Jaundice is a yellow discoloration of the skin and membranes, often most visible in the whites of the eye which become yellow. This is due to a pigment called bilirubin which is made in the liver. Bilirubin is a waste product that’s produced during the normal breakdown of red blood cells. The liver combines bilirubin with bile and it is released into the digestive system and passed out of the body in urine or stools. It is bilirubin that gives urine its light yellow colour and stools their dark brown colour. In certain instances, levels of bilirubin in the blood rise or the normal passage of bilirubin is blocked and it accumulates in the body, causing jaundice.
Jaundice can occur as a result of any condition or disorder that disrupts the functions of the liver, such as sickle cell anaemia, Gilbert’s syndrome or cirrhosis.
It’s very common for newborn babies to be born with the symptoms of jaundice. Newborn jaundice tends not to be a cause for concern. It usually resolves within two weeks without treatment. However, there are instances when there can be complications.
Caution: If you exhibit any of the symptoms of jaundice, seek prompt medical attention, including having blood tests. Other tests may also be needed, such as liver biopsy or ultrasound scanning of the liver.
There are different types of jaundice and these are classified by the point at which disruption to the normal removal of bilirubin from the body occurs.
The three main types are:
- Pre-hepatic jaundice – the disruption occurs before the bilirubin has been transported from the blood to the liver. Most cases of pre-hepatic jaundice are the result of conditions that cause the red blood cells to break down too rapidly, such as malaria or sickle cell anaemia (a genetic blood disorder).
- Intra-hepatic jaundice (also known as hepatocellular jaundice) – the disruption occurs inside the liver. Common causes are conditions that affect the liver, such as alcoholic cirrhosis or hepatitis C. People who are obese can also develop cirrhosis as a result of a build-up of fat inside their liver. This type of liver damage is known as non-alcoholic fatty liver disease.
- Post-hepatic jaundice (also known as obstructive jaundice) – the disruption prevents the bile (and the bilirubin inside it) from draining out of the gallbladder and into the digestive system. A common cause of post-hepatic jaundice is gallstones, which create a blockage in the bile duct system.
Due to the associated risk factors, intra-hepatic and post-hepatic jaundice are more common in middle-aged and elderly people than the young. Pre-hepatic jaundice can affect people of all ages, including children.
The most common symptoms of jaundice are:
- yellowing of the skin, eyes and mucus membrane (the cell lining of the body’s passageways and cavities, such as the mouth and nose)
- pale coloured stools (faeces)
- dark coloured urine
Depending on the underlying cause of your jaundice, you may have a number of additional symptoms.
In cases where jaundice is the result of an infection, such as hepatitis C, you may have symptoms such as:
- a high temperature (fever) of 38ºC (100.4ºF) or above
- abdominal pain
- flu-like symptoms, such as muscle and joint pain
In cases where jaundice is caused by damage to the liver, such as cirrhosis, common additional symptoms include:
- unexplained weight loss
- itchy skin
In cases of post-hepatic jaundice (where an obstruction, such as a gallstone, is preventing bile from draining out of the gallbladder) common additional symptoms include:
- upper abdominal pain
- high temperature
Jaundice in Babies
Jaundice is a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of their eyes. (The medical term for this condition is neonatal jaundice.)
Other possible symptoms include:
- dark urine
- pale coloured stools (faeces) instead of bright yellow or orange coloured stools
Symptoms usually develop 2-3 days after birth.
Your baby will usually be checked for jaundice 72 hours after their birth by a midwife or health visitor. However, if your baby develops jaundice after this time contact your licensed health practitioner for advice. While jaundice is not usually a cause for concern it is important to get it checked to see if it needs treating.
Most cases of jaundice in babies do not require treatment as the symptoms normally pass within 10-14 days (although in a minority of cases symptoms can last longer).
Treatment is usually only recommended if tests show a baby has very high levels of bilirubin in their blood (this is known as significant hyperbilirubinaemia). This is because there is a small risk that the bilirubin could pass into the brain and cause brain damage.
There are a number of very effective treatments used to quickly reduce bilirubin levels, including phototherapy – a special type of light that shines on the skin which breaks down bilirubin.
Most babies respond well to treatment and can leave hospital after a few days.
However, sometimes there can be complications.
Excessively high levels of bilirubin cause permanent brain damage. This is known as kernicterus and is rare, affecting less than 1 in every 100,000 births. There were only 7 reported cases of kernicterus in England during 2011.
Kernicterus tends only to be a significant problem in countries with limited access to medical care.
Kernicterus is a rare but serious complication of untreated jaundice in babies caused by excess bilirubin damaging the brain or central nervous system.
In newborn babies with very high levels of bilirubin in the blood (hyperbilirubinaemia), the bilirubin can cross the thin layer of tissue that separates the brain and the blood (the blood-brain barrier).
The bilirubin can damage the brain and spinal cord which can be life threatening.
Brain damage caused by high levels of bilirubin is also called bilirubin encephalopathy.
Your baby may be at risk of developing kernicterus if:
- they have a very high level of bilirubin in their blood
- the level of bilirubin in their blood is rising rapidly
- they do not receive any treatment
Kernicterus is now extremely rare in England affecting less than 1 in a 100,000 babies.
Initial symptoms of kernicterus in babies include:
- decreased awareness in the world around them – for example they may not make any reaction when you clap your hands in front of their face
- their muscles become unusually floppy like a rag doll – this is known as hypotonia
- poor feeding
As kernicterus progresses additional symptoms can include:
- seizures (fits)
- they begin arching their neck or their spine back, or in some cases, both
Treatment for kernicterus involves using an exchange transfusion as used in the treatment of newborn jaundice.
Although if significant brain damage has occurred a child can often develop long-term symptoms that will persist throughout their lifetime, such as:
- cerebral palsy (a condition that affects the brain and nervous system) that causes both increased and decreased muscle tone, and affects your baby’s movement and coordination
- hearing loss – which can range from mild to severe
- learning difficulties – though this tends to be only mild to moderate
- involuntary twitching of different parts of their body
- problems maintaining normal eye movements; people affected by kernicterus have a tendency to gaze upwards or from side to side rather than straight ahead
- the normal development of the teeth can be disrupted resulting in teeth that are misshapen, discoloured and vulnerable to tooth decay.
Jaundice is caused by a build-up of a substance called bilirubin in the blood and tissues of the body.
Bilirubin is a waste product that’s produced when red blood cells break down. Human blood cells have a lifespan of 120 days, after which they’re broken down and replaced with new cells.
The bilirubin is transported in the bloodstream to the liver where specialised cells help to combine it with digestive fluid called bile. Bile is stored in the gall bladder and is released into the digestive system through a series of tubes known as the bile duct system or biliary system.
The bile (and bilirubin contained with it) is converted by bacteria inside the digestive system into a substance called urobilinogen, which is passed out of the body in urine (in very small quantities) or in stools. It is bilirubin that gives urine its light yellow colour and stools their dark brown colour.
Jaundice can occur as a result of any condition, problem or underlying factor that disrupts the movement of bilirubin from the blood to the liver and then out of the body.
Pre-hepatic jaundice occurs when a condition or infection speeds up the breakdown of red blood cells. This results in an increase in bilirubin levels in the blood and triggers the symptoms of jaundice.
Causes of pre-hepatic jaundice include:
- malaria – a blood-borne infection spread by mosquitoes and common in tropical areas of the world
- sickle cell anaemia – a genetic condition that causes red blood cells to develop abnormally; sickle cell anaemia is most common among black Caribbean, black African and black British people
- thalassaemia – a similar genetic condition to sickle cell anaemia in that it affects the production of red blood cells; thalassaemia is most common in people of Mediterranean, Middle Eastern and, in particular, South Asian, descent
- Gilbert’s syndrome – a common genetic condition where the transportation of bilirubin from the blood to the liver is slower than it should be, leading to a build-up of bilirubin in the blood
- Crigler-Najjar syndrome – a rare genetic condition where an enzyme that’s need to help move bilirubin out of the blood and into the liver is missing
- hereditary spherocytosis – an uncommon genetic condition that causes red blood cells to have a much shorter life-span than normal
Intra-hepatic jaundice occurs when damage to the liver, either as the result of infection or exposure to a harmful substance, such as alcohol, disrupts the liver’s ability to process bilirubin.
Causes of intra-hepatic jaundice include:
- the viral hepatitis group of infections – hepatitis A, hepatitis B and hepatitis C
- alcoholic liver disease – where the liver is damaged as a result of alcohol misuse
- leptospirosis – a bacterial infection that’s spread by animals, particularly rats; it’s common in tropical areas of the world and uncommon in the UK
- glandular fever – a viral infection that’s caused by the Epstein-Barr virus
- drug misuse – two leading causes are the recreational drug, ecstasy, and overdoses of the painkiller, paracetamol
- primary biliary cirrhosis – a rare and poorly understood condition that causes progressive liver damage
- liver cancer – a rare and usually incurable cancer that develops inside the liver
- exposure to substances that are known to be harmful to the liver, such as phenol (a compound used in the manufacture of plastic) or carbon tetrachloride (a compound that was widely used in the past in processes such as refrigeration, although now its use is strictly controlled)
- autoimmune hepatitis – a rare condition where the immune system (the body’s natural defence against infection and illness) starts to attack the liver
- primary sclerosing cholangitis – a rare type of liver disease that causes chronic (long-lasting) inflammation of the liver
- Dubin-Johnson syndrome – a rare genetic condition where the liver is unable to combine bilirubin with bile and move it out of the liver
Post-hepatic jaundice is triggered when the bile duct system is damaged, inflamed or obstructed, which results in the gallbladder being unable to move bile into the digestive system
Causes of post-hepatic jaundice include:
- gallstones obstructing the bile duct system
- pancreatic cancer – an uncommon type of cancer that develops inside the pancreas (a gland that helps with the digestion of food)
- gallbladder cancer or bile duct cancer, which are both relatively rare types of cancer
- pancreatitis – inflammation of the pancreas, which can either be acute pancreatitis (the inflammation only lasts for a few days) or chronic pancreatitis (the inflammation lasts for many years)
Causes of jaundice in newborn babies:
There are three main reasons why jaundice is common in new born babies:
- newborn babies have a greater number of red blood cells than adults
- the red blood cells in babies have a shorter lifespan than those found in adults, so they need to be broken down and replaced at a faster rate
- the process to break down and excrete the bilirubin is slower than it is in adults
By the time a baby is two weeks old, they are producing less bilirubin and their liver is more effective at removing it from the body which means the jaundice usually corrects itself without causing harm.
Breastfeeding your baby makes it more likely they will develop jaundice; which tends to last longer than in bottle-fed babies.
The reasons for this are unclear. A number of theories have been suggested, such as:
- when you first start breastfeeding it can be hard to provide all the nutrients your baby requires so they are not getting nutrients and fluids necessary to help their body break down and excrete bilirubin; this tends to only be a short-term issue
- breastfeeding may somehow cause the bilirubin in the intestines (part of the digestive system) to be re-absorbed back into the blood, instead of being passed out
- it is also possible that breast milk contains an unidentified, but harmless, substance that causes jaundice in newborn babies
If you are breastfeeding your baby, continue to do so even if your baby has symptoms of jaundice as they will pass in time. Benefits of breastfeeding outweigh any potential risks associated with jaundice. You may wish to discuss this further with your licensed health practitioner or midwife.
Your baby is more likely to need treatment for high levels of bilirubin in their blood if:
- they were born before the 38th week of your pregnancy
- you have another child that needed treatment for jaundice
- you intend to only breastfeed your baby (not bottle-feed as well)
- they develop jaundice within 24 hours of being born
There is also some evidence that babies with a low birth weight (less than 2 and a half kilos or 5.5 pounds) are more likely to need treatment for jaundice.
In some cases, jaundice may have an alternative cause. Some of these are described below.
- An underactive thyroid gland (hypothyroidism).
- Blood group incompatibility, when the mother and baby have different blood types, and these are mixed during the pregnancy or the birth.
- Rhesus factor disease, a condition that can occur if the mother has rhesus-negative blood, and the baby has rhesus-positive blood.
- An inherited enzyme deficiency (enzymes are proteins that speed up and control chemical reactions in the body), such as a deficiency of glucose-6-phosphate-dehydrogenase (G-6-PD), an enzyme that helps red blood cells function.
- The baby experiences bleeding in and around the skull (cephalohaematoma) due to a difficult delivery – this condition is not usually serious.
- The mother of the baby has diabetes.
- The baby has a urinary tract infection (an infection, usually bacterial, that develops inside any part of the body used to pass urine, such as the bladder)
- Crigler-Najjar syndrome, an inherited condition that adversely affects the enzyme responsible for processing bilirubin, leading to an excess build up of bilirubin.
- An obstruction or defect in the biliary system. The biliary system is made up of the bile ducts and gall bladder, and it creates and transports bile (a fluid used to help digest fatty foods).
As with all diseases this did not happen overnight. The very first thing you must do is see a licensed health professional. Find a list of practitioners in your local area here
Here are some things you can discuss with your practitioner:
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Constitutional hydrotherapy is recommended. (Apply daily.) Try foot and hand baths with a handful each of celandine leaves, artichoke leaves, dog’s tooth roots and a handful each of chicory leaves and dandelion flowers in two quarts water.
- We recommend regular colonics to remove toxicity from the body. Read more about colonics by clicking here. Find a practitioner here.
- Most of the water that we drink is very acidic and in order to heal our bodies need a more alkaline state. During the programme drink alkalised water, which you can buy from Real Water.
We know that when the body is out of balance, energy doesn’t flow, leading blockages and eventually disease. Here are some things you can do to combat stress and restore balance:
- Go to a Dr Morter BEST (Bio-Energetic Synchronisation Technique) Practitioner.
- Sign up for Energetic Re-Balancing: 2 practitioners to consider are:
Stephen Lewis, founder of the Aim Program. Find out more by clicking here.
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- Consider using Mary Millers Iching System Products – ichingsystemsinstruments.com
- Reiki healing is very powerful in releasing stress and emotional baggage. Find a practitioner here.
- Emotional Freedom Technique (EFT) has had remarkable results in dissolving stress. Find a local practitioner here or go to www.thetappingsolution.com or www.tftrx.com
- Try Hypnotherapy to relax the mind. Find a practitioner here.
We recommend you consult a licensed practitioner in order to receive the best advice and treatment. However there are several home remedies which can be beneficial in helping to strengthen liver function including the following:
- Take a quarter teaspoonful of Berberis, sometimes known as jaundice berry, extract three or four times daily.
- To prevent a sluggish liver, drink chicory tea throughout the day.
- Grind Indian aloe leaves into a paste, add a pinch of ginger and black salt, and consume for two weeks.
- Drink coconut water several times a day.
- Begin the morning with eight ounces of tomato juice with a dash of salt and pepper.
- Heat a quart of water with a cup of barley until boiling, cool, and consume by the end of the day.
These special formulas may also be beneficial in the treatment of jaundice. They only take a few minutes to prepare and can help the liver significantly
- Combine four ounces of lemon juice with an equal amount of beet juice. Drink for several days.
- Process radishes, bitter gourd, and other bitter vegetables. Press the juice from the pulp, and drink six to eight ounces every day.
- Mix Bhumyamalaki with enough honey to sweeten and take a teaspoon three times a day.
- Take a teaspoonful of Arogya Vardhini in honey two times a day.
- Make a tea using the root of Gokulakanta and drink two or three times a day.
- Turpeth powder, or nisoth, can be consumed in hot water twice a day.
- A tea may be made with the leaves of snake gourd and consumed twice a day to ease jaundice.
Liver function may also become more normal after the use of a mild natural laxative. Several choices are available, but you might want to try prune juice or licorice tea as a good beginning treatment. Purgation therapy rids the body of toxins and lightens the load placed on the liver.
Traditional Chinese Medicine
We recommend you consult a licensed practitioner who will be able to explain the treatments necessary. In TCM, jaundice is usually divided into two general types: Yang Huang type, which is acute, and Yin Huang type, which is chronic. In both cases, it is caused by dampness – in the case of Yang jaundice, by heat dampness, and in the case of Yin jaundice by cold dampness. Herbs are therefore recommended that will remove the dampness (diurectics) or that will strengthen the stomach and spleen Qi.
Heat can be removed with the Capillaris Formula where the three main herbs used are: Capillaris (Yin chen hao – Artemisia Capillaris Herba), Gardenia (Zhi zi – Gardenia jasminoides fructus) and Rhubarb (Da huang – Rheum emodi rhizome.)
Bupleurum (Chai hu – Bupleurum chinensis radix), Turmeric (Jiang huang – Curcuma longa rhizoma) and Sichuan chinaberry (Chuan lian zi – Melia toosendan fructus) are also often recommended if there is pain. For nausea the following an be used: Pinellia (Ban xia – Pinellia ternata rhizoma) and Agastaches (Huo xiang – Agastaches rugosa / Pogstemi herba).
For agitation and nervousness from the liver heat, the following are used: Coptis (Huang
lian – Coptis chinensis Rhizoma), Gentiana (Long dan cao -Gentiana scabra radix), or Bupleurum (Chai hu – Bupleurum chinensis radix).
If the urine is scanty and yellow, Poria (Fu ling – Poria cocos sclerotium), Talcum (Hua shi – Calcium carbonate), Grifola mushroom (Zhu ling – Polyporus umbellatus / Grifola umbellata) or Plantago (Che quian zi – Plantago ovata semen) are beneficial. For severe heat signs Scute (Huang qin – Scutellaria baicalensisradix) and Turmeric (Jiang huang – Curcuma longa rhizoma) may be recommended.
In the case of Yin jaundice, where the cold dampness needs to be tackled, Capillaris is the king herb, and the other ingredients are adjusted according to signs and symptoms. The following are used:
Capillaris (Yin chen hao – Artemisia capillaris herba)
White Atractylodes (Bai zhu – Atractylodes macrocephala rhizoma)
Aconite – (Fu zi – prepared Aconitum palmatum)
Dry Ginger (Gan jiang – dry Zingiber officinalis rhizoma)
Zhi gan cao (Glycyrrhiza glabra radix – honey fried Licorice)
Cinnamon bark (Rou gui – Cinnamon zeylanicum cortex)
Sometimes the jaundice progresses to liver enlargement, or cirrhosis and in this case, the Turtle Shell formula is used. The main herb is Turtle shell (Bie jia – Amyda Sinensis Carapax / Trionyx sinensis) which is combined with a number of other herbs, including:
Scute (Huang qin – Scutellaria baicalensis radix)
Bupleurum (Chai hu – Bupleurum chinensis radix)
Dry Ginger (Gan jiang – dry Zingiber officinalis rhizoma)
Rhubarb (Da huang – Rheum emodi rhizoma)
White Peony (Bai shao – Peonia lactiflora radix)
Red peony (Chi shao – Peonia rubra radix)
Cinnamon twig (Gui zhi – Cinnamomi cassis ramulus)
Magnolia bark (Hou po – Magnolia officinalis cortex)
Mu dan (Mu dan pi – Paeonia suffruticosa cortex)
Pinellia (Ban xia – Pinellia ternata rhizoma)
Ginseng (Ren shen – Panax Ginseng radix)
Peach kernel (Tao ren – Prunus persica semen)
Mirabilitum (Mang xiao – Depuratum mirabilitum)
Cockroach (Tu bie chong – Eupolyphaga sinensis)
Pyrrosia leaves (Shi wei – Pyrrosia lingua folium)
Hornet’s nest (Lu feng fang – Polistes mandarinus nidus)
Dianthus (Qu mai – Dianthus superbus herba)
Donkey skin gelatin (E jiao – Equus asinus gelatinum)
Lepidium seeds (Ting li zi – Lepidium apetalum semen)
Campsis (Ling xiao hua – Campsis grandifolia)
Caution: Because this formula contains several toxic ingredients, it should only be
prescribed by a competent TCM doctor.
Geranium, rosemary, and/or lemon are useful essential oils.
We recommend you consult a licensed practitioner who may suggest the following remedies: bryonia, cinchona, merc sol., chelidonium, nat phos, kali bich., chamomile (babies), phosphorus, Nux vom
Combine milk thistle and dandelion root in equal parts and add to a glycerin solution. Take 1/2 teaspoon of this mixture three times a day. Other useful herbs include aloe vera gel, barberry, chamomile, dandelion, gentian root, goldenseal, neem, parsley, rose hips, tumeric, and yellowdock.
The following juice combinations can be helpful: Carrot and beet juice with a little radish and/or dandelion root juice added; grapes, pear, and lemon; carrot, celery, and parsley; and carrot, beet, and cucumber.
Maintaining a healthy weight for your height and build can reduce the risk of getting jaundice. Obesity and the resulting damage it can sometimes cause to the liver (non-alcoholic fatty liver disease) is an often-overlooked cause of cirrhosis (scarring of the liver) and jaundice. Therefore, achieving and maintaining a healthy weight is an effective way of preventing jaundice.
In addition, a diet that’s high in fat can increase your blood cholesterol level, which in turn will also raise your risk of developing gallstones.
The most successful weight loss programmes include at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. cycling or fast walking) every week, eating smaller portions and only having healthy snacks in between meals. A gradual weight loss of around 0.5kg (1.1lbs) a week is usually recommended.
Giving up drinking alcohol altogether is the most effective way of reducing your risk of developing jaundice, particularly if you’ve been drinking for many years.
As a minimum preventative measure, stick to the recommended daily amounts for alcohol consumption. The recommended daily amounts are:
- 3-4 units a day for men
- 2-3 units a day for women
A unit of alcohol is approximately equal to half a pint of normal-strength lager, a small glass of wine or a single measure (25ml) of spirits.
Many experts would recommend that as well as sticking to the recommendation daily amounts, you also spend 2-3 days not drinking any alcohol.
Visit your GP if you’re finding it difficult to moderate your alcohol consumption. Counselling services and medication are available to help you reduce your alcohol intake.
Limiting exposure to Hepatitis A, B and C can all lessen the risk of developing jaundice.
Foods to prevent and treat jaundice: www.articlesbase.com/diseases-and-conditions-articles/foods-to-prevent-and-treat-jaundice-6115738.html
Jaundice and homeopathy: www.whereincity.com/medical/topic/diet-and-nutrition/articles/754.htm
Jaundice and acupuncture: tcm.health-info.org/Acupunture/treatment/jaundice.htm
Chinese herbs for jaundice: taoofmedicine.com/tag/chinese-herbs-for-jaundice
Home remedies for jaundice: www.homeremedycentral.com/en/home-remedies/natural-cure/jaundice.html
Herbal cure for jaundice: www.livestrong.com/article/390360-herbal-cure-for-jaundice
Natural treatment for jaundice: www.youtube.com/watch?v=QY_edI9wodk
Home ayurveda treatments for jaundice: /www.youtube.com/watch?v=nyl4mQz_98M
Herbs effective in curing jaundice: articles.timesofindia.indiatimes.com/2011-07-06/varanasi/29742818_1_bilirubin-jaundice-hepatitis
Breast milk jaundice and maternal diet with Chinese herbal medicines: www.hindawi.com/journals/ecam/2012/150120/
Further Information (links and books)
Herbal Treatment for Jaundice and Liver Disorders (Herbal Cure) by Vaidya Bhagwan Dash
Andrea Butje | Aromahead firstname.lastname@example.org – aromatherapy
Carrie Vitt email@example.com – organic food recipes.
David Spector-NSR/USA firstname.lastname@example.org – meditation, stress
Judith Hoad email@example.com – herbalist.
Kath May firstname.lastname@example.org – reiki, tai chi.
Lillian Bridges email@example.com – Chinese medicine, living naturally.
Monika firstname.lastname@example.org – aromatherapy.
Rakesh GAC@AyurvedicLifeStyles.com – Ayurvedic Practitioner.