What is Jaundice?
The telltale sign is for the urine to turn a dark-brown color – similar to strong tea. This is due to the presence of bilirubin, the liver product normally excreted in the stools. As it is no longer excreted this way, the stools take on a whitish, non-pigmented coloration. Often jaundice sets in, the color being related to the severity of the disease and the degree of swelling of the liver cells, so blocking the normal flow of fluids.
The whites of the eyes are often the first to be noticed. They turn a yellowish shade. Later the skin becomes icteric (jaundiced or yellow) also. As this occurs, it often becomes very itchy, due to the high levels of bilirubin circulating in the superficial blood.
Many cases occur in which there is only mild jaundice, and other symptoms may also be minimal. This is called subclinical hepatitis, and many of these cases may be responsible for actively moving in the community and spreading the disease to others.
This is about the most common cause of jaundice, and is readily diagnosed when there is an epidemic in the community. However, the doctor may elect to carry out tests to pinpoint the disorder. Bilirubin checks on the blood, urine and perhaps some of the enzyme tests on the liver (performed on blood samples) may give added information, of value particularly if the diagnosis is in doubt.
In the average case, this is usually quite straightforward, and most patients fare well. Bed rest in the early stages is recommended, for symptoms and weakness make this the ideal place. The patient should stay there until the jaundice fades, and tests return to their former relatively normal levels.
There are no dietetic restrictions. The old idea of a low-fat diet is not substantiated. However, the patient usually feels better with little if any fat, for this tends to nauseate. A high-protein, high-vitamin intake is desirable. Small, attractively served meals are best.
Plenty of fluids are essential. Water, previously boiled then chilled, is excellent. Fruit juices, preferably unsweetened, arc also recommended. Freshly squeezed juices are best.
Sometimes the disease persists and symptoms worsen, so specialized medical care and hospitalization are frequently advised. In the past it has been customary to administer the steroid drugs to these very ill patients, although recent investigations cast doubt on the value of this. However, the patient is under specialized care by the time this situation is reached, and decisions will be made by specialists.
An injection of gamma globulin may protect contacts. Hepatitis A prevention is now readily available with three injections from the doctor. After the first, a second is given one month later, and a final one six months later.