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 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

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

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


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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