion
Toxins from infections or medications

Ayurvedic Treatment of Jaundice

1. Detoxification (Shodhana)

Virechana (Purgation Therapy): Removes excess Pitta and toxins.
Basti (Medicated Enema): To balance Vata and eliminate toxins.

2. Herbal Remedies

Kutki (Picrorhiza kurroa):

Improves liver function and detoxification.

Bhumi Amla (Phyllanthus niruri):

Protects liver cells and reduces inflammation.

Guduchi (Tinospora cordifolia):

Enhances immunity and reduces Pitta.

Punarnava (Boerhavia diffusa):

Diuretic and reduces water retention.

Haritaki (Terminalia chebula):

Helps in digestion and detoxification.

3. Diet and Lifestyle Changes

Light, easily digestible food like rice gruel (kanji), barley water, and boiled vegetables.
Avoid oily, spicy, and processed foods.
Stay hydrated with coconut water, sugarcane juice, and herbal teas.
Adequate rest and stress management through yoga and meditation.