Jaundice Ayurvedic Treatment aims to cure the disease and rejuvenate the organs affected. The name jaundice came from the French word Jaune meaning yellow. Jaundice or icterus is a term used to describe yellowish discoloration of the skin, mucous membrane, body fluids, and sclera of the eye. It happens due to the increased amount of bilirubin in blood & body fluids and the colour may vary from yellow to brown. Though the term is familiar as Neonatal jaundice, which affects newborn babies, the disease can affect people of all ages. It is usually an indicator of an underlying issue like diseases of the liver, obstruction in the bile duct or an infection. Jaundice occurs when there is a derangement in the metabolism or excretion of bilirubin. Thus, jaundice itself is not only a disease but an indicator of an underlying issue.
Signs & symptoms
Yellowish tinge to the skin, mucous membranes, body fluids and sclera.
Pale stools.
Dark or yellow coloured urine.
Itching of the skin, partial or all over the body.
Fatigue & weakness
Abdominal pain
Weight loss
Nausea& Vomiting
Fever & chills.
Loss of appetite.
Diarrhoea & rectal bleeding.
Headache.
Confusion.
Swelling in the extremities.
Swelling in the abdomen.
Causes
It can be divided into three based on where the disruption/dysfunction occurs.
- Pre-hepatic or haemolytic
Haemolytic anaemia/Jaundice can happen due to diseases like:
Sickle cell anaemia
Glucose-6-phosphate dehydrogenase deficiency (G6PD)
Hereditary spherocytosis
Malaria
Thalassemia
Some drugs or toxins,
and
Autoimmune disorders.
- Hepatic
Conditions with a hepatic cause of jaundice include:
Acute or chronic hepatitis (commonly viral Hepatitis A, B, C, D, E] or alcohol-related)
Liver cirrhosis (caused by various conditions including alcohol toxicity)
Drugs or other toxins
Crigler-Najjar syndrome
Autoimmune disorders
Gilbert’s syndrome
Carcinoma of liver
- Post hepatic
Conditions that can cause post-hepatic jaundice include
Cholecystitis
Carcinoma of the pancreas, gall bladder or bile duct
Stricture of the bile ducts
Cholangitis
Pancreatitis
Certain worms/parasites like liver flukes
Pathophysiology
Jaundice in adults is caused by various medical conditions that affect the normal metabolism or excretion of bilirubin. Bilirubin is normally formed from the daily breakdown and destruction of red blood cells in the bloodstream, which release haemoglobin as they rupture. The haeme portion of this haemoglobin molecule is then converted into bilirubin, which is transported in the bloodstream to the liver for further metabolism and excretion. In the liver, the bilirubin is conjugated and made more water-soluble, it is excreted into the gallbladder for storage and then eventually passed into the intestines, where a portion of the bilirubin is excreted in the faeces, while some are metabolized by the intestinal bacteria and excreted in the urine.
Jaundice with a pre-hepatic cause is due to the excessive destruction (haemolysis) of red blood cells. This causes a quick rise in bilirubin levels in the bloodstream which disturbs the liver’s capability to metabolize the bilirubin, and consequently the levels of unconjugated bilirubin increase.
Jaundice caused during the hepatic phase can arise from abnormalities in the metabolism and/or excretion of bilirubin. This can lead to an increase in both unconjugated and/or conjugated bilirubin levels. Jaundice caused during the hepatic phase can arise from abnormalities in the metabolism and/or excretion of bilirubin. This can lead to an increase in both unconjugated and/or conjugated bilirubin levels.
Jaundice from a post-hepatic cause arises from an obstruction in the normal drainage and excretion of conjugated bilirubin in the form of bile from the liver into the intestine. This leads to increased levels of conjugated bilirubin in the bloodstream. Jaundice from a post-hepatic cause arises from an obstruction in the normal drainage and excretion of conjugated bilirubin in the form of bile from the liver into the intestine. This leads to increased levels of conjugated bilirubin in the bloodstream.
Diagnosis
Diagnosis includes history taking, physical examination and laboratory tests.
All of them together will determine the cause of jaundice.
Blood tests to be done are,
Liver function tests
Total count or Complete blood count
Lipase levels
Blood tests for various Hepatitis infections
Depending on the results of initial blood tests, further studies may be needed to help diagnose the underlying disease. In certain cases, imaging studies like
- Abdominal ultrasound
- CT scan
- MRI
- Cholescintigraphy (HIDA scan)
are taken to confirm the diagnosis.At times, further invasive tests like endoscopic retrograde cholangiopancreatography (ERCP) or a liver biopsy will be needed to determine the cause of jaundice.
Treatments
The treatment is decided according to the cause of jaundice and severity. Some patients will require hospitalization, whereas others can be managed as outpatients at home.
- Mild viral hepatitis can be managed at home with care and rest.
- Hepatitis C can be cured with medications now.
- Alcohol consumption should be stopped.
- Jaundice caused by drugs/medications/toxins requires discontinuation of the same. In cases of intentional or unintentional acetaminophen overdose, the antidote N-acetylcysteine is required.
- Several medicines are used to treat jaundice, such as steroids in the treatment of jaundice due to some autoimmune disorders. Certain patients with cirrhosis will need diuretics and lactulose.
- Antibiotics are required for infectious jaundice or the complications associated with certain conditions leading to jaundice (for example, cholangitis).
- Blood transfusions may be required in individuals with severe anaemia from haemolysis or as a result of bleeding.
- Individuals with carcinoma leading to jaundice will require consultation with an oncologist, and the treatment will vary depending on the type and extent of the disease.
- Surgery and various invasive procedures like cholecystectomy or liver transplant may be required in rare cases of jaundice.
Prognosis
The prognosis of jaundice solely depends upon the cause or underlying condition. Some jaundice patients recover so well that they indicate an excellent prognosis whereas some severe cases can be fatal despite medicines and surgical invasion. The development and severity of complications will also determine an individual’s prognosis, as well as underlying comorbidities (other diseases present). Therefore, a case-by-case assessment is necessary to determine a more accurate prognosis. Some persons recover fully without any complications whereas some people carry a lifelong set of complications after a jaundice attack. It depends upon the general health of the person and the cause leading to jaundice.
Complications
A few of the potential complications include:
- Electrolyte imbalance
- Anaemia
- Bleeding disorders
- Sepsis
- Chronic hepatitis
- Cancer
- Liver failure
- Kidney failure
- Hepatic encephalopathy (brain dysfunction)
- Death
Disease & Ayurveda
Jaundice – Kaamala
Nidana
Excessive intake of ruksha(dry), Shita(cold), Guru (heavy to digest), and madhura(sweet) food items
Excessive intake of Paittika ahara & vihara by Pandurogi or a person with aggravated Pitta
Excessive exercise & physical exertion
Holding natural urges like urine, faeces etc.
Purvaaroopa
General poorvarupa mentioned under Pandu applied to kamala are;
Twacha: sphotanam-cracking of skin
Sthivanam-excess spitting
Gatrasada-Weakness of body
Mridbhakashana-tendency to eat soil/pica
Prekshanakootsotha-swelling of eyelids
Pitamutra&vit- Yellow urine and stools
Avipaaka-indigestion
Nissaara-decrease built&strength
Alparakta – Anaemia
Alpamedasa – Decrease in the fatty layer of skin and internal organs
Gatravaivarnya – discolouration of body
Sithilendriya – Malfunctioned sense organs
Samprapti
Due to the nidanas, Vaata & Kapha prakopa
Vitiated Vaata & Kaha circulates through Pittavahasrotas
Avarodha of Pittavahasrotas by vitiated Kapha
Margavarodha of Pitta
Pitta starts to get accumulated in the liver, causing yellow discolouration of eyes, skin, nails etc.
Lakshana
Haridranetyra twak, netra, moothra- Yellow skin, eyes and urine
Swetavarchas -Pale stools
Tilapishttanibhavarchas – Stools like ground sesame paste
Atopa – Gurgling sounds in the abdomen
Vishtambha – Stiffness and dullness in the abdomen along with fullness.
Hrudayaguruta – Heaviness in chest
Daurbalya – Fatigue
Alpagni – Low appetite and digestive power
Parshva arti – Pain in flanks
Aruchi – Anorexia
Jwara – Fever
Arati(restlessness)
Tandra(giddiness)
Balakshaya(loss of strength)
Along with the symptoms of Paandu
Divisions
- Koshthasrita kamala
- Saakhasritakaamala
- Kumbhakaamala
Prognosis
Sukhasadhya – With minimal nidana, poorvaroopa and roopa
Asadhya – When the disease is chronic and presented with complications like krishna-peeta malamutra, chardi, raktavid-mutra etc.
Chikithsa
Samana
Vaatakaphasamana
Pittahara
Yakridudwejaka(Liver stimulant)
Agnideepana (Digestive)
Rechana (Laxative)
Rakta-shodhana (Blood purifying)
Jwarahara (Anti-pyretic)
Sothahara (Anti-oedematous)
Sodhana
Snehana with tiktarasadravyas
Mrduvirechana
Daahakarma
Commonly used medicines
Patolakadurohinyadi Kashayam
Avipathi Churna
Mandoora Vatakam
Punarnavamandooram
Phalatrikadi kwatham
Arogyavardhini Ras
Brands available
AVS Kottakal
Vaidyaratnam Oushadhasala
SNA oushadhasala
AVP Coimbatore
Home remedies
Diet
- To be avoided
Salt and oil as a part of the diet.
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase Kapha and cause respiratory problems
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Quit alcohol/smoking/narcotics.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid day sleep.
Yoga
Vigorous exercises are not allowed in jaundice.
Only stretching, moderate walking, and mild cardio exercises are advised. Also, specific yogacharya including Ardhamathsyentrasana, Dhanurasana, Gomukhasna and naukasana is recommended. Physical strength, Blood pressure, Haemoglobin level, Range of movement and flexibility must be considered while doing every exercise.
Sookshma sandhi vyayama (warming up small joints) is advised.
Regular exercise helps improve the bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Ardhamathsyentrasana
Dhanurasana
gomukasana
Naukasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/28145671/
https://pubmed.ncbi.nlm.nih.gov/14515028/
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