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Jaundice

 

Jaundice is a clinical problem where eyes and urine become yellow due to increased level of bilirubin in the blood. Bilirubin is produced when the old red blood cells are broken down in the liver and are excreted in the bile. Jaundice is a way of presentation of a group of diseases. In medical terms it is a clinical symptom and not a disease.

Causes

  • Hepatitis viruses A, B, C, D, E
  • Stones
  • Cancers
  • Complex diseases which affect liver

The commonest disease which causes jaundice is hepatitis or infection of the liver.
Hepatitis B and C are dangerous viruses as they can destroy the liver and even cause cancer. They are transmitted through blood or sexual contact. Hepatitis D requires help from B to infect and cause liver disease. Luckily, majority of infections in the liver are due to Hepatitis A virus which is mostly harmless, self-limiting problem. Hepatitis A and E are water borne infections and behave in similar manner.

Stone in the passage of bile (juice produced by liver) can block the bile flow in to intestine. Blocked bile is absorbed in to the blood and can cause jaundice.

Symptoms

  • Yellow eyes and urine
  • Loss of appetite
  • Pain
  • Vomiting
  • Fever

Treatment
A person detected to have jaundice needs to be investigated to identify the cause. This can be achieved majority of the times with few simple blood tests and an ultrasound scan of abdomen.

If the cause is found to be Hepatitis A or E, the patient is not treated actively, but is only watched whether for the progress of the disease resulting in liver failure, so that necessary treatment can be given.

If the jaundice is due to stones, then stones have to be removed by most suitable method for that particular person. Various methods available are endoscopic technique (ERCP), open or laparoscopic surgical techniques.

In case of cancer, it is investigated further to assess the extent of disease by a CT scan or MRI scan and treatment is given accordingly. If a surgical intervention is required, then the cancer is operated upon.

If it is spread beyond the point of cure then jaundice is relieved by endoscopic route (ERCP and stenting) or surgically bypassing the biliary route to intestine.

In majority of conditions, jaundice is either self limiting or can be cured, if detected early. Therefore, all jaundices should not be considered as one disease and neglected from medical care. They should be evaluated by an expert and treated accordingly as early as possible.

Prevention

  • Vaccines
  • Maintaining hygiene