( By Dr. H.K.Bakhru )
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Jaundice is the most common of all liver disorders. It is a condition in which yellow discoloration of the skin and mucous membranes occurs due to an increase in the bile pigment, bilirubin, in the blood.
The bile, produced by the liver, is a vital digestive fluid which is essential for proper nutrition. It exercises a most favourable influence on the general processes of digestion. It also prevents decaying changes in food. If the bile is prevented from entering the intestines there is an increase in gases and other products. Normally, the production of bile and its flow is constant.
There are three forms of jaundice. These are : haemolyptic jaundice due to excessive destruction of red blood cells resulting in increased bilirubin formation and anaemia ; obstructive jaundice which occurs when there is a block to the pathway between the site of conjugation of bilirubin in the liver cells and the entry of bile into the duodenum ; and hepatocellular jaundice resulting from damage to liver cells either by viral infection or by toxic drugs. All the three forms are marked by yellow discoloration of the skin and the whites of the eyes.
The symptoms of jaundice are extreme weakness, headache, fever, loss of appetite, undue fatigue, severe constipation, nausea and yellow coloration of the eyes, tongue, skin and urine. The patient may also feel a dull pain in the liver region. Obstructive jaundice may be associated with intense itching.
Jaundice is indicative of the malfunctioning of the liver. It may be caused by an obstruction of the bile ducts which discharge bile salts and pigment into the intestines. The bile then gets mixed with blood and this gives a yellow pigmentation to the skin. The obstruction of the bile ducts could be due to gall-stones or inflammation of the liver, known as hepatitis, caused by a virus. In the latter case, the virus spreads and may lead to epidemics owing to overcrowding , dirty surroundings, insanitary conditons and contamination of food and water. Other causes of jaundice are pernicious anaemia and certain diseases affecting the liver such as typhoid, malaria, yellow fever and tuberculosis.
The simple form of jaundice can be cured rapidly by diet therapy and exercises. Recovery will, however, be slow in serious cases which have been caused by obstruction or pressure in the bile ducts. The patient should rest until the acute symptoms of the disease subside.
The patient should be put on a juice fast for a week. The juices of oranges, lemons, grapes, pears, carrots, beets and sugarcane can be taken. A hot water enema should be taken daily during this period to ensure regular bowel elimination, thereby preventing the absorption of decomposed, poisonous material into the blood stream. The juice fast may be continued till the acute symptoms subside.
After the juice fast, the patient may adopt an all-fruit diet for further three to five days. In this regimen, he should have three meals a day of fresh juicy fruits such as apples, pears, grapes, oranges, and pineapples, but no bananas. Thereafter a simple diet may be resumed on the following lines :
Upon arising : A glass of warm water with juice of half a lemon.
Breakfast : One fresh juicy fruit such as apple, pear, mango, papaya, or some grapes, or berries. One cup wheat dalia or one slice of whole meal bread with a little butter.
Mid-morning : Orange or pear juice.
Lunch : Raw vegetable salad, two small chappatis of whole wheat flour, a steamed leafy vegetable such as spinach, methi saag or carrot and a glass of butter-milk.
Mid-afternoon : Coconut water or apple juice.
Dinner : One cup strained vegetable soup, two chappatis of whole meal, baked potato and one other leafy vegetable like methi, spinach, etc.
Before retiring : A glass of hot skimmed milk with honey if desired.
All fats like ghee, butter, cream and oils must be avoided for atleast two weeks, and after that butter and olive oil may be included in the diet but their consumption should be kept down to the minimum. A light carbohydrate diet, with exclusion of fats, best obtained from vegetables and fruits should be taken.
The patient should take plenty of fresh vegetables and fruit juices. Dandelion leaves, radishes with leaves, endive should be added to the daily raw vegetable salad. Raw apples and pears are especially beneficial. Barley water, drunk several times during the day, is considered a good remedy for jaundice. One cup of barley should be boiled in six pints of water and simmered for three hours.
Digestive disturbances must be avoided. No food with a tendency to ferment or putrefy in the lower intestines like pulses and legumes should be included in the diet. Drinking a lot of water with lemon juice will protect the damaged liver cells.
The jaundice patient can overcome the condition quite easily with the above regime and build up his sick liver until it functions normally once again. A recurrence of liver trouble can be prevented with reasonable care in the diet and life style, with regular, moderate exercise and frequent exposure to sunshine , fresh air and adequate rest.
Research has shown that the liver has an excellent capacity to regenerate itself provided all essential nutrients are adequately supplied. Diets high in complete proteins, vitamin C, and B vitamins, particularly choline, and vitamin E can hasten its regeneration. Even after recovery, it is essential to maintain the diet for a long period to prevent recurrence of the trouble.