Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

Jaundice is a disease that is related to the liver. It affects thousands of people across the globe. Due to an increased build-up of bilirubin in the body, the skin, nails, and the eyes becomes yellowish in colour. While the condition is easily treatable, if detected in the early stages, it can be easily avoided if certain precautionary measures are taken.

Food: It should be ensured that food is consumed fresh and hot in order to avoid jaundice. This is more applicable especially, during the monsoons when the chances of food contamination are on the higher side. Vegetables should be thoroughly washed before cooking in order to avoid any liver infection.
Clean water: Consumption of clean water is a pre-requisite in order to avoid jaundice. Drinking filtered water should be an absolute must. If the water is known to be unsafe, it makes sense to boil it before drinking. Bottled or packaged water should be consumed when travelling outside to avoid the risk of jaundice.
Frequent hydration: Drinking at least 3-4 litres of water per day goes a long way in refraining from jaundice. Water has multiple health benefits. Apart from keeping the body hydrated, it ensures good blood circulation and cleanses a lot of unwanted body waste. Even fruit juice can be consumed to stay away from jaundice. Certain beverages such as sweetened water should be eschewed to remain healthy.
Vaccination: A jaundice vaccination goes a long way in ensuring that the disease cannot infiltrate the body. There are separate vaccines available to safeguard against both Hepatitis A and Hepatitis B. In most countries jaundice vaccination are injected free of cost for children under 10 years. Jaundice vaccines are available over the counter as well.
Alcohol consumption: Alcohol consumption can kill slowly. They are known to have adverse effects on the liver which can result in jaundice and a host of other complicated diseases. An alcohol addict also takes a lot of time to recover from jaundice. It, therefore, makes sense to refrain from alcohol or limit it to a bare minimum in order to avoid jaundice.
Maintaining weight: Obesity is closely connected with the occurrence of jaundice. Fat cells not only increase the cholesterol level of the body but raise the risk of gallstones as well. It is important to maintain a healthy BMI to ensure that the liver functions well.
Maintaining hygiene: Maintaining good hygiene is a good way to stay away from jaundice. Small yet important things such as washing hands before a meal, regularly taking bath, washing teeth twice a day, wearing clean and washed clothes will ensure that the liver is not infected in any manner what so ever.

Jaundice Precautions -  You Must Take to Avoid It

Biliary stricture or a bile duct stricture is a condition where the bile duct narrows due to the presence of scar tissues in the body. There are many reasons for scar tissue formation   bile duct surgery, stone in the bile duct or exposure of the abdominal area to radiation. 

This condition can be either malignant or benign. In some cases, the presence of a tumour in the gallbladder can narrow the bile ducts. 

Signs of biliary stricture  

Bile ducts are very small. Because their diameter ranges from 4-10 millimetres, they can easily be blocked by scar tissue. The symptoms are similar to other disorders of the bile duct, where the bile duct is blocked. This stops it from releasing bile into the intestine. 

The symptoms may take a while before they become obvious. In fact, they may take several years as scar tissue takes time to develop.

The common signs are  

Stomach pain, especially on the right side

Fever

Itching

Your skin and eyes turn yellow 

The stools are light coloured

Fatigue

No appetite

Besides this, the biliary stricture can also cause organ inflammation. Liver, gallbladder, and pancreas are the most vulnerable ones in this regard. It can also lead to low blood pressure and sepsis (infection of the blood). 

The link between jaundice and biliary stricture

Because biliary stricture blocks bile ducts, the level of bile in the blood can increase. This may happen because the bile won t follow its normal route   from the liver to the intestine. Hence jaundice might occur.

To treat jaundice resulting from biliary stricture, the first line of treatment involves IV fluids, antibiotics, and antiviral medications. If that doesn t work, then surgery may be necessary to get rid of the bile duct obstructions.

Apart from this, you will also need to adopt certain self-care practices such as alcohol avoidance, proper hydration, and adhering to strict dietary guidelines.



Biliary Stricture & Jaundice - Know The Link!

The medical name for the yellow tint on your skin and around the white portion of the eye is jaundice. However, jaundice is a symptom of a variety of underlying medical conditions, and not a specific disease. When the body break downs deceased red blood cells, a yellow pigment known as bilirubin is formed. Jaundice develops when your system contains excess bilirubin. Usually, the bilirubin, as well as the dead blood cells, are exterminated by your body.
Jaundice may symbolise a critical problem with your pancreas, blood cells, gallbladder or liver.
Causes:
Jaundice isn t a disease; it is a symptom. Thus if you have jaundice, it might indicate you may have any of the following complications:
Alcohol abuse.
Liver infection.
Liver cancer.
Cirrhosis (Liver scarring mostly due to alcohol).
Gallstones.
Hepatitis (Swollen liver that decreases its functionality).
Pancreatic cancer.
Blood disorders.
An overdose or adverse reaction to certain medications.
Symptoms:
The major indication of jaundice is yellow tinted skin and eyes. In serious cases, the sclera (white parts) of the eye can turn orange or brown. You might additionally exhibit other symptoms such as pale stools and dark urine.
If a concealed condition such as viral hepatitis is causing jaundice, you will probably experience symptoms such as vomiting and excessive fatigue.
Misdiagnosis is common when it comes to jaundice. Sometimes, an abundance of beta carotene (a type of anti-oxidant found abundantly in fruits and plants) can turn your skin yellow.
Treatments:
Since jaundice is a symptom of some other underlying disease, the treatment will focus on that disease. When your treatment starts, the yellow tint will disappear on its own.
If the jaundice is serious, blood transfusions might be needed to expel the excess bilirubin and rejuvenate the body s red blood cells. However, if the body s bile duct mechanism gets blocked, a surgery might be required to unblock the same.

Jaundice: Causes, Symptoms and Treatments

Infants often suffer from certain diseases which need proper care and timely treatment for quick recovery. At times, it can be difficult to communicate with an infant and understand his/her needs and problems but with a close observation you will surely be able to detect any alteration in the baby's behavior and sense it when he/she is ill. Here are some of the most common diseases infants are susceptible to and what you can do about them.

1. Abdominal distension
It is normal for a baby's belly to stick out after he/she has been fed, but if between feedings there is swelling in the abdomen or it feels hard, it can be an indication of a problem. If this symptom is accompanied by vomiting and absence of bowel movements for more than two days, your baby may be suffering from abdominal distention. This condition may have been caused by swallowing of extra air by the baby while crying or feeding. In such a situation, a pediatrician should be consulted for proper diagnosis and treatment.

2. Jaundice
It is common among newborns to develop mild forms of jaundice as the undeveloped liver is often not able to eliminate the chemical bilirubin from the blood. Mostly, this situation proves to be harmless till the level of bilirubin reaches a certain limit. After that, the disease must be properly treated to avoid damage to the baby's brain or nervous system.

3. Rsv infection
Rsv or respiratory syncytial virus is responsible for causing respiratory problems among infants. Rsv infection usually affects the bronchial passage and shows symptoms like cough, runny nose and mild fever which may even lead to bronchitis. Moreover, this infection may also develop into viral pneumonia, which makes it more important to consult a pediatrician if your baby shows any of the above symptoms.

4. Diarrhea
Infants are susceptible to watery bowel movements due to the action of virus, allergens, specific medications or bacteria. If you observe that your baby is passing stools more often than usual and it is watery, then it may be a case of diarrhea. Sometimes, these symptoms are accompanied by high fever, abdominal pain, lethargy, vomiting, dry eyes and mouth etc. In this situation you should consult your pediatrician and focus on replacing the fluids your baby has lost, to prevent dehydration.

4 Common Diseases that Babies are Susceptible To

Jaundice is a disease which causes the skin and the sclerae of the eye to turn yellow. It is caused by hyperbilirubinemia or excess secretion of bilirubin into the blood. The body fluids may also turn yellow. The shade of the skin depends on the bilirubin level. A mild increase in the bilirubin turns the skin pale yellow, and high level makes the skin turn brown.

There are three primary types of jaundice:

    Hepatocellular jaundice: This type of jaundice occurs due to liver disorders.
    Hemolytic jaundice: This type of jaundice occurs due to the breakdown of erythrocytes or red blood cells, and then excess bilirubin is produced.
    Obstructive jaundice: This type of jaundice develops due to an obstruction in your bile duct, restricting the bilirubin to exit the liver.

The common causes of jaundice are as follows:

    Inflammation of the liver disables the secretion and production of bilirubin and results in a buildup of bilirubin.
    Inflammation of the bile duct disables the secretion of bile juice, which results in bilirubin removal and leads to jaundice.
    In case the bile duct gets obstructed, the liver cannot dispose the bilirubin and leads to hyperbilirubinemia.
    Hemolytic anaemia may result in jaundice. When a large number of red blood cells break down, bilirubin production gets enhanced.
    An inherited condition known as Gilbert s syndrome may also lead to jaundice. The enzyme s ability to process bile excretion is also impaired.
    Another medical condition called Cholestasis disrupts the flow of bile from the liver. The conjugated bilirubin containing bile remains in the liver and leads to jaundice.
    Jaundice is also caused from alcoholic liver disease, caused due to excess alcohol consumption.

Treatment of jaundice
Jaundice itself cannot be cured and hence, the underlying cause of the jaundice is treated. Different types of jaundice are cured using different methods:

    Jaundice induced by anaemia can be cured by increasing the iron amount in your blood. This is done by intake of iron supplements or having iron rich food.
    Jaundice caused from hepatitis is treated by injections of anti-viral and steroid medicines.
    Obstruction induced jaundice has to be treated by surgical means. The obstruction is removed by surgery.
    Jaundice inflicted from medication is usually treated by choosing alternative medicines and abstaining from the medicines which caused the jaundice.
    Jaundice can be kept away if you take proper care of your liver. For this, you should eat a balanced diet, work out regularly and prohibit yourself from consuming excess of alcohol.

Jaundice is the most common type of liver disorder and occurs in people of all ages and also in newborn babies. Keep away from contaminated food and water, if you want to avoid jaundice.

Jaundice - 7 Factors That Can Cause It

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