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 medical condition where the bilirubin level shoots up in the blood of the affected person. Also referred to as icterus, the condition may affect adults as well as newborn babies (Neonatal Jaundice), whereby the skin and the white part of the eye (sclera) appears yellowish in color (due to the accumulation of bilirubin).

Bilirubin is the bile pigment that results from the breakdown of hemoglobin (when the RBC cells breakdown). The bilirubin thus produced is released into the plasma. The liver then filters the released bilirubin for further metabolism. In the case of a diseased condition, injury or infection to the liver, it fails to remove the bilirubin from the bloodstream. As a result, there is an abnormal rise in the bilirubin level in the blood (Hyperbilirubinemia), resulting in jaundice. In jaundice, Bilirubin can go upto much higher levels. At 2.5-3 it just starts to get manifest as yellow eyes. Obstructive jaundice may require an endoscopic procedure or surgery. 

Types of jaundice:
Jaundice may be of the following types:

Hepatocellular jaundice: In Hepatocellular jaundice, the elevated bilirubin level in the blood is an outcome of a liver disease or an injury (altering the normal functioning of the liver).
Hemolytic jaundice: Here, the increased level of bilirubin in the blood results from an increased breakdown of the RBCs (Hemolysis).
Obstructive jaundice: As the name suggests, Obstructive jaundice results from an obstruction in the bile duct. As a result, the bilirubin does not get filtered and remains in the liver.

Factors contributing to jaundice:
The increased buildup of bilirubin may be an outcome of

Obstruction and inflammation of the bile duct.
Chronic liver disease including liver cirrhosis and hepatitis.
Pancreatic Cancer.
Hemolytic anemia: It is a condition resulting from increased breakdown of RBCs.
Gilbert's syndrome.
Certain medications may also interfere and alter the normal functioning of the liver (steroids, birth control pills, and acetaminophen, to name a few).
In cholestasis, the bile (conjugated bilirubin), instead of getting eliminated, remains in the liver.
Symptoms:
The symptoms associated with jaundice include

The skin (particularly, the face, hands, nails, and feet) and the sclera appear yellowish.
The urine appears dark in color.
Fever, vomiting, tiredness, and loss of body weight.
Abdominal pain (mild to severe).
The stool appears pale in color.
Itchiness or Pruritus.
Diagnosis and treatment:
The earlier the diagnosis, more effective is the treatment.

Jaundice can be diagnosed by
Physical examination.
Bilirubin tests to determine the total bilirubin level.
CBC is used to determine the levels of RBCs, WBCs, and platelets.
Liver function tests.
The treatment for jaundice involves identifying the underlying factor responsible for the condition and treating it.

In the case of obstructive jaundice, operation helps to improve the condition.
Patients with hepatitis may benefit from antiviral medicines as well as steroids.
In hemolytic anemia, use of iron supplements helps to improve the condition.
Avoid oily and spicy foods, smoking and drinking.
Rest as much as possible.

Jaundice - The Right Way It Can Be Treated!

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

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 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

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