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Jaundice Overview
Jaundice is not a disease but rather a sign that can occur in many different diseases. It is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes caused by increased amounts of bilirubin in the blood. Jaundice is a sign of an underlying disease process. Bilirubin is a by-product of the daily natural breakdown and destruction of red blood cells in the body. Normally, the liver metabolizes and excretes the bilirubin in the form of bile. However, if there is a disruption in this normal metabolism and/or production of bilirubin it causes hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids causing jaundice.
What is neonatal jaundice (jaundice in newborn babies)? Top
Neonatal jaundice is jaundice that begins within the first few days after birth (Jaundice that is present at the time of birth suggests a more serious cause of the jaundice) it is usually harmless In fact, bilirubin levels in the blood become elevated in almost all infants during the first few days following birth, and jaundice occurs in more than half this condition is often seen in infants around the second day after birth, lasting until day 8 in normal births, or to around day 14 in premature births. For all but a few infants, the elevation and jaundice represents a normal physiological phenomenon and does not cause problems.

Serum bilirubin normally drops to a low level without any intervention required: the jaundice is presumably a consequence of metabolic and physiological adjustments after birth. When an infant is born, the infant's body begins to rapidly destroy the red blood cells containing the fetal-type hemoglobin and replaces them with red blood cells containing the adult-type hemoglobin. This floods the liver with bilirubin derived from the fetal hemoglobin from the destroyed red blood cells. The liver in a newborn infant is not mature, and its ability to process and eliminate bilirubin is limited. As a result of both the influx of large amounts of bilirubin and the immaturity of the liver, bilirubin accumulates in the blood. Within two or three weeks, the destruction of red blood cells ends, the liver matures, and the bilirubin levels return to normal.
What are the causes of Jaundice? Top
Jaundice can be classified into three categories on the bases of its cause. 1) Pre-Hepatic: Too much bilirubin being produced for the liver to remove from the blood
2) Hepatic: A defect in the liver that prevents bilirubin from being removed from the blood.
3) Post-Hepatic: Blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines.
Pre-hepatic (before bile is made in the liver)
Jaundice in these cases is caused by rapid increase in the breakdown and destruction of the red blood cells (hemolysis), overwhelming the liver's ability to adequately remove the increased levels of bilirubin from the blood. Examples of conditions with increased breakdown of red blood cells include:
  • Malaria,
  • Sickle cell crisis,
  • Spherocytosis,
  • Thalassemia,
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD),
  • Drugs or other toxins, and
  • Autoimmune disorders.
Hepatic (the problem arises within the liver)
Jaundice in these cases is caused by the liver's inability to properly metabolize and excrete bilirubin. Examples include:
  • Hepatitis (commonly viral or alcohol related),
  • Cirrhosis,
  • Drugs or other toxins,
  • Crigler-Najjar syndrome,
  • Gilbert's syndrome, and
  • Cancer.
Post-hepatic (after bile has been made in the liver)
Jaundice in these cases, also termed obstructive jaundice, is caused by conditions, which interrupt the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.
Causes of obstructive jaundice include:
  • Gallstones in the bile ducts,
  • Cancer (pancreatic and gallbladder/bile duct carcinoma),
  • Strictures of the bile ducts,
  • Cholangitis,
  • Congenital malformations,
  • Pancreatitis,
  • Parasites,
  • Pregnancy, and
What are the Causes of newborn jaundice? Top
  • Jaundice in newborn babies can be caused by several different conditions, although it is often a normal physiological consequence of the newborn's immature liver. Newborn jaundice is the most common condition requiring medical evaluation in newborns.
The following are some common causes of newborn jaundice:
Physiological jaundice
  • This form of jaundice is usually evident on the second or third day of life. It is the most common cause of newborn jaundice and is usually a transient and harmless condition. Jaundice is caused by the inability of the newborn's immature liver to process bilirubin from the accelerated breakdown of red blood cells that occurs at this age. As the newborn's liver matures, the jaundice eventually disappears.
Maternal-fetal blood group incompatibility (Rh, ABO)
  • This form of jaundice occurs when there is incompatibility between the blood types of the mother and the fetus. This leads to increased bilirubin levels from the breakdown of the fetus' red blood cells (hemolysis).
Breast milk jaundice
  • This form of jaundice occurs in breastfed newborns and usually appears at the end of the first week of life. Certain chemicals in breast milk are thought to be responsible. It is usually a harmless condition that resolves spontaneously. Mothers typically do not have to discontinue breastfeeding.
Breastfeeding jaundice
  • This form of jaundice occurs when the breastfed newborn does not receive adequate breast milk intake. This may occur because of delayed or insufficient milk production by the mother or because of poor feeding by the newborn. This inadequate intake results in dehydration and fewer bowel movements for the newborn, with subsequent decreased bilirubin excretion from the body.
How are jaundice and its causative factors diagnosed? Top
The health care practitioner will need to take a detailed history of the patient's illness, and he or she will also be examined to see if there are any findings that indicate the cause of the patient's jaundice. However, additional testing is usually required to clearly determine the underlying cause of jaundice. The following tests and imaging studies may be obtained:
Blood tests
These may initially include a complete blood count (CBC), liver function tests (including a bilirubin level), lipase/amylase level to detect inflammation of the pancreas (pancreatitis), and an electrolytes panel. In women, a pregnancy test may be obtained. Additional blood tests may be required depending upon the initial results and the history provided to the practitioner. Urinalysis: Urinalysis is an analysis of the urine and is a very useful test in the diagnosis of screening many diseases.
  • Ultrasound
  • Liver Biopsy: a liver biopsy can be useful for diagnosing inflammation of the liver, cirrhosis, and cancer.
What is the role of Homoeopathy in Hyperthyroidism? Top
Jaundice as described in the article above can have multifactor ail causes. Homoeopathy follows an individualistic approach towards patients suffering from jaundice, we believe that every individual is different and thus a full in-depth case study is the first step so as to diagnose the cause. Then referring to the risk factors the individual was subjected too, a particular line of treatment is adopted.
The response to treatment can differ from one individual to another depending upon the cause. Patients are advised to consult so that the mode of treatment can be discussed pertaining to their particular case.
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