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

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 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

Jaundice is a disease that is caused by high levels of bilirubin in the human body. It is a serious condition of the liver that needs to be treated on time because it leads to weakness, weight loss, fever, loss of appetite and other disturbing symptoms. It severely affects the functioning of the liver and since the liver is one of the most important organs of the body, its dysfunction can cause a lot of trouble to the patient. So, most of them prefer Ayurvedic treatment to get jaundice cured as allopathic medicines are harsh and not every patient can handle them with weak immunity.



Ayurveda treatment principle in jaundice
In Ayurveda, jaundice is known as  Kamala  and it is believed to be caused by pitta aggravation. When the liver starts producing bile in excess, the liver becomes dysfunctional and it causes jaundice. Therefore, Ayurveda tries to correct this aggravation. It focuses on curing the pitta imbalance and therefore, all of the Ayurvedic medicines that are used to treat jaundice have diuretic, detoxification, anti-bacterial, and anti-inflammatory properties. These medicines work by flushing out the toxins, in this case, excessive pitta from the liver, while also relaxing the liver muscles.

Ayurvedic medicine effects
Medicines have anti-inflammatory and anti-bacterial properties and it restores the normal functions of the liver. So, Ayurveda aims to correct the root cause of the disease and does not suppress the symptoms of the disease. It cures the disease completely without being harsh on the liver. Also, the diet guidelines prescribed in Ayurvedic treatment increase the efficiency of the medicines, thereby, helping in quicker recovery.

Liver cleansing in jaundice
In the Ayurvedic treatment of jaundice, correction of pitta dosha is the prime goal. Even the therapies help in detoxifying the body so that the liver does not have to work hard to remove the toxins. The idea is to restore the liver to its previous state so that it can perform the normal functions without any trouble. So, all the Ayurvedic remedies work at strengthening the liver and it can be done only when the liver does not have excess pitta in the form of toxins.

Also, excess water and fluid intake are especially emphasized during Ayurvedic treatment and the motive behind this instruction is also the same   to expel the toxins. The liver is badly affected by jaundice. The excessive bile secretion makes it work extra hard to filter the toxins, which puts additional strain on the liver and as a result, it gets inflamed.

Ayurveda is a holistic and permanent curing system that works to provide lasting relief to the patient. It does not harm the body either and the remedies are always in sync with the medical state of the patient. Ayurveda diagnoses the patient before prescribing the medicines as every patient differs from another.

In case you have a concern or query, you can always consult an ayurvedic doctor for a proper line of treatment.

Treatment Of Jaundice - The Ayurvedic Approach!

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 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!

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