Curing Jaundice In Adults

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Jaundice is a condition when the liver is not working properly. When a waste material called bilirubin is built up in the blood, jaundice is said to have occurred.  It causes the skin and sclera to turn yellow because of a high level of bilirubin, a yellow-orange bile pigment. Jaundice has many causes, including hepatitis, gallstones, and tumors. 

Bilirubin forms when hemoglobin is broken down. It binds with bile in the liver and moves into the digestive tract, where it is mostly eliminated in the stool. However, if bilirubin cannot travel through the liver and bile ducts quickly enough, it accumulates in the blood and is deposited in the skin, eyes, and other tissues leading to jaundice.

Causes

Certain adults are more susceptible to jaundice. Some people exhibit no symptoms. For others, signs may include a change in skin colour, flu-like symptoms such as fever and chills, dark urine, clay-coloured stool, itchy skin, and weight loss. Other signs of jaundice in adults include blood in vomit or stool, tarry black stool, extreme abdominal pain and tenderness, sudden drowsiness, agitation, confusion, and easy bruising or bleeding.

Jaundice in adults is usually caused owing to reactions to drugs or underlying disorders that damage the liver, interfere with the flow of bile, or trigger the destruction of red blood cells. Causes of jaundice in adults include but are not limited to reabsorption of a large hematoma, hemolytic anemias, where blood cells are prematurely destroyed and removed from the bloodstream, medications, including acetaminophen, penicillin, oral contraceptives, chlorpromasine, and estrogenic or anabolic steroids, viruses, including hepatitis A, chronic hepatitis B, and C. 

Autoimmune disorders, alcohol overuse leading to hepatitis, rare genetic metabolic defects, and gallstones, inflammation of the gallbladder, gallbladder cancer, pancreatic cancer, and nonalcoholic fatty liver disease from risk factors including diabetes and obesity.  Hereditary disorders that interfere with how the body processes bilirubin, such as Gilbert syndrome and Dubin-Johnson syndrome, can also cause jaundice but is less common.

In adults, the duration of jaundice will depend on the underlying cause and will vary from short-term to unresolvable.  For example, in jaundice that is triggered by an infection, symptoms may get better when the infection subsides. If medication has caused jaundice, it is likely to go away when we stop taking the medicine. Jaundice caused by gallstones will disappear after the gallbladder is removed. But if a person has long-term liver disease, such as chronic hepatitis or untreatable hepatobiliary cancers, jaundice may not improve.

A diet plays a crucial role in the management of jaundice. The liver produces bile that helps in the breakdown of fats. The liver is also responsible for metabolizing digested nutrients, toxins, and medications. The liver has to metabolise any foods or drinks we consume. However, different nutrients and chemicals are metabolised differently, making some more liver-friendly than others.

The amount of work the liver has to do increases when foods are difficult to digest particularly for large amounts of refined sugars, salt, and saturated fats. Toxins, such as alcohol and some medications, can cause damage to liver cells. People with jaundice are usually advised to eat foods and drinks that are liver friendly. Suggestions vary depending on the severity of the case and underlying medical conditions. Moreover, there are certain foods and drinks most people with jaundice are advised to add to their diet.

Foods and drinks to consume during jaundice recovery include water, fresh fruits, and vegetables. Fresh fruits and vegetables contain powerful antioxidants and fiber that can help limit liver damage during metabolism and ease digestion. Liver-friendly fruits and vegetables include grapes, citrus fruits, especially lemons, and limes, papayas and melons, pumpkins, sweet potatoes, yams, avocados and olives, tomatoes, carrots, beets, turnips and broccoli, cauliflower, ginger, and garlic. All fruits and vegetables contain some level of liver-friendly nutrients, but some varieties are more beneficial during jaundice. 

Coffee and herbal teas have been shown to be liver friendly. High amounts of liver-friendly nutrients, including healthy fats, fiber, antioxidants, and minerals are present in whole-grain foods. Nuts and legumes, lean proteins, including tofu, legumes, and fish, put less stress on the liver than red meat. 

Avoidance

Foods and drinks to avoid or limit during jaundice recovery include alcohol, refined carbohydrates such as soda, baked goods, white bread, and pasta all containing high amounts of refined sugar. Too much sugar has been linked to health conditions such as type 2 diabetes and obesity that impair liver function. Packaged, canned, and smoked foods and some dairy products contain high levels of saturated fat and should be avoided. 

Many packaged, canned, or smoked foods, especially meats and canned vegetables, contain high levels of preservatives. Fried, oily, and fast foods contain high amounts of saturated and trans fats are suggested to avoid. Some dairy products, including cheeses, whole milk, and full-fat yogurts, also contain high levels of saturated fat and are suggested to avoid. Rich meats, such as pork, contain high levels of animal amino acids and fats that can be difficult to digest and put a strain on a damaged liver. 

Lean meats, such as poultry and fish, as well as plant-based proteins, such as legumes and tofu, are more liver-friendly. The take-home message is to consult a liver specialist (Hepatologist) when jaundice is suspected in order to find out the underlying cause of jaundice and the appropriate diet.


(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. lohanis@gmail.com)

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