Jaundice in India is so widely misunderstood because of the regenerating capacity of the liver. Sometimes jaundice in mild form resolves on its own without any treatment. This is the reason for the misunderstanding, said Dr R Surendran, director of hepato-pancreato-biliary centre for surgery and transplantation, MIOT Hospital, Chennai, in an interview with Sinduja Jane. Edited excerpts:
Why is jaundice so widely misunderstood in India?
Jaundice is so widely misunderstood because of its presentation. On one side it may be mild like in the case of hepatitis A virus infection which sometimes goes unnoticed or becomes alright with simple measures like rest, food, maintaining hygiene etc. In some cases it may be very serious like protracted illness due to hepatitis B and C infection or use of psychedelic drugs.
Can jaundice infections lead to liver damage?
Jaundice, the yellow colouration of the sclera of the eye in the mild form, is more often self-limiting, while yellow colouration of skin and the deep colouration of the sclera often needs attention. The mild form of jaundice is caused by infectious liver diseases like viral infections with hepatitis A, B, C, D and E viruses. Hepatitis A and B virus infections can be prevented by taking vaccines. Infections like C, D and E can be prevented by hand hygiene and avoiding exposure to the body fluids of the infected patients.
The liver has enormous capacity to regenerate unlike many other organs. As long as people do not damage it with alcohol, hepatotoxic drugs, etc., the jaundice infection comes as a mild infection and subsides on its own even without medication. Though hep A virus causes mostly self limiting disease, the B and C viruses are dangerous and lead on to chronic liver diseases, fibrosis and later cirrhosis and cancer. It can be prevented by vaccines, early detection and treatment.
Are protein restriction, bland diets advised in liver disease?
Absolute protein restriction and bland diets are no longer advised. In fact, the patient needs protein which can be easily digestible and does not stress the liver. It is advised to take plant protein and milk animal protein, and avoid red meat etc. High protein intake was believed to be detrimental as it liberates high volumes of ammonia, which again has to be cleared by the liver. But the present consensus is to give easily assimilable protein, mostly plant based and eggs to avoid breakdown of muscle protein which is more harmful.
How to protect the liver and keep it healthy?
To protect the liver one needs to avoid alcohol in any form and drugs that are toxic to the liver. Healthy diet and exercise are advised to avoid fatty liver, while obesity is really a cause of concern these days.
When does one reach the liver transplant stage?
Liver transplant may be required to save the patient in severe acute liver failure and late stages of chronic liver disease (cirrhosis) due to various causes.
Does liver disease only affect alcoholics?
The liver does not get affected only in alcoholics. Poor dietary habits, obesity, hormonal problems can lead to fatty liver and become a serious problem. Use of contaminated syringes can also lead to hepatitis B and C, and HIV infections.