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Jaded by jaundice?

The prevention of jaundice, particularly the infective variety, is important, says Dr. UMA KRISHNASWAMY.

Prevention includes having access to clean water.

JAUNDICE is a yellow discolouration of the skin and the eyes, brought about by the accumulation of bilirubin, a by-product formed during the break down of haemoglobin within the red blood cells. Normally, the liver processes this bilirubin and excretes it into the bowel through the bile duct.

The mechanisms by which jaundice can occur are three-fold: an overload of unprocessed bilirubin in the system or an inability of the liver to process bilirubin or a block in the bile duct, preventing the excretion of the processed bilirubin into the bowel.

The causes of jaundice are many and range from the common to the rare, from the serious to the not-so-serious. The most common causes encountered in Indian adults are: Viral Hepatitis (Hepatitis A, B, C), obstruction to bile ducts by gall stones or tumours, alcoholic liver disease and drugs.

The onset of jaundice may be sudden or insidious, mild or severe and often accompanied by symptoms related to the underlying cause of the jaundice. The illness in turn may range from mild to fulminating, threatening life itself.

All instances of jaundice, whether in children or adults, must be evaluated by the doctor to determine the cause and take appropriate action.

This evaluation includes a thorough examination by the doctor along with specific blood tests and other investigations chosen to confirm the suspected cause. E.G.: an ultrasound scan to confirm the presence of gall stones. The range and intensity of investigations will depend on the individual condition and may even necessitate hospital admission.

The treatment of jaundice is two-fold: supportive and specific to address the underlying cause. For instance, all jaundiced patients will be advised rest during the acute phase and a low fat diet. On the other hand, a gallstone blocking the bile duct may require surgical removal. Some varieties of jaundice such as that caused by Hepatitis C virus may benefit from specific drugs called interferons.

In the very mild infective instances of jaundice, home care may be adequate, whereas a fulminant case of jaundice may require intensive care and monitoring. A number of drugs belonging to the Indian, Chinese and European herbal traditions are available in the market. These may have value as supplements to conventional allopathic treatment. E.G. Phyllanthus Amarus is a popular option in South India for viral hepatitis. However, these supplements must be used under proper guidance.

The prevention of jaundice, particularly the infective variety, is important in countries such as India, where the incidence of infection is very high. Some of the general measures include: avoiding unclean food and water, washing hands thoroughly after using the toilet or contact with body fluids.

Specific vaccines may be suggested by the doctor to prevent Hepatitis A and B.

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