Jaundice- new approach | liver

A man surprised to see his report of jaundice

                   Jaundice-new approach

This article intends to provide all medical care providers and learners the latest scientific knowledge. 

Upon completing the article, you will have increased knowledge regarding the subject and use it with great confidence.

About' totalphysiology.com.'

This article is part of my mission to provide trustworthy recent health information to support the general public, patients, and professionals globally.

Here you will find human Physiology, Anatomy, and health-related topics.

  This article will be helpful for you.

 In one line, Jaundice is a yellow discoloration of the skin and or mucosa.

Keywords: jaundice | jaundice definition| neonatal jaundice|what causes jaundice in newborns|obstructive jaundice| jaundice newborn|jaundice symptoms| bilirubin jaundice| jaundice adult|jaundice at birth| jaundice alcohol|jaundice and liver failure|jaundice and liver failure| jaundice bilirubin levels|jaundice bilirubin| jaundice causesIcterus|dark brown |colored stoolPale stool| Clay stool| Neonatal Jaundice|Gilbert syndrome|Hepatotoxic|Hepatitis|Conjugated|Unconjugated

Table of contents

1.	Introduction
2.	Classification of Jaundice
3.	Causes and incidence
4.	Investigation and diagnosis
5.	Prognosis and Prevention

Liver

Introduction

Jaundice is a yellow discoloration of the body tissues. The main cause is excess bilirubin accumulation. In the early stage, it appears in the sclera of the eyes and oral mucosa and later in other parts of the skin and mucosa. Actually, bilirubin gets deposited on the conjunctival membrane overlying the sclera.

Jaundice is not a disease. It indicates abnormal bilirubin metabolism, liver dysfunction, or obstruction in the biliary tract. Jaundice only suggests the presence of an underlying disease.

Jaundice is also known as icterus. The root of Jaundice is the French word 'jaune,' meaning yellow, and 'jaundice' stands for yellow disease. 

The word icterus is derived from the Greek word 'ikteros'. In ancient times, it was a false belief that looking at the golden-yellow small bird 'icteria' could cure Jaundice.

Yellow discoloration of the eye

Causes:

Jaundice is caused by an increased bilirubin level in the blood. The average total bilirubin level in an adult is 1.2 mg/dl. When it rises to 2mg/dl, it is known as hyperbilirubinemia, and Jaundice appears when the bilirubin level is more than 2.5mg/dl.

Types of bilirubin:

1.     Unconjugated bilirubin 0.9mg%  

2.     Conjugated bilirubin 0.3 mg% and

3.     Delta bilirubin in a small amount of  bilirubin

High-conjugated bilirubin is present  in

1. Hepatitis, cirrhosis,

2. Hepatotoxic drugs,

3. Obstruction of bile duct-carcinoma, gallstone.

High unconjugated bilirubin is present  in

1. Large bruises and hemolysis,

2. Jaundice of the newborn,

3. Prolonged fasting and

4. Congenital diseases, e.g., Gilbert syndrome.

 Types of Jaundice:

1. Pre hepatic

2. Hepatic 

3. Post hepatic.

Another way of classification is:

1. Hemolytic= Pre hepatic

2. Hepatocellular= hepatic, and

3. Obstructive.= post hepatic.

In neonates, Jaundice appears, which may be Physiological or Pathological.

Physiological 

Jaundice appears 48-72 hours after birth. Infants' red blood cell count is 7-8 million per cubic millimeter of blood. After birth, rapid destruction of red blood cells occurs, increasing bilirubin production. The enzymes concerned with bilirubin metabolism need to be well-developed in neonates.

A case of neonatal jaundice

The infant's immature liver fails to conjugate the excess bilirubin, resulting in the rise of unconjugated bilirubin in the blood. The increase may be up to 12 mg/dl or more. In 7-10 days, enzymes concerned with bilirubin metabolism mature, and physiological Jaundice resolves by itself, but it is treated with phototherapy if the level is higher.

Pathological 

jaundice in infants from birth is due to some severe disorder and needs immediate treatment. Usually, it is due to 'hemolytic diseases of newborns'.

Incidence:

Jaundice is common in males, alcoholics, and smokers.

The most common cause of Jaundice in developed countries is obstruction of the common bile duct or drugs.

And in developing countries, the most common causes are viral hepatitis, leptospirosis, and malaria.

Pre hepatic Jaundice: 

Isolated raised bilirubin levels may be due to:

1. Haemolytic cause –

A healthy liver can conjugate bilirubin load six times greater than usual, raising the conjugated bilirubin level.

2. Non-haemolytic Jaundice 

Non-hemolytic Jaundice occurs in some congenital disorders. However, the most common hereditary disease is Gilbert syndrome, in which the conjugated bilirubin level is raised.

Hepatocellular Jaundice may be acute or chronic and is multifactorial. It may be due to :

1.     The inability of hepatocytes uptake of unconjugated bilirubin into the cells.

2.     The failure of hepatocytes to transport conjugated bilirubin into the bile canaliculi.

3.     Obstruction of the bile canaliculi due to swelling of hepatocytes due to diseases.

In this type of Jaundice, conjugated and unconjugated bilirubin are raised.

Obstructive Jaundice or cholestatic Jaundice may as a result of 

1. Failure of hepatocytes  to initiate bile flow

1.    Obstruction of a) bile duct, b) Portal tracts, c) Hepatic duct, common hepatic duct, common bile duct, sphincter of Oddi.

Causes of obstructive Jaundice are divided into :

A. Intrahepatic causes –Defect in hepatocytes.  

 1. Congenital-

  2. Primary biliary cirrhosis, cystic fibrosis, etc

 2. Non-congenital - due to drugs, infections, toxins- alcohol,  chronic heart failure, hepatic infiltration, pregnancy.

B. Extra hepatic: trauma, parasitic infection, choledocholithiasis(stone), chronic pancreatitis and carcinoma of the gall bladder, bile duct, ampulla of Vater. 

In obstructive Jaundice, hepatocytes fail to conjugate unconjugated bilirubin into conjugated bilirubin. In addition to that, the conjugated bilirubin fails to enter the bile canaliculi and returns to the blood. Therefore, serum conjugated bilirubin level is raised.

Signs and symptoms

Yellowish discoloration of the eye's sclera and skin is the most common sign of jaundice.

Other common signs are dark urine and clay-colored stool.

Symptoms

Non-specific symptoms are 

Loss of appetite that is progressively increasing.

Weakness, lethargy, and weight loss.

Pain in the abdomen, nausea, and vomiting.

Severe itching.

Diagnosis

SyDDThe patient's history helps determine a diagnosis of Jaundice.

Alcohol or drug intake –hepatocellular cause.

Pregnancy- and Itching

Abdominal pain –Stone –obstruction

Dark urine in hepatic and post-hepatic Jaundice.

Pale stool hepatic Jaundice-reduced amount of conjugated bilirubin so the decreased amount of stercobilinogen in the stool.

Clay-colored stool in post hepatic Jaundice due to the absence of stercobilinogen in the stool.

The dark brown stool is seen in prehepatic Jaundice due to increased stercobilinogen in the stool.

The pale, greasy, foul-smelling large stool is in hepatic and post-hepatic Jaundice.

Jaundice is diagnosed by yellow discoloration of skin and mucosa, especially in the upper eye cornea. A history of the patient's symptoms will help in diagnosis. 

Differential diagnosis

Carotenemia: This yellowish skin discoloration occurs when one eats large amounts of food containing carotene for a long time. It is differentiated from Jaundice by the absence of an increased bilirubin. 

Drugs: This condition may be due to drugs, e.g., rifampicin.

Investigations will confirm the diagnosis.

  serum bilirubin estimation

 Urine bilirubin, urobilinogen, and 

 Liver function tests - 

Alanine aminotransferase (ALT)

Aspartate aminotransferase (AST)

Alkaline Phosphatase (ASP)

Gamma Glutamyl transferase (GGT)

Ultrasound examination of the whole abdomen,

MRI

Cholecystography

Liver Biopsy

Prognosis

The prognosis depends on the cause of the Jaundice and the duration or complication of the Jaundice.

Prevention 

Healthy lifestyle
Avoid alcohol, and stop smoking.

Avoid junk food. Eat a healthy diet.

Protect yourself from Hepatitis A, B, C, and other infections. 

Like to meet again? Sign up to get an email when I publish.

Email me                         bkp337390@gmail.com

 Follow me on Instagram @ bijaykprasad

                        Twitter@ at bijaykrishnapr3

                                       @BijayPr60250287

 

Remember to follow me on learning and flying.c o.

I am more enthusiastic, and you can get new insights from my articles later.

Thank you.

Your queries

What's another name for Jaundice?

Jaundice is also known as icterus. 

How did Jaundice get its name?

The root of Jaundice is the French word 'jaune,' meaning yellow, and 'jaundice' stands for yellow disease.

The word icterus is derived from the Greek word 'ikteros'. In ancient times, it was a false belief that looking at the golden-yellow small bird 'icteria' could cure Jaundice.

Hashtags:

Healthy life # Healthy diet # healthy lifestyle # Pale stool # Clay stool|# Neonatal Jaundice#Gilbert syndrome#Hepatotoxic#Hepatiti#Conjugated#Unconjugated

Internal link:

https:// totalphysiology.com/2022/08/save-liver-stay-healthy.html

https://totalphysiology.com/2021/05/liver-introduction-we-must-know.html

https://totalphysiology.com/2021/05/liver-structure-we-must-know.html

https://totalphysiology.com/2021/05/liver-functions-we-must-know.html

https://total physiology.com/2021/05/bilirubin-we-must-know.html

https://total physiology.com/2021/05/liver-function-test-we-must-know.html

External Link:

https://en.wikipedia.org/wiki/Jaundice

https://my.clevelandclinic.org/health/diseases/15367-adult-jaundice

Thank you very much for reading. I appreciate that you spent some time with us. If you enjoyed reading, please leave a review or a comment. Your comments will encourage other folks to read. 

 Disclaimer: All possible measures have been taken to ensure the accuracy and reliability of the information; however, 'totalphysiology.com' does not take any liability for using any information provided by the website solely to the viewers. 'The information is provided as an educational service and public awareness. It is not medical advice. We advise you to review a reference book in case of any doubt and more accurate and advanced knowledge.

If you have any medical issues, we advise you to seek the advice of a qualified doctor and follow his instructions.