JAUNDICE?

Eat all you want

By: Neelanjana Singh on Sat Jul 29 2006, THE INDIAN EXPRESS (leading English daily)

A well-known heart physician of Delhi who also happens to be a good friend, was mortally scared of jaundice. It was not the discomfort of the condition that he minded. It was rather the restrictions on his diet that he abhorred. Of course, he was perfectly justified. During his illness and long after he had recovered, he was condemned to a zero fat, boiled, bland vegetarian diet. The twist in the tale is that even after I showed him clear and overwhelming medical evidence that indicates that such dietary restrictions are just a tradition and have no medical justification, he was hesitant to accept it. Such is the power of folklore and entrenched custom. What is the current wisdom on diet in jaundice? General views concerning bedrest, diet and working capability in viral hepatitis have been evolving over the last 30 years. Yet, many in the medical fraternityincluding my cardiologist friendthink otherwise. WHY THE CUSTOM? The symptoms that characterise jaundicenausea, listlessness, the deep yellow in the whites of eyes and skinand the fact that an important digestive organ, liver, which metabolises fats, carbohydrates and proteins, is affected, causes all these dietary myths to float around. Anti-inflammatory substances in commonly available foods such as turmeric, works for the liver too. Yet the yellow colour of turmeric is viewed as a potentially aggravating substance for the sufferers.

The food dished out to such patients is colorless (no haldi), flavorless (no fat, no spices) and lacking in essential nutrients, fat and calories. Of course taste is as big a casualty as nutrition. WHAT IS JAUNDICE? Jaundice is a manifestation of symptoms that indicate an infection in the liver caused generally by any one of four types of viruseslabeled A, B, C or E. But there are other reasons as well. It could be some toxic drugs or chemicals or just chronic alcoholism. There are some other causes of jaundice too, that are not so common. But while the causes may be varied, the symptoms remain the same. In hepatitis, there is inflammation in the liver cells and there is a build-up of bile in the blood. This bile buildup causes the characteristic yellowing of eyes and skin. Bile is a digestive substance normally controlled by the liver. However, the role of bile in the digestion of fats is minimal. In fact, despite the inflammation, the digestive process goes on as usual and is not hindered in any significant way. WHAT SHOULD BE EATEN? A well-balanced, hygienically prepared diet is what is required for this condition. Meals should be small but taken frequently. Nausea is a common symptom in the early phase of viral hepatitis. During this period it is advisable to avoid strong flavors as this could precipitate nausea. There is absolutely no taboo in eating non-vegetarian food too, provided it is cooked adequately and hygienically. RESTRICTED DIET HARMFUL

The restricted diet causes a delayed recovery. Even for a healthy individual, a prolonged zerofat diet in the form of boiled vegetables and with the all time favorite radish juice is debilitating enough. Of course, it does make sense to avoid potentially harmful products for the liver, such as alcohol and hepato toxic drugs, but the rest of the restrictions are completely unjustified. Scientific evidence in the journal Gastroenterology says extra calories are needed for recovery of health. The liver cells need nutrients to recover from the inflammation. Poor nutrition only delays recovery and high-energy diets shorten the course of the disease (which is equally true for any other disease condition). STILL, MYTHS PREVAIL My cardiologist friend is only now beginning to be convinced with my arguments and he remarks in jest that he does look forward to unfolding this myth among his patients and colleagues. Certainly, I cannot fail to miss the delight in patients who are told they can continue to consume foods that are a significant part of their normal meals. Of course, I still have to deal with obstinate senior members of their family, who insist on sticking to the traditions. On such occasions, my cardiologist friend, if he happens to be nearby, pitches in to give a second opinion. Unfortunately, there are still instances when the patient has been intimidated by well-wishers into reverting to the bland and boiled diet. PREVENTION Drink water that is: Boiled for 5 minutes

 Filtered by membrane filters like RO systems Chlorinated Ozonised Avoid raw foods when sanitation and hygiene is suspect Consume adequately cooked food as cooking destroys virus Patients must wash hand thoroughly to avoid spread by contamination Treatment Avoid exertion Take plenty of fluids Stay on normal diet Use supplementary vitamins Get symptomatic treatment for nausea/pain in abdomen