OVERVIEW
Jaundice is a term used to describe a yellowish discoloration to the skin and the sclera. Body fluids and tissues may also be yellow. Earlier Jaundice was called as the “Morbus regius” (the regal disease) in the belief that only the touch of a king could cure it.
The color of the skin and sclera will vary depending on the levels of bilirubin. Bilirubin is developed by the breakdown of red blood cells in the body which is excreted through the liver. Elevated bilirubin levels lead to jaundice. Also, any condition that disrupts the movement of bilirubin from the blood to the liver and out of the body results in jaundice.

Causes
Jaundice is classified into three categories, depending on the pathology. They are,
 Pre-hepatic jaundice
 Hepatocellular jaundice
 Post-hepatic jaundice

Pre-hepatic jaundice: Pre-hepatic jaundice is caused due to the increased rate of haemolysis (breakdown of RBCs). Causes of haemolysis include:
 Malaria
 Sickle cell anemia
 Thalassemia
 Gilbert syndrome

Hepatocellular jaundice: Hepatocellular jaundice happens as a result of any infection in the liver. It may be due to infection or exposure to a harmful substance, such as alcohol, thereby disrupts the liver’s ability to process bilirubin.

Post-hepatic jaundice: Post-hepatic jaundice, is commonly known as obstructive jaundice, is caused by a blockage to the drainage of bile in the biliary system. The most common reasons are due to gallstones in the common bile duct or due to pancreatic cancer. Other medical conditions include:
• Acute inflammation of the liver – May impair the ability of the liver to conjugate and secrete bilirubin, resulting in a buildup of bilirubin.
• Inflammation of the bile duct – May prevent the secretion of bile and removal of bilirubin, causing jaundice.
• Obstruction of the bile duct – Prevents the liver from disposing of bilirubin, which results in hyperbilirubinemia.
• Hemolytic anemia – Production of bilirubin increases when large quantities of erythrocytes are broken down.
• Gilbert’s syndrome – An inherited condition that impairs the ability of enzymes (biomolecules that provoke chemical reactions between substances) to process the excretion of bile.
• Cholestasis- A condition in which the flow of bile from the liver is interrupted. The bile containing conjugated bilirubin remains in the liver instead of being excreted.

Tests and diagnosis
A blood test is suggested to determine the total amount of bilirubin in the body. The urine test can be carried out to measure levels of a substance called urobilinogen
Other diagnostic tests including liver function tests, complete blood count (CBC), imaging studies, which may include abdominal ultrasounds or CT scans and liver biopsies can be carried out.

Symptoms
• The color of the skin and sclera changes to yellow. In more severe cases, eyes may turn brown or orange.
• Pale-colored stools
• Dark yellow-colored urine
• Skin itching
• Nausea and vomiting
• Rectal bleeding in some cases
• Diarrhea
• Fever and chills
• Weakness
• Weight loss
• Loss of appetite
• Confusion
• Abdominal pain
• Headache
• Swelling of the legs
• Swelling and distension of the abdomen due to the accumulation of fluid (ascites)

DIET
At least eight glasses of water should be taken which flush the harmful waste products of liver.
Foods to Avoid
• Never touch any food which is oily. Jaundice affects your liver. It will load more works to liver. During jaundice the liver will be very weak and it will be no longer able to digest oily, fat foods.
• Avoid spicy, hot and fried food items. Don’t take junk food.
• Alcohol, coffee and tea should be avoided
• Do not take non-vegetarian food since it requires time for the body to digest it and further slows the digestion.
• Avoid pulses and legumes in the diet until the symptoms reduces.