Jaundice is not a disease in itself but a symptom that arises due to underlying conditions affecting the metabolism or excretion of bilirubin. As such, the treatment of jaundice focuses on identifying and managing the root cause while also addressing any complications that may arise. Because jaundice may be caused by conditions ranging from benign viral infections to life-threatening malignancies, a tailored treatment approach is crucial. In most cases, this involves a combination of medical, surgical, and supportive therapies. Importantly, the specific intervention chosen depends on whether the jaundice is pre-hepatic, hepatic, or post-hepatic, a distinction based on the site of disruption in bilirubin metabolism. Thus, the management of jaundice varies significantly across clinical presentations and is best guided by diagnostic investigations and clinical assessment.
General Supportive Measures
No matter the cause, certain basic steps can ease symptoms and help patients feel better. First, keeping well hydrated supports liver work and helps flush out toxins. Next, a balanced diet rich in antioxidants and low in saturated fats can ease liver stress. For patients with chronic liver disease, doctors may recommend special diets, such as low-protein meals for those with hepatic encephalopathy. Avoiding alcohol is vital because it can harm liver cells and worsen jaundice. Also, stopping medicines that can hurt the liver, like high doses of paracetamol, some antibiotics, and statins, can prevent further damage. These basic steps build a foundation while doctors treat the underlying cause more specifically.
Treatment of Pre-Hepatic Jaundice
Pre-hepatic jaundice happens when the body destroys red blood cells too fast, making the liver unable to keep up with processing bilirubin.
Management of Haemolysis
First, doctors find and remove the cause, which might be certain drugs, infections, or immune reactions. They then treat blood disorders like sickle cell anemia, thalassemia, or hereditary spherocytosis. These may need blood transfusions, iron removal treatments, or even bone marrow transplants. For autoimmune haemolytic anaemia, doctors often use corticosteroids or, sometimes, immunosuppressants or spleen removal surgery. Infections like malaria get treated with anti-malarial drugs and supportive care. If the case is severe, patients may need hospital stays to stabilize their condition and manage anemia.
Treatment of Hepatic Jaundice
Hepatic jaundice occurs when liver cells get damaged or stop working well. The most common causes include viral hepatitis, alcoholic liver disease, drug damage, and cirrhosis.
Viral Hepatitis
Hepatitis A and E usually get better on their own. Treatment involves rest, fluids, and avoiding anything that harms the liver. Hepatitis B and C might need antiviral medicines. For chronic cases, long-term treatment reduces the virus and stops the liver from getting worse. Doctors regularly check liver function with blood tests to track recovery or decline.
Alcoholic Hepatitis
Stopping alcohol use is key for healing and long-term liver health. Patients also need good nutrition and vitamin support, especially thiamine, folate, and B vitamins. Corticosteroids may help reduce inflammation in severe cases, but doctors watch patients closely because this treatment can be risky.
Non-Alcoholic Fatty Liver Disease (NAFLD)
Weight loss and lifestyle changes are the main treatments. Diet and exercise help most. Managing other health problems like diabetes, high blood pressure, and high cholesterol slows the disease.
Autoimmune Hepatitis
Doctors treat this with immune-suppressing drugs, usually corticosteroids plus azathioprine.
Drug-Induced Liver Injury
Doctors stop the harmful drug right away. For paracetamol overdose, they use N-acetylcysteine as an antidote. Supportive care helps, and in severe cases, liver transplantation might be needed.
Treatment of Post-Hepatic (Obstructive) Jaundice
This type happens when bile ducts get blocked, stopping bilirubin from leaving the body.
Gallstones
Doctors use a procedure called ERCP to remove stones blocking the common bile duct. Often, they remove the gallbladder surgically to stop stones from coming back.
Tumours (e.g., pancreatic cancer, cholangiocarcinoma)
Doctors place stents to keep bile ducts open and relieve blockage. If the tumor can be removed, surgery is done. Advanced or inoperable tumors may get chemotherapy or radiotherapy.
Biliary Strictures or Infections
These conditions might need antibiotics, bile drainage, or surgery depending on severity.
Phototherapy in Neonatal Jaundice
Newborn jaundice is common and usually harmless, but very high bilirubin levels can cause brain damage called kernicterus.
Phototherapy
This treatment changes bilirubin into a form the body can easily get rid of. Hospitals use blue lights or fiber-optic blankets. Phototherapy is safe and effective but needs close monitoring to prevent dehydration or overheating.
Exchange Transfusion
Doctors use this when phototherapy doesn’t work. They replace the baby’s blood with donor blood to quickly lower bilirubin.
Liver Transplantation
In severe liver failure, cirrhosis, or liver cancer, a liver transplant can save a life. Doctors decide who qualifies based on health scores like MELD and overall condition. After transplant, patients need lifelong medicines to stop rejection and regular check-ups. Surgical techniques and care have improved outcomes greatly.
Treatment of Underlying Metabolic or Genetic Disorders
Sometimes jaundice comes from rare inherited problems.
Examples include:
- Gilbert’s Syndrome, which usually needs no treatment.
- Crigler-Najjar Syndrome, where Type I may require transplant but Type II responds to phototherapy and medicine.
- Wilson’s Disease, treated with medicines that remove excess copper.
- Haemochromatosis, managed by removing blood or using iron-binding drugs.
Early diagnosis and treatment of these rare causes are vital to stop permanent damage.
Managing Complications of Jaundice
Doctors often need to treat problems caused by jaundice too.
Hepatic Encephalopathy
Doctors use lactulose, rifaximin, and diet changes to manage this brain condition.
Ascites
Salt restriction, diuretics, and sometimes fluid removal help control fluid buildup in the belly.
Coagulopathy
Vitamin K or plasma transfusions may help when blood doesn’t clot well.
Pruritus
Doctors relieve itching with cholestyramine, ursodeoxycholic acid, and antihistamines.
Regular check-ups and patient education help prevent worsening and hospital visits.
Conclusion
The treatment of jaundice needs a clear understanding of its cause. It ranges from simple care and lifestyle changes to surgery and liver transplants. Quick action saves lives in acute cases, while chronic problems need long-term care from many specialists. New tests and treatments have improved patient outcomes. Still, fast diagnosis, correct treatment, and ongoing care remain the keys to success.
