Book Clinic Appointment
Submit a review for Dr. Rajeev ShandilYour feedback matters!
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.
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.
Having some fat in your liver is legit. But, if you have too much of fat say more than 5%-10% of the organ's weight then you are at risk of getting fatty liver disease. At the onset, you can do one important thing to help your liver stop drinking. It causes fatty liver disease.
There are two main types of fatty liver disease
- Alcoholic liver disease or ALD
- Non-alcoholic fatty liver disease or NAFLD
- If you are a woman who is pregnant, you can also get fatty liver disease.
Alcoholic Liver Disease (ALD)
- You can get ALD from drinking lots of alcohol. ALD can also present itself after a short period of heavy drinking.
- Genetics has a role to play in ALD. Genes can make you hit the bottle and increase your chances of becoming an alcoholic.
- Genes can also impact the way your body breaks down the alcohol you drink.
Other root causes of ALD are:
- Hep C doesn't cause ALD. it is one of the causes of fatty liver.
- Hep B is also a cause of fatty liver. There are certain medications which may be helpful from person to person besides lifestyle management.
- Excess iron in your body
Non-alcoholic Fatty Liver Disease (NAFLD)
The cause of NAFLD is not clear, but we know that it tends to run in families.
NAFLD is also more common in the middle-aged and the obese or, those who have high cholesterol and diabetes.
Other risk factors are:
- Certain medicines
- Viral hepatitis
- Auto-immune or inherited liver disease
- Gaining weight fast
- Acute Fatty Liver during Pregnancy
- Fat can build up in your liver when you're pregnant, causing this kind of fatty liver disease.
- It’s a serious condition as it can be risky for both you and your baby. It can cause liver or kidney failure in you and your child, both.
- Causes are unknown. But, hormones may play a role.
Symptoms of fatty liver disease
This disease can sometimes cause no symptoms for long. But, the things to look out for are-
- Feeling tired all the time
- Loss of appetite or weight
- General weakness
- Confusion and trouble concentrating
- Your liver can become larger
- Pain in the centre or right upper part of your belly
In ALD, your symptoms get worse after bouts of heavy drinking. Fatty liver disease is diagnosed during routine exams when your doctor notices your enlarged liver. Ultrasound, blood tests to check for certain enzymes and biopsy of the liver are performed to confirm it.
- There is no specific treatment for the fatty liver disease.
- You can manage it by managing your diabetes and giving up drinking. If you have ALD and you don’t quit, you get complications like alcoholic hepatitis or cirrhosis.
- Even if you have a non-alcoholic fatty liver disease, alcohol cessation helps.
- Losing weight if you are overweight also helps to manage this disease and having a good balanced diet with exercise also shows benefits. If you wish to discuss about any specific problem, you can consult a Gastroenterologist.
Exocrine Pancreatic Insufficiency or EPI is also known as pancreatic deficiency, a disorder where the pancreas is unable to produce sufficient amount of enzymes that are required to digest food. The pancreatic enzymes help to break down and absorb nutrients from the food in the small intestine. So, this disease causes nutritional deficiencies.
Causes of Exocrine Pancreatic Insufficiency :
This condition is generally caused as a complication of other diseases because EPI develops only as a result of severe damage to the pancreas. The following reasons can cause EPI:
- Inflammation of the pancreas: After surgery in the pancreas, stomach or the intestines, there may be inflammation in the pancreas as a post-surgical complication. A high content of triglyceride fat in the blood can also cause pancreatic inflammation and hinder the secretion of the enzymes.
- Chronic Pancreatitis: In this disease, the pancreatic ducts are swollen and blocked and so the digestive enzymes cannot be passed into the small intestine. This condition is often caused by a heavy consumption of alcohol.
- Cystic Fibrosis: The digestive fluids and enzymes become thick and sticky and block the passageways of the pancreas and other organs like the lungs and the kidneys. This can obstruct secretion and passage of enzymes afterwards.
- Shwachman-Bodian-Diamond syndrome or SBDS: SBDS is an autosomal recessive genetic condition where enzyme producing pancreatic cells is not formed properly. This rare disorder causes a number of associated disorders like bone marrow diseases, skeletal defects and exocrine pancreatic insufficiency.
Symptoms of Exocrine Pancreatic Insufficiency:
Symptoms of EPI often appear in the middle stages of the disease when the process of absorption of nutrients has already been affected. The common warning signs are:
- Digestive problems like gas, diarrhea and indigestion because the food remains mostly undigested.
- Severe and frequent stomach pain in the lower abdominal region
- Greasy stools due to the excretion of undigested fat
- Rapid loss of weight and body mass due to malabsorption of nutrients
- Constantly feeling bloated and full even if you have not eaten anything
- A general sense of fatigue and exhaustion
- Excessive bleeding from small wounds because protein deficiencies hamper blood clotting
- Pain in the muscles and bones
- Increased susceptibility to infections of the body system
- Joint pain
- Abnormal swelling of the limbs or edema
If you wish to discuss about any specific problem, you can consult a gastroenterologist.
Irritable bowel syndrome or IBS includes a group of medical symptoms. These include abdominal pain and changes in the pattern of bowel movements. The symptoms mostly continue for a long period of time and are divided into four types depending on diarrhoea or constipation symptoms.
Irritable bowel syndrome causes several negative effects on our health and should be treated as soon as possible. IBS is caused because of various reasons and factors. They are as follows:
- Digestive problems: Food is moved through the digestive system with the help of squeezing and relaxation movement of the intestinal muscles in a certain rhythm. In case of IBS, this process is altered and food moves through the digestive system very fast or very slow. When the food moves too fast, diarrhoea is caused as there is not enough time for absorption of water from food. In case of slow food movement, constipation occurs as a result of too much absorption of water. Disorders such as malabsorption of bile acid may also cause IBS in some cases.
- Psychological factors: Psychological factors also play a vital role in IBS. When a person is overtly emotional or is suffering from intense stress or anxiety, then these emotions trigger chemical changes in the body which affect the proper functioning of the digestive system. This is not likely in all people who get IBS. People who did not have IBS before, may undergo changes in bowel movements because of immense stress and tension. Many people who have undergone a traumatic experience such as abuse, neglect or a childhood disease can get IBS. These traumatic events or experiences in the past made these people more sensitive to stress, which may result in IBS.
- Several triggers of IBS: There are several food items and drinks, which may trigger the symptoms of IBS in a person. These triggers vary from person to person. The most common ones include alcohol, aerated drinks, chocolates, drinks which contain caffeine like coffee or cola, processed snacks such as crackers and biscuits and fried foods, which contain a lot of fat. You should maintain a food diary for identification of triggers that may lead to IBS in your everyday diet. Stress is also an important trigger which may lead to IBS. You should try to find ways to get rid of stress and must avoid over stressing.
Irritable bowel syndrome or IBS results due to several reasons which may be physical or psychological. If you experience symptoms of IBS, you must try to detect or diagnose the reason and then look for proper treatment while consulting with gastroenterologist.
A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen. Also, check out Stomach Aches and Pains in Kids.
Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:
Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.
Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.
H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine. Consult a doctor for all stomach related problems.
Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.
Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.
Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.