Sunday, March 10, 2013

Jaundice

What is Jaundice ?

    Due to increase bilirubin level than normal (Normal level:0.3-1 mg/dl )in blood ; if eye, Urine & skin tone changes into yellowish, that condition is referred as Jaundice.


Jaundice, Hepatitis, Liver Disease, Bilirubin

Types of Jaundice:
  • Clinical Jaundice: When bilirubin level in blood exceeds 3mg/dl
  • Latent Jaundice: Clinically there is no jaundice, but serum bilirubin is more than normal and < 3mg/dl
Another Classification:

      1. Haemolytic/ Prehepatic jaundice
      2. Hepatocellular/Hepatic Jaundice
      3. Obstructive/ Post-hepatic Jaundice

Causes of Jaundice:
 

1. Haemolytic/ Pre-hepatic jaundice:

              - Congenital defect in RBC(Red Blood Cell/Corpuscle) such as sickle cell anaemia, Thalassaemia, Haemoglobinopathics.
              - Certain infection such as Malaria
              - Certain Drugs such as Quinine
              - Incomplete Blood Transfusion

2. Hepatocellular/Hepatic Jaundice:

              - Viral Hepatitis
              - Chronic Alcoholic Hepatitis
              - Liver Cirrhosis
              - Infections: Yellow fever, Septicaemia

3. Obstructive/ Post-hepatic Jaundice:

             - Impaction of gall stone in common bile duct
             - Carcinoma of head of Pancreas
             - Metastatic Carcinoma of common bile duct
             - Stricture of common bile duct
             - Ascaris(worm)impaction in common bile duct
             - Pressure from outside by enlarged coeliac lymph nodes.

Symptoms of Jaundice:
  • White part of eye(Sclerae), mucous membrane of oral cavity, skin turn into yellowish color
  • Urine become dark yellow
  • Stool become pale or whitish
  • Abdominal pain, Nausea, Fever
Available Treatment:
  • Vaccine for Hepatitis B & Hepatitis C
  • Also different interventional & surgical method for Obstructive Jaundice.



Jaundice, Jaundice vaccine, Hepatitis Immunoglobulin

How Physician Diagnose Jaundice:

         Physician confirm diagnosis of Jaundice by -
              - Medical History
              - Physical Examination
              - Diagnostic Test: Such as-
                               - Serum bilirubin level
                               - Liver enzymes level
                               - Prothrombin Time
                               - Ultra sonogram of Abdomen
                               - Liver Biopsy in some cases
                               - Test for detection of Hepatotropic virus in the body
                               - Urine & Stool Examination


It should remind that,
           Jaundice is not a disease. It just a symptoms of  any other disease of liver, bile duct & pancreas. So it is essential to find out the exact cause of Jaundice.


How to differentiate between Viral Hepatic Jaundice & Obstructive Jaundice ?

  • Viral Jaundice appears with Fever, Vomiting, Nausea, Anorexia,Weakness etc& in majority of cases regress spontaneously
  • But in Obstructive Jaundice,they increase in severity gradually.
Along with these symptoms, itching can be seen in Obstructive jaundice

Jaundice in Pregnancy:


           Jaundice during pregnancy can be harmful for both mother & fetus. In 50% cases different viral hepatitis is responsible for jaundice in pregnancy. Among them Hepatitis B is more dangerous, for which up to 15% maternal & 50% fetal death occur. Via contaminated food & drinks this viral infection occur. So it is important to detect the cause of Jaundice in pregnancy to save both maternal & fetal life.

Obstructive Jaundice:

         Bile is required for the digestion of fat & it is produced by the liver cell(Hepatocyte), After production in Hepatocytes, it goes into intestine through biliary System. If Obstruction occur anywhere in this biliary system(Specially by gall stone), billirubin level increase in the body, as the bile can not pass into intestine.As a result, Jaundice occur which is known as Obstructive Jaundice.

Usually due to gall Stone, Tumour, Pancretic tumour, narrowing of bile duct or infection of billiary tree. This jaundice rapidly hasten the activity of liver & kidney. So, in obstructive jaundice, Rapid diagnosis & appropriate treatment is required

What we should do in Jaundice:

          - Firstly,Consult with physician as soon as the symptoms of Jaundice appears.
          - Drink as much water as possible
          - Taking normal diet &
          - Maintain normal lifestyle

What shouldn't do in Jaundice:


We should stay away from any unscientific treatment. Cause, it can causes serious liver damage & threaten your life without advancing the main disease.


          - Do not take any medication without physician's prescription or advice
          - Don not drink excess fluid of green coconut
          - Avoid sugarcane
          - Avoid excess Bed rest.


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