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!

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 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 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!

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