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

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


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

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 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!

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