HERBS

JAUNDICE

ABOUT THE DISEASE

Jaundice, known as “Icterus” in medical term is the yellowish tinge in the skin, white membrane of eyes (Sclera) and mucus membranes. Jaundice is derived from word “Jaune” which means yellow.

Jaundice in itself is not a disease but a clinical sign of yellowish staining of eyes, skin and mucous membranes.

Jaundice in itself is not a disease but a clinical sign of yellowish staining of eyes, skin and mucous membranes.

Bilirubin

Bilirubin is a brownish yellow pigment derived from the Bile salts. It is produced from the breaking of old Red Blood cells.

This Bilirubin circulates in the blood stream in unconjugated (free) form which is then brought to the liver to bind with a protein (Globulin). This is called as conjugated (Bound) Bilirubin. It is then excreted out in urine and stool.

Thus Bilirubin circulates in two forms in Blood

  • Indirect (Unconjugated) Bilirubin - This form travels to liver and change into a (direct) conjugated form. This form is insoluble in water and can cross Blood brain barrier and can lead to brain cells death (Kernicterus).
  • Direct (Conjugated) Bilirubin – It is made in liver from indirect Bilirubin and is soluble in water.

CAUSES

Causes of Hyperbilirubin levels or jaundice can be divided into three ways:-

a) Prehepatic causes - Due to excessive breakdown of red blood cells (Haemolysis) – diseases causing this includes Malaria, sickle cell anemia, Thallasemia, G6 PD deficiency, Hemolytic uremic syndrome. Various syndromes which lead to defective production of Bilirubin include Gilbert’s Syndrome, Crigler najar syndrome (Type I and Type II).

b) Hepatic causes – It includes hepatocellular dysfunctioning which causes defective or no conjugation of Bilirubin in liver. This includes Hepatitis, liver cirrhosis, Hepatotoxicity due to drugs and alcohol.

c) Post Hepatic causes – Also called as obstructive jaundice because it is caused due to obstruction of drainage of conjugated bilirubin from liver. Causes include – obstruction of bile duct due to gall stones, stricture formation or any undue growth in the duct, Pancreatitis or carcinoma of pancreas head, parasites in the liver.

SIGNS AND SYMPTOMS

The main sign of jaundice is yellowing of eyes, skin, lower part of tongue and inside the mouth. The white part of eyes (Sclera) are first to detect yellowish staining as they high affinity for bilirubin due to their high elastin content. Other clinical features include dark coloured urine and stool. In case of obstructive jaundice, Pale or white coloured stools are passed due to absence of bilirubin derivatives, patient also complains of severe body itching (pruritis) in case of obstructive jaundice. Other clinical features include loss of appetite, nausea, vomiting, abdominal pain and weakness.

AYURVEDIC VIEW

In Ayurveda, this disease has been described in the name of “Kamla”. It is Pitta Dosha predominant disorder.

Acharyas have described the colour of skin in Kamla like frog’s colour.

CAUSES

According to Acharyas, the causative factors includes:-

  • Intake of excessive sour, salty, alkaline, spicy diet. Regular Intake of incompatible diets.
  • Excessive alcohol drinking.
  • Excessive physical or mental exertion without proper nutrition.

According to Acharya Charaka, if a patient is already suffering from Pandu Roga (Anemic condition), eats Pitta predominant food (for eg –hot and spicy food items, alcoholic beverages etc.) and does not follow the proper routine, it will lead to Kamla Roga as a complication. Thus, Kamla is an aggravated stage of Pandu Roga.

Types

Acharyas have described Jaundice into two types:-

  • Kosthaashrita Kamla.
  • Shakhaarishta Kamla (Obstructive jaundice).

PATHOGENESIS

Due to the intake of etiological factors Pitta Dosha gets aggravated. Aggravated Pitta hampers the functioning of Rakta (Red Blood cells) and Mansa (liver parenchyma). This leads to yellowish or greenish discoloration of body.

Rakta Dhatu and Pitta share same characteristics and same causative factors, therefore aggravation of Pitta Dosha lead to aggravation of Rakta Dhatu.

In case of 2nd type i.e., Shakhashrita Kamla (Obstructive jaundice), Kapha Dosha gets aggravated which blocks the path of Vata Dosha and leads to its aggravation. Vitiated Vata Dosha throws Pitta out from its normal pathway which then accumulates in blood and causes yellowness of skin, eyes, nails and urine. However the stool remains white or clay coloured due to absence of Pitta Dosha.

SYMPTOMS

  • Yellowish discolouration of nails, skin, eyes & mouth.
  • Yellowish or reddish discoloration of urine & stool. White coloured stool in case of Shakha ashrita kamla (Obstructive jaundice).
  • Indigestion.
  • Weakness.
  • Lassitude.
  • Anorexia.
  • Burning sensation.
  • Constipation.
  • Flatulence.

PRINCIPLE OF TREATMENT

The main line of treatment for Kamla is to balance the impaired Agni through Deepana karma and to treat Pitta Dosha.
In Case of Obstructive Jaundice, the line of treatment is to balance Kapha Dosha and improve the circulation of Vata Dosha along with Pitta Dosha chikitsa.

MANAGEMENT

1. Jaundice leads to very low digestive power therefore very light semisolid and easily digestible meals should be given to the patient during jaundice.

2. Complete bed rest should be given.

3. Single herbs – Bhumyamalki (Phyllanthus niruri), Daruhaldi (Berberis aristata), Kutki (Picrorhiza kurroa), Nagarmotha (cyperus rotundus), Indravaruni (Citrullus colocynthis), Pippali (Piper longum), Giloy (Tinospora cordifolia), Neem (Azadirachta indica), Mahanimba (Melia azedarach), Chirayta( Swertia chirata), Patola (Trichosanthes dioca), Punarnava (Boerhavia diffusa).

4. Ayurvedic Herbal combinations – Trikatu churna, Triphala churna, Darvyadi churna, Vishaladi churna, Avipattikar churna, Aarogyavardhni vati.

5. Iron preparations – Yograj rasayana, Nisha lauha, Navayas Lauha, Vidangadi Lauha, Punarnava Mandoor.

6. Liquid preparations – Phaltrikadi Kwath, Beejakarishta, Kumaryasava, Lohasava.

7. Panchkarma procedures like Virechan and Basti are used in jaundice to remove the accumulated toxins and aggravated Pitta Dosha.

HOME REMEDIES

1. Eat light and easy to digest carbohydrate rich diet and do not take fatty, spicy diet.

2. Take lot of glucose mixed water (4-5 litres/day).

3. Take proper rest.

4. Take 4-5 fresh Neem leaves and take their juice or boil them in 2 glasses of water to prepare a fresh decoction. Intake of Juice or decoction on neem leaves is very beneficial for faster recovery from Jaundice.

5. Intake of Giloy juice 10 ml daily empty stomach is very beneficial for faster liver healing.

6. To prevent constipation take triphala powder 5- 10 gms at night with luke warm water. Avoid other laxatives during jaundice.

7. Drink 1-2 glass of buttermilk seasoned with Roasted cumin seeds and ginger in lunch daily. This will help in improving digestion and appetite.

8. Take 5 gms of Harad powder (Terminalia chebula) along with equal quantities of Guda daily. It is a very good option to naturally improve bloating, flatulence in jaundice. This combination can mainly be used in hemolytic jaundice.

9. Take 1 Amla (gooseberry) or 10 ml Amla juice daily as it is a very good remedy for aggravated Pitta Dosha. Also it is said to be a good rejuvenator (Rasayan) for body.

10. Take 4-5 fresh Bael tree leaves along with 1 pinch of black pepper twice daily.

11. Intake of 5 gm dried ginger powder along with 5-10 gm jaggery regularly empty stomach for 10-15 days helps in faster recovery from jaundice.

12. 5-10 ml of Onion juice along with half teaspoon of black pepper and 1 pinch of black salt twice daily helps in detoxification of liver and recovery from jaundice.

13. Regular intake of Raddish or Raddish juice and Kulattha Dal soup (Horse gram) is very good for healing of liver during jaundice.

14. Pomegranate juice, sugarcane juice and lemon water are very good for liver. Avoid pulses like Urad, Rajma, chhole and Lobia.

Disclaimer

The purpose of Ayurvidya is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider regarding your medical condition or treatment and before undertaking any new health care regimen.