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 disorder marked by yellowness of the skin as well as the eyes. An increased amount of bilirubin in the body triggers this condition. Bilirubin is the product that is left after the break down of red blood cells. The liver excretes bilirubin. But if too much bilirubin is produced because of an underlying illness, or the liver function has been impaired, it will lead to jaundice.

Which Illnesses does Jaundice indicate?
In adults, jaundice could be the symptom of any of the following illnesses or conditions-

  Reaction to a medicine
  Liver cancer
  Infection of the liver
  Liver parasites
  Cirrhosis of the liver
  Gallstones
  Hepatitis
  Haemolytic anaemia
Jaundice may strike both adults as well as children. It is very common among babies who have been born preterm because their livers have not developed completely.

Jaundice in Siddha -
Siddha is a very old branch of medicinal science that cropped up in the southern part of India. According to Siddha, the human body mirrors the world around it. And our bodies too are made of the five elements- earth, fire, air, water and ether and three humours- Vata, pitta and Kapha. Usually, if there are too much of one of the elements in the body it may trigger an imbalance in the humor and this is at the root of all illnesses. So the aim of Siddha is to discover which humour is present in excess and then restore to balance.

Jaundice is mentioned in the ancient texts of Siddha medicine. It is called  manjal kamalai .  Manjal  means yellow and  Kamalai  means losing interest. It refers to a common side effect of jaundice. The person afflicted by it often loses interest in food and his/her everyday duties and activities.

Jaundice, in the Siddha texts, is the result of the distortion of pitta humour and it turns the skin, eyes and tongue yellow. When a person consumes too much spicy and hot food or if the person is too active, pitta levels will rise. This leads to  pitta neer  to mingle with blood, which will stagnate in different parts of the body.

According to Siddha, the symptoms of jaundice are -

  Constant fatigue
  Different parts of the body may turn yellow
  Constipation
  Sleepiness
  Headache
  Fever and shivers
The medicines of Siddha are all derived from herbs. Jaundice medicine is taken in the form of powder or a paste that is applied to the forehead or mixed with milk and consumed.

A person is advised against staying out in the sun for too long. As for diet, meat, poultry, salt and tamarind are prohibited. Rice has to be cooked twice before consuming. Fast food should strictly be avoided. Vegetables should be fried in ghee. Some foods that Siddha recommends are -

  Whole wheat flour
  Bananas
  Mangoes
  Almonds
  Berriesgrapes
  Potatoes
  Spinach
  Tomatoes

Siddha is a safe and secure way to treat jaundice because unlike allopathy, it does not leave a lasting and detrimental effect on the human body.

Can Siddha Help Cure Jaundice?

Jaundice is a medical condition, which is characterized by the yellow coloring of the skin and eyes. It generally occurs when there is an excess of bilirubin in your system. Bilirubin is a yellow pigment formed in the liver by the breakdown of red blood cells. It normally gets discharged by the liver along with other dead red blood cells. So if you are suffering from jaundice, it usually indicates that you have some serious problems regarding the functioning of your liver, pancreas, or gallbladder.

Signs and symptoms
Signs and symptoms commonly associated with jaundice include:
1.  Yellow-tinted eyes and skin
2.  The whites of your eyes may turn orange or brown in color
3.  Dark urine
4.  Pale stools
5.  High fatigue and vomiting (in severe cases)

Causes
Jaundice, as mentioned above, occurs when there is an excess of bilirubin and the liver is incapable of metabolizing it along with the old red blood cells. It is more common in infants than in adults, because their livers are not fully developed. However, it is also a frequent occurrence in adults and could be a potential sign of any of the following problems:
1.  Liver infection
2.  Scarring of the liver, or cirrhosis
3.  Hepatitis
4.  Alcohol abuse
5.  Liver cancer
6.  Gallstones
7.  Pancreatic cancer
8.  Blood disorders, like hemolytic anemia
9.  Parasites in the liver
10. Abnormal reactions to or overdose of medication

Diagnosis
Diagnostic tests may include:
1. Jaundice is diagnosed primarily by taking blood tests, to help measure the amount of bilirubin as well as to trace the presence of other diseases like Hepatitis.
2. Liver function tests in order to make comparisons between levels of certain proteins and enzymes when the liver is in good shape and when it is damaged.
3. Liver biopsies, where samples of liver tissue are first extracted and later examined under a microscope.
4. Imaging studies, consisting of abdominal ultrasounds, computed tomography scans and magnetic resonance images (MRI) tests.

Signs, Symptoms and Diagnosis of Jaundice

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 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

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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