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

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

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!

Jaundice or hyperbilirubinemia is a medical condition that is caused by the high level of bilirubin in the system of a person. It is not a disease in itself but a symptom of various underlying illnesses such as malaria, hepatitis, infection of the liver, destruction of red blood cells or some other causes. It manifests in the form of discoloration of the skin. It turns yellow and so does the white parts of the eyes. The signs and symptoms of jaundice are, yellow skin and whites of the eyes, loss of appetite, weakness, drowsiness, dark colored urine, and fever. Jaundice is diagnosed by physical examination, blood test, or skin test. It can be cured by diet management and allopathic medicines. However, the latter are harsh by nature and if one seeks gentler remedies then Ayurveda is the answer. It has many effective remedies to cure jaundice (pilia) of roots and give quick and lasting relief. 

So, here are some such remedies.

Aloe vera: This Ayurvedic herb is a gentle cleanser that detoxifies the kidneys and liver of the toxins accumulated in the system. It improves the overall digestive functions of the body and is a great tonic for the digestive system. It can be consumed in the form of juice or its pulp can be taken with water.
Bhumyamalaki (Phyllanthus Niruri): A comprehensive liver tonic, bhumyalaki is effective in all kinds of liver disorders. It gives relief in case of all the symptoms of jaundice. Being anti-inflammatory, anti-bacterial, and anti-spasmodic, it cures the liver of infections and also treats the dysfunction.
Yakrit Plihantak Churna: A mixture of beneficial herbs such as kalmegh, katuki, bhringaraj, bhumi amla and others, this churna is a complete medicine for liver disorders. It reduces inflammation and also flushes out the toxins accumulated in the body. It also restores the health of the liver by boosting the regeneration of liver cells.
Changeri (Indian Sorrel): This is helpful in curing symptoms of low appetite and poor digestion. It stimulates digestion and also helps in proper bowel movement.
Chichinda (Snake Gourd): Effective in detoxification and improving the digestive system, chichinda is a rich source of nutrients needed by the human body. It boosts the immune system and also removes worms from the intestines. A natural diuretic, it increases urine secretion, thereby, helping the body get rid of toxins. It can be consumed in the form of juice or taken in mashed form after boiling.
Karela (bitter gourd): A natural cleanser, karela improves the filtration functions of the liver. Being an anti-oxidant, it also restores the immunity of the body, thereby, helping it recover fast.
Ayurveda believes that jaundice or pilia is caused by pitta dosha in the human body and all these remedies work to correct this dosha. Along with these natural remedies, Ayurveda also prescribes plenty of water intake and fluids and abstinence from oily and spicy food as they are known to aggravate the pitta dosha. So, one should follow these instructions and also, take the advice of an Ayurvedic practitioner before taking these remedies.

Jaundice - 6 Ayurvedic Herbs That Can Treat It!


How To Prevent Jaundice

During monsoons, many people fall prey to Jaundice. Not to be taken lightly, jaundice can prove fatal if strict care is not taken. However there are ways to ensure that we don't fall sick with jaundice. The four main ways in which it spreads are.

1. Enlargement of liver
2. Loss of blood
3. Infection
4. A previous ailment which has left bacteria in the body

SYMPTOMS: Once can have jaundice any time of the year however one needs to be extremely careful during the months of monsoon. The symptoms of jaundice are.
1. Nails and eyes become yellow
2. Skin and urine change colour to yellow
3. Loss of appetite and irritability
4. Loss of taste
5. Nausea and vomiting
6. Tiredness and weakness
7. High temperature with shivering
8. Taste/tongue becomes bitter
9. Vision also becomes yellow
10. Stool changes colour to yellow or black
11. Heavy pulse and headache

DO’s & DON’Ts
Once diagnosed, patients have to be on strict bed rest with regulated medication on diets. They are advised to drink a lot of sugarcane juice, radish juice, glucose water, take ample rest and not do anything strenuous.

Fried and oily foods are strictly prohibited. Ghee, oil, butter or cream should not be consumed. Alongside, vegetables like okra arbi, brinjal and cauliflower should not be consumed. Alcohol, tobacco, tea, coffee and hot & spicy foods are not allowed.

What jaundice patients should eat are light and healthy foods that are easy to digest. Sugarcane juice, tomato juice, lime water, carrot juice, orange juice, and sweet lime juice should be given to the patient. The patient is allowed to drink only boiled water as resistance to infection is very low at this point of time.
 
Moong and masur dals should be included in the diet, along with lots of buttermilk, without any spices in it. It is very important to follow the diet plan as given by the doctor.

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Monsoon Time Prevention For Jaundice: DO's & DONT's

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