Diseases

Learn more about diseases and integrative cure for illnesses.......A Sakalya Ayurveda Approach

JAUNDICE

JAUNDICE-KAAMALA

yellow staining of skin, urine, sclerae, raised bilirubin, liver damage

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Jaundice also known as Icterus, is a liver disorder which produces a yellowish or greenish pigmentation of skin and sclera of eyes associated with high bilirubin level. Jaundice affecting babies within first week after birth is considered to be physiological and negligible clinical condition, only if bilirubin level is very high for too long may lead to Kernicterus.

Cause

Jaundice is a clinical condition in which the bilirubin level becomes high. It may vary from non-serious to fatal. There are two varieties namely; Conjugated (Indirect) and Unconjugated (Direct) Bilirubin.

High unconjugated bilirubin is due to excess red blood cell (RBC) breakdown or due to genetic factor as in Gilbert’s syndrome, starvation, new born jaundice or thyroid problems.

High conjugated bilirubin is due to other liver disorders such as cirrhosis or hepatitis, viral infections, medication or bile duct blockage.

Pre-hepatic jaundice is a condition in which increased unconjugated bilirubin formed from increased breakdown of RBC caused by severe malaria, sickle cell anaemia, thalassemia etc.

Hepatic jaundice is caused by acute or chronic jaundice, heoatotoxicity, cirrhosis, alcoholic liver disease.

 

 

Pathophysiology

Jaundice is rather a sign of many underlying pathological processes occurring in the metabolic pathway of bilirubin. When RBC reaches its life span expectancy, the cell membrane rupture while passing through the reticuloendothelial system and the cellular content Haemoglobin is phagocytosed. Then produced haeme molecule is oxidized to form biliverdin. Again the biliverdin undergoes reduction to form yellow colour pigment, Bilirubin. This bilirubin is unconjugated or free or direct as it is water non-soluble. Approximately 4mg bilirubin per kg of blood is produced daily from body. The unconjugated bilirubin then travels to the liver through blood stream and get conjugated with glucoronic acid to become more water soluble. The conjugated bilirubin is now released into the biliary duct as part of bile. Intestinal bacteria convert the bilirubin into urobilinogen. Urobilinogen is either oxidized to stercobilin and passed out through faeces or oxidized to urobilin and passed through urine; thus imparting a yellowish colour.

According to part of metabolic pathway affected the jaundice is categorized into three: Pre-hepatic (Haemolytic), Hepatic (Hepatocellular) and Post Hepatic (Cholestatic).

Signs & symptoms

Yellowish discolouration of skin and sclera are the significant characterized jaundice. Faeces become pale and urine becomes dark. It is commonly associated with itchiness.

In Pre-hepatic jaundice, serum unconjugated bilirubin  and urobilnogen is high but urine bilirubin is absent.

In Hepatic jaundice, due to cell necrosis unconjugated bilirubin increase and conjugated bilirubin abnormally increased in blood. Urine urobilinogen is absent and conjugated bilirubin is present in high quantity and hence imparts urine a dark colour.

 

Complication

Severity may lead to CNS involvement as bilirubin may deposit in the grey matter of brain causing a irreversible neurological damage known as Kernicterus.

Ayurveda Treatment for Jaundice

The treatment is started with excluding emergency cases.

Strict diet regime and internal medicines are needed to start at the earliest.