What is jaundice?
Jaundice is yellow discoloration of skin and urine.
What is the cause of jaundice?
We must know that all jaundice is not the same. There are multiple causes of jaundice.
It can be infective; which is the commonest one and usually it is viral in origin; it is called as viral hepatitis which means infection in the liver due to viral infection; viral infection also can be from infected water (very common in our country) or it could be due to multiple time use of single needle to give medication. This practice was very common in India. Now it is usually not done but still this practice is prevalent in rural India.
It can be due to stone disease of the gallbladder due to obstruction of the bile duct.
It can be due to obstruction of the bile duct due to cancer growth in the bile duct and pancreas.
It also can be due to abnormality in the liver because of congenital defects.
Most important is the fact that jaundice can also occur in new born babies which also have multiple etiologies.
Jaundice can be due to excessive use of alcohol which kills liver and this jaundice is usually most dangerous and only treatment is liver transplant.
What are the alarming symptoms of jaundice?
Most important initial symptom is disliking food, feeling of nausea, fatigue and weakness. Low grade may be there to start with and later on pattern changes based on the cause behind jaundice. If it is due to obstruction in the bile duct due to stone then fever may be associated with chills and rigor.
Yellow discoloration of the eye; this is the most important initial feature. Most of the time some close one notices yellow discoloration and tells the person about the eye getting yellow.
Yellow discoloration of urine; after that it is associated with yellow discoloration of urine which may go deeper and deeper
Pain in right upper abdomen; third most important feature is pain in the right side of upper abdomen which may tolerable or it may be intense pain if it due to cancer of stone disease
Fever; fever may be low grade or it may be high grade with chills and rigor if it due to stone or cancer
Itching all over the body; jaundice produces itching which is usually all over the body and if it deepens with time then it is alarming. One must go to a physician or surgeon since it may be due to hidden cancer in the bile duct, gallbladder or pancreas.
Loss of appetite and weight; Most important thing everyone should know that once there is jaundice which persists for more than two week and then he or she starts losing weight and appetite decreasing daily; it is alarming, it may be due to cancer it must be investigated.
When to consult a doctor?
It is important to understand that every jaundice needs to be investigated. So once anyone has jaundice rather than going to an unqualified person it is very important to see a qualified doctor and at least liver function test and an USG of the abdomen must be done. No time should be wasted. One simple test of USG of the abdomen is enough to make a diagnosis.
In our country people have different ideas for jaundice and it is a general feeling that all jaundice is the same which is dangerous. Reason behind this feeling is that commonest cause of jaundice is viral infection which recovers on its own in a span of two to three week and people think that Baba has cured jaundice
Is treatment possible?
As explained earlier treatment depends upon cause and if diagnosis is made on time treatment is possible.
The most important message is to see a qualified doctor once anyone develops jaundice; get a proper diagnosis and then treatment according to cause. Again, one must know that all jaundice is not the same and it is most important to make a proper diagnosis
Viral hepatitis; antiviral treatment is available and after making diagnosis medicine can be given depending upon the cause. In rural India we should start using boiled water. One simple precaution can save you from getting infective jaundice. Second would be to see whether your doctor (usually unqualified one) is using disposable syringes or not. If not, don't take an injection from this type of doctor and force him to use a disposable needle. SameÂ with the barber; never allow the barber to reuse blades. Always check whether the blade being used for you is fresh or not.
Stone disease producing jaundice; it is usually stone in GB slipping to CBD or there can be stone in the liver which also is treatable either by endoscopy or by surgery
Cancer producing jaundice; gallbladder cancer, liver cancer, pancreas cancerÂ Â and cancer of the bile duct all can produce jaundice and if that is diagnosed early treatment is possible by surgical removal at a good center. But unfortunately, our people roam around, miss the train and come late so again it is important to seek opinion from a qualified doctor at appropriate time.
Jaundice due to alcohol and drug abuse;
In Punjab alcohol intake is so prevalent that there is need of social awareness program to make people aware of consequences of excessive alcohol and other addictive drugs which kills the liver and jaundice diagnosis is always late and liver transplant is the only treatment so here prevention is better that cure
Jaundice in newborn; almost all new born babies develop jaundice and it subsides in a span of two week but if it persists then it is again advisable to seek opinion and take treatment from a qualified doctor.
Jaundice in pregnancy; jaundice can occur in pregnancy it is autoregressive however one must meet physician and get it checked once
To summarize it canâ€™t be emphasized more that all jaundice is not the same and taking proper advice by a qualified doctor is the must.
Thakur Deen Yadav
Deptt. of Surgical Gastroenterology