The apple of the eye is yellow. Causes, symptoms and treatment of yellow eyes. Causes of hepatic dysfunction are

Yellow whites of the eyes indicate that a person has problems associated with the health of internal organs! If the proteins turn yellow, it is necessary to consult a doctor and undergo the necessary examinations so that he can diagnose the cause of this symptom.

In this article we will try to tell you why the whites of the eyes turn yellow, describe the causes and treatment. The color of the white of the eye can tell the doctor about the various diseases that have affected the body. If a person is healthy, then the white of his eyes is white, but if there is yellowness, then this means that he has some kind of pathology. In this case, the doctor diagnoses icteric sclera.

Often, if a person sees that his protein is slightly yellowish, he does not attach much importance to this, since it does not hurt, and is not particularly noticeable. However, this is the wrong approach. Indeed, there are people who have yellowish sclera from birth, which is due to genetic predispositions. However, if the proteins were completely white before, then in no case should you delay a visit to the doctor.

Important! Even if you have only small yellow blotches, it is worth visiting a doctor, suddenly some kind of disease began to develop in the body. The earlier the pathology is detected, the less negative consequences it will bring. Therefore, it is imperative to establish the reasons why you have yellow whites of the eyes.

In medicine, yellowing of the white of the eye is called scleral icterus. The eyes may turn yellow and acquire a color from pale lemon to deep dark - it depends on the disease and how badly the body is affected. There are several diseases that are the causes of yellow whites of the eyes.

Internal diseases of the body:

  • liver diseases (hepatitis, cirrhosis of the liver and others);
  • blood disorders (malaria, babesiosis and others);
  • lesions of the bile ducts;
  • jaundice in newborns.

Eye diseases:

  • pinguecula;
  • malignant conjunctiva.

Wrong lifestyle:

  • unhealthy diet;
  • body overload.

Internal diseases of the body

The eye turns yellow, usually due to an excess of bilirubin in the blood, a yellow-brown compound that is an important component of the body's bile. It turns out during the decomposition of proteins (this includes hemoglobin, myoglobin, cytochromes). After their splitting, free bilirubin is released - a toxic substance that must be immediately neutralized. This process is done by the liver. It contains a special acid, which, when interacting with bilirubin, neutralizes it. Non-hazardous direct bilirubin is passed by the liver to the bile ducts, which remove it from the body.

Liver disease

It is known that these liver diseases are very dangerous and their treatment must be approached with great responsibility. Any failure in the liver increases the blood levels of two types of bilirubin. Bilirubin is an enzyme produced by the liver. In diseases of this organ, the breakdown of bilirubin occurs, i.e. it is not excreted as it should be in a healthy liver. The decay products of this enzyme affect the human body, causing yellowing of various integuments, skin and visual apparatus.

This includes the following diseases:

Hepatitis

With it, the liver tissue is affected, due to various kinds of penetrations into it, this pathology happens:

In fact, this is a liver disease that occurs as a result of exposure to one of the modifications of worms, echinococci. They come from contaminated food, drink or contact with animals.

Cirrhosis of the liver

This is a pathology that affects the liver tissue and replaces it with a pathological one. Thus, the ability of the liver to neutralize dangerous compounds, which include, along with other substances, free bilirubin, is impaired. Accumulating, as we already know, it gives the tissues a yellow tint, that is, the icterus of proteins and human skin is manifested.

Cirrhosis of the liver occurs against the background of:

  • alcoholism;
  • complications after hepatitis;
  • venous insufficiency;
  • prolonged use of antibiotics;
  • diseases associated with an excess of heavy metals in tissues and other diseases.

Liver cancer

It is characterized by the formation and rapid growth of a tumor that destroys healthy liver tissue. From this, the liver loses its abilities, which, as we know, include the neutralization of bilirubin. Its excess leads to yellowing of the sclera.

Infection of the liver with microorganisms

  • Opisthorchiasis;
  • Echinococcosis;
  • Epistorchiasis.

Flatworm

The whites of the eyes turn yellow even with a disease such as opisthorchiasis. It is caused by a variety of flatworms that come to us with improperly thermally processed fish.

  1. Gradually, multiplying, they begin to irritate the walls inside the hepatic ducts, this disrupts the excretion of bile.
  2. Its stagnation leads to their breakthrough and the entry of bile into the blood.
  3. This, in turn, causes the accumulation of conjugated bilirubin, of course also in the sclera of the eye, as a result of which it acquires a yellow tint.

Blood diseases

They are accompanied by excessive destruction of red blood cells, which increases the content of free bilirubin. The body is not able to neutralize it, therefore, it is deposited and gives the tissues and whites of the eyes a yellow color. These diseases include:

  • malaria;
  • babesiosis;
  • various kinds of hereditary and congenital pathologies;
  • sickle cell poisoning.

Malaria

Yellow whites of the eyes may also indicate an infection with malarial mosquitoes.

The infectious disease babesiosis is similar to malaria, but its causative agent is not a mosquito bite, but a tick.

It is important to know that if a person has high immunity, then the risk of this disease is almost zero.

Heredity

There are also many different diseases that are inherited:

  • erythrocyte membranopathies;
  • enzymopathies;
  • hemoglobinopathies.

They are characterized by the defeat of red blood cells and their rapid decay, during this process an excess of bilirubin is formed in the blood. The liver cannot cope with it, which means that it can easily penetrate everywhere, not to mention the sclera of the eye.

Poisoning with sickle cell (hemolytic) poisons

Such poisoning causes the breakdown (hemolysis) of red blood cells, the consequence of which is:

  • lack of red blood cells and hemoglobin (anemia);
  • yellowness of proteins and skin.

Sickle cell poisons: benzene, nitrates, chloroform, arsenic, copper and others. Natural poisons are those of bees, snakes, spiders, certain mushrooms and berries, and so on.

Diseases of the biliary tract

Bile is of great importance in the removal of unnecessary substances from the body. To get into the intestines, it is transported by the biliary tract, and if there are any lesions of these tracts, then there are failures in the passage of bile. Accordingly, places of its large accumulation appear, which causes an increase in pressure in these places and a rupture of the duct. Bile, through breaks, enters the bloodstream, which means that an excess of bilirubin appears and the patient's proteins become yellow. These diseases include the following.

Primary sclerosing cholangitis

Irritation of the bile ducts, the origin of which is still being determined. Constant inflammation transforms their walls, closed places appear. The more of them, the more difficult it is for bile to enter the intestines. Partially it is injected into the blood, together with bound bilirubin, it accumulates in the white of the eye and tissues, due to which they acquire a yellow tint.

Cholelithiasis

In this case, stones are formed - glued particles of sediment of a substance, such as cholesterol. If these stones are in the bile ducts, blockage occurs, the duct ruptures and bile enters the bloodstream. The bilirubin contained in it, accumulating, gives yellowness to the sclera of the eye and skin.

Pancreas cancer

Yellowing of proteins is observed with such a tumor outside the hepatic bile ducts and other organs included in the biliopancreatoduodenal zone. As it grows, stagnation of bile occurs, both outside the hepatic ducts and in the thin internal ones. They break through and squirt out part of the bile, along with its bilirubin, into the blood. The protein is saturated with it, which leads to icterus of the sclera.

Jaundice

Or, scientifically, hepatitis A. This disease is very dangerous for the human body. With jaundice, there is also a change in the color of various tissues and mucous membranes, which indicate the processes of breakdown of bilirubin. The degradation products of this enzyme are toxic to humans. From the rate of excretion of bilirubin, jaundice is divided into three types:

  1. hemolytic;
  2. hepatic;
  3. cholestatic.

Hemolytic jaundice

Manifested at a high rate of disintegration of hemoglobin. The formation of bilirubin occurs in such quantities that the liver cannot process it from an indirect form to a direct one.

Hepatic jaundice

The disease can be caused by:

  • exposure to viruses;
  • Poisoning with toxic substances;
  • Poisoning with alcoholic beverages;
  • cirrhosis of the liver;
  • Leptospirosis;
  • Pseudotuberculosis and other diseases.

With this pathology, there is an increase in the level of indirect bilirubin in the blood. This means that the liver is weakened and cannot cope with the processing of the enzyme and absorption into the blood occurs again.

cholestatic jaundice

The whites of the eyes with a pathological disease of the presented species acquire a yellowish tint, and this may indicate that the bile ducts have been clogged with tumor or stone formations.

Jaundice in newborns

In addition to the types of jaundice presented, neonatal jaundice is distinguished in ophthalmology. With such a pathology, the whites of the eyes of newborns, during the first days, may acquire a yellowish tint. Sometimes the skin is also stained. This is due to the fact that, even in the prenatal state, in the mother's body, the baby receives an excess of blood cells (erythrocytes). At birth, in order to get rid of so many red blood cells, they break down with the formation of bilirubin. It causes yellowing of the eyes and skin.

If this disease does not go away after two weeks, then the person is sent for a thorough examination with hospitalization.

Eye diseases leading to yellowing of the whites of the eyes

Pinguecula

Yellowness in the whites of the eye may appear as a result of formations on the conjunctiva of the eye - a pinguecula. In fact, this is a wen, which appears in violation of fat metabolism. These veins are colored yellow.

This disease appears:

  • due to the aging of the body;
  • frequent irritation of the conjunctiva when unprotected eyes are exposed to strong sun, wind, smoke, and so on.

Very often, this disease does not affect vision in any way and is not dangerous. People rarely go to the doctor in this case. But, if this neoplasm begins to bother you, discomfort appears in the eyes and the pingvecula becomes inflamed (pingveculitis), you should consult a specialist. It is difficult to get rid of them with the help of medications, so surgical operations are used for this.

Melanoma

If a pinguecula is not a malignant formation, then there are malignant conjunctiva, in which the whites of the eyes turn yellow, for example, melanoma.

This education can be:

  • even, may have a bumpy character;
  • yellow, brown, and sometimes transparent;
  • occurs in the inner corners of the eye.

This is a very rare disease, it is difficult to identify it and it is difficult to find a quick effective treatment, which is why it is so important to contact a specialist in time.

pterygium

A disease characterized by the growth of the conjunctiva of the eyes. As a result, it is a rim that crawls out onto the protein shell and creates unpleasant sensations when considering various objects. Pterygium must be identified at the developmental stage, as there is the possibility of effective removal. When launched, the circle will increase in thickness, tightening the eye up to the pupil (and even with it). After complete tightening, blindness occurs.

Gilbert's syndrome

The disease is hereditary. It is associated with an increase in the concentration of bilirubin in the blood. A person who has this syndrome does not need treatment. This is one of the physiological features that can appear in anyone.

Where can it come from? A newborn may have a large amount of bilirubin, which changes over time to the required amount. That is, neonatal jaundice is manifested. However, some children have such a high level of this enzyme that even after this decrease, it remains quite high. The result is bright yellow eyes.

Individuals with this syndrome should avoid situations that lead to an enzyme surge. These include stress, intense physical activity, viral infections.

Wrong lifestyle as the cause of yellowing of the whites of the eye

With improper nutrition, we can also get yellowing of the sclera. To prevent this from happening, you need to change the diet:

  • exclude highly salty foods;
  • remove spicy foods from the diet;
  • refuse flour and fried;
  • do not abuse alcohol;
  • eat foods rich in vitamins, especially those with vitamin C.

If you do not get enough rest, work for a long time at the computer in a dry and poorly ventilated room, do not get enough sleep - this can also lead to yellowness and inflammation of the eyes. However, this is easy to fix, if you walk more and rest your eyes, it will quickly pass.

There are a lot of reasons for the yellowing of the whites of the eye, and, basically, these are very serious diseases. That is why, at the first signs, and even small inclusions of yellowness in the sclera of the eye, it is necessary to consult a specialist so that he can make a diagnosis and start treatment on time.

yellow pupils

Healthy eyes have completely black pupils. There are cases when, over time, from a black pupil it becomes cloudy, gray, grayish-yellow. Many people at the same time believe that they have yellow pupils. But it is not so. As such, there are no yellow pupils near the eyes. But they can be cloudy yellow, sometimes with yellow patches. In this case, we are most often talking about, namely, its mature or overripe stage.

Another disease due to which the pupils can sometimes turn yellow is. But most often, with her, the pupil becomes gray and cloudy.

Prevention

Prevention of diseases that cause yellow whites of the eyes, as well as yellowing of the mucous membranes, is aimed at improving the health of the liver:

  1. Balanced diet. In order for the liver to function properly, it must be supplied with all the useful components. This will help the addition of a large number of vegetables and fruits to the diet. It is also necessary to exclude flour, fried and smoked foods, alcoholic beverages.
  2. Physical activity. If you walk in the fresh air for an hour or more, it will positively affect the functioning of the liver.
  3. Healthy sleep. A person's sleep should be at least 8 hours.
  4. Mode of work and rest. For long-term work, which is performed on a computer, it is necessary to take rest breaks.
  5. Reception of multivitamin complexes. They combine all the substances necessary for human health with a high concentration. They have a positive effect on the functioning of the liver.

When yellowing of the pupils of the eyes appears, it is necessary to visit not only the ophthalmologist, but also other doctors, in particular, the therapist. This is due to the fact that this pathology is more often associated with diseases of the internal organs.


Do I need to immediately call an ambulance if the whites of the eyes turn yellow, and tune in to the treatment of jaundice? No. Even the diagnosis of hepatitis - more commonly called "jaundice" - has other symptoms, and the presence of the disease must be confirmed by a doctor. In addition, yellow eyes are not necessarily hepatitis A. There are many diseases that have the same symptom, and not all require hospitalization.


If a person has yellow eyeballs, the reasons may be as follows:

There are also absolutely “harmless” causes of this condition that do not require urgent treatment, but gradually undermine the body from the inside - chronic lack of sleep, constant sitting at a computer monitor, bad habits - in particular, smoking.

Yellowness in the eyes is a mandatory reason to see a doctor, even if there is no temperature and nausea. It is always necessary to find out why the eyeballs have changed their color. The chance to eliminate ophthalmic diseases at the first sign of a change in the color of the eye proteins is almost 100% - if the symptom is neglected, you can lose your eyesight.

Red blood cells in the human body contain bilirubin, which is produced by the liver. Why is bilirubin needed? This enzyme has an important role in the process of digestion - it emulsifies fats and prepares them for splitting, which occurs in the duodenum. If there were no bilirubin, fat particles would not be absorbed. If the synthesis of bilirubin is increased, or the body does not perceive it, the whites of the eyes immediately turn yellow.

Violation of the production of bilirubin indicates a pathology of the liver of a different nature.

Allocate the following types of hepatitis.

  1. Hemolytic. It develops with the accelerated breakdown of hemoglobin - the liver does not have time to process the amount of indirect hemoglobin that is formed during the breakdown of red blood cells into direct hemoglobin.
  2. Hepatic.

It is called:

  • Viral lesions. Symptoms of the disease with various strains of viruses: chills, headache, fever, fever, abdominal pain, nausea, loss of appetite, enlargement of the liver, discoloration of stools and urine - the stool becomes light, and the urine becomes dark.
  • Leptospirosis. The onset is sudden, the temperature rises sharply, hemorrhagic syndrome, myalgia (muscle pain) appear, ESR rises, hemoglobin levels decrease, and thrombocytopenia occurs. The liver increases from the first days of the disease.
  • Toxic hepatitis develops acutely, and the symptoms resemble viral hepatitis. The kidneys can be simultaneously affected - renal failure occurs. Hepatic function is impaired.
  • Symptoms of acute alcoholic lesions resemble the development of viral hepatitis.

Additional symptoms are diarrhea, ascites.

  1. Cholestatic jaundice. The bile ducts are clogged with stones or stagnation of bile, which causes nausea, dizziness, pain in the right hypochondrium.
  2. enzymopathic jaundice. Due to a hereditary defect in the enzyme system of the body, the synthesis of bilirubin is insufficient.

Newborn jaundice rarely leads to pathological changes in the liver. It occurs in the first days after birth due to adaptation to the extrauterine period. Before childbirth, a huge amount of red blood cells enters the blood of the fetus, and the liver cannot cope with the processing of bilirubin, which was released during their decay. Newborn jaundice usually goes away on its own on the 10-12th day of life.

Newborn jaundice is dangerous when the parents' Rh factor is incompatible. In this case, babies need treatment.

Chronic liver disease may have the following symptoms: pain in the hypochondrium on the right, nausea, enlarged spleen, subfebrile temperature, esophageal varicose veins, ascites, anemia, and others.


Treatment of all liver diseases is the prerogative of the doctor. In this case, folk methods can only have an additional effect.

The yellowness of the eyeball and iris can be caused by malignant formations of the tissues of the organ of vision - more often the conjunctiva. Yellowness is one of the symptoms of melanoma in the eye area. So do not delay a visit to the ophthalmologist if there are discomfort in the eye socket and yellow spots on the surface of the eye, which can be seen when looking at yourself in the mirror.

Proteins turn yellow in diseases such as pinguecula and pterygium.

A pinguecula is a small formation similar to a wen, which is localized due to a violation of lipid metabolism in the body on the eyeball.

Pterygium is an overgrowth of the conjunctiva of the eye (popularly called the disease "wild meat"). It begins to enter the sclera and reduces the field of view.


Surgical treatment of pinguecula and pterygium. Pterygium can be eliminated only at the initial stage. If the conjunctiva grows so large that it closes the pupil, then reverse recovery is impossible.

All eye diseases are a reason to consult an ophthalmologist.

This disease has a second name - constitutional jaundice. Boys get sick 5 times more often than girls. If we consider only clinical signs - yellowing of the eyelids and eyeballs, then we can say that Gilbert's disease is rare. However, if you pay attention to the blood formula regarding the emerging bilirubinemia, then the frequency of manifestations increases.

Yellowness of the sclera does not always appear, but only with a delay in feeding, due to which hemolysis increases. That is, in the absence of starvation, symptoms of the disease do not occur.

It is impossible to cure Gilbert's disease, but there are ways to eliminate the symptoms. This is a sparing diet, the use of choleretic drugs and soy emulsions.

Smoking itself does not affect the color of the sclera, but it must be taken into account that the constant supply of nicotine to the body increases the load on the liver.

In addition to nicotine, when smoking, other combustion products, tars and toxins enter the body. The liver is involved in cleansing the body, and overloads negatively affect its function.

That is why long-term smokers have yellowish whites of the eyes and skin. In medicine, this is called "signs of subacute toxic hepatitis."

If the unhealthy appearance and yellowness of the eyeballs are caused by eye fatigue, it is necessary to balance the regime of work and rest, walk more, increase the amount of healthy food in the diet - vegetables, fruits, seafood and nuts - which includes vitamins for the eyes: A, C, E , nicotinic and folic acid, saturated fatty acids.

Sometimes the eyeballs turn yellow if there is a lot of carotene in the body. This happens, for example, if you "abuse" carrots. In this case, the treatment is a variety of diet.


In all other situations - when the color of the sclera changes - you need to see a doctor. This state is a signal: not everything is in order in the body.

are a sign that the patient has

jaundice. Jaundice is a pathological condition that occurs when

diseases of the liver, diseases of the blood

Pancreas, bile ducts and associated with an increase in the concentration in the blood of total

bilirubin

Jaundice is not only accompanied by yellowing of the eyes. With it, the skin often turns yellow, skin

Fever, pain in the right hypochondrium, sensation

bitterness in the mouth decreased appetite

Appears

nausea, vomiting, headache

weakness insomnia

Enlargement of the liver and

spleen

The structure of the mucous membrane of the eye and the membranes of the eye

The human organ of vision consists of the eyeball, oculomotor muscles, eyelids, lacrimal apparatus, vessels and nerves. This organ is the peripheral part of the visual analyzer and is necessary for the visual perception of external objects. The main structure in the organ of vision is the eyeball. It is located in the eye socket and has an irregular spherical shape. Visually, on a person's face, you can only see the anterior part of the eyeball, which is only a small part of it and is covered in front by the eyelids. Most of this anatomical structure (

eyeball

) is hidden in the depth of the eye socket.

There are three main membranes in the eyeball:

  • outer (fibrous) shell of the eyeball;
  • middle (vascular) membrane of the eyeball;
  • inner (sensitive) shell of the eyeball.

The outer shell of the eyeball The outer shell of the eyeball consists of two important sections, which differ from each other in their anatomical structure and functions. The first section is called the cornea of ​​​​the eye. The cornea of ​​the eye is located in the anterior central part of the eyeball. Due to the absence of blood vessels and the homogeneity of its tissue, the cornea is transparent, so the pupil and iris of the eye can be seen through it.

The cornea consists of the following layers:

  • anterior stratified squamous epithelium;
  • anterior limiting membrane;
  • own substance of the cornea (consists of homogeneous connective tissue plates and flat cells, which are a type of fibroblasts);
  • the posterior limiting membrane (Descemet's membrane), which mainly consists of collagen fibers;
  • posterior epithelium, which is represented by the endothelium.

Due to its transparency, the cornea easily transmits light rays. It also has the ability to refract light, as a result of which this structure is also referred to as the light refracting apparatus of the eye (together with the lens, vitreous body, fluids of the eye chambers). In addition, the cornea performs a protective function and protects the eye from various traumatic effects.

The cornea is the most convex part of the eyeball. Along the periphery, the cornea of ​​the eye smoothly passes into the sclera of the eyeball, which is the second important section of the outer shell of the eye. This department occupies most of the area of ​​the outer shell of the eye. The sclera of the eye is represented by a dense fibrous formed connective tissue, consisting of bundles of collagen fibers with an admixture of elastic fibers and fibroblasts (

connective tissue cells

). The outer surface of the sclera is covered anteriorly by the conjunctiva, and the posterior by the endothelium. conjunctiva (

conjunctiva

) is a relatively thin shell, which consists of a cylindrical stratified epithelium. This sheath covers the inside of the eyelids (

secular part of the conjunctiva

) and the eyeball outside (

ocular part of the conjunctiva

). Moreover, this structure does not cover the cornea.

The outer shell of the eyeball performs a number of important functions. Firstly, it is the most durable in comparison with the other two shells of the eyeball, as a result of which its presence allows you to protect the organ of vision from traumatic injuries. Secondly, the outer shell of the eye, due to its strength, helps to maintain the eyeball in a certain anatomical shape. Thirdly, the oculomotor muscles are attached to this shell, as a result of which the eyeball can make various movements in the orbit.

Middle shell of the eyeball

The middle layer of the eyeball is located inside the eye. It consists of three unequal parts (

back, middle and front

). Of all parts of the middle shell, only the iris can be visually seen (

anterior part of the middle shell of the eyeball

), which is located between the pupil and the sclera of the eyes. It is the iris that gives the eyes a certain color. It consists of loose connective tissue, blood vessels, smooth muscles, nerves, and pigment cells. iris of the eye (

unlike the other two parts of the middle shell

) is not adjacent to the outer shell of the eyeball and is separated from the cornea by the anterior chamber of the eye, which contains intraocular fluid. Behind the iris is the posterior chamber of the eye, which separates the lens (

a transparent structure that is located directly opposite the pupil inside the eyeball and is a biological lens

) and rainbow. This chamber is also filled with intraocular fluid.

The back part of the middle shell of the eyeball is called the own choroid of the eyeball. It is located directly under the white of the eye in the back of it. It consists of a large number of vessels, connective tissue fibers, pigment and endothelial cells. The main function of this anatomical structure is to provide nutrients to the cells of the retina (

inner lining of the eyeball

) eyes. The posterior part of the middle shell lines almost two-thirds of the entire area of ​​the sclera, and therefore is the largest of all three parts of the middle shell.

A little ahead of her

back of middle shell

), in the form of a ring, the ciliary body is located (

middle part of the middle shell of the eyeball

), represented by the ciliary muscle, which plays an important role in the accommodation of the eye (

it regulates the curvature of the lens and fixes it in a certain position

). Also in the composition of the ciliary (

ciliary

) of the body includes special epithelial cells that are engaged in the production of intraocular fluid that fills the anterior and posterior chambers of the eye.

The inner lining of the eyeball

or retina

) envelops the inside of the iris, the ciliary body and the own choroid of the eyeball. The totality of those places where the retina is adjacent to the iris and to the ciliary body is called non-visual (

) part of the retina. The rest, posterior, more extensive part of the retina is called visual. In this part of the retina, light is perceived as it enters the eyeball. This perception is possible due to the presence of special photoreceptor cells inside the retina. The retina itself consists of ten layers, which differ from each other in different anatomical structures.

In the liver cells, indirect bilirubin binds to glucuronic acid (a chemical substance necessary to neutralize bilirubin), and it turns into direct bilirubin (detoxified bilirubin). Further, direct bilirubin is transported by liver cells to bile, through which it is excreted from the body. In some cases, some of it can be reabsorbed back into the blood. Therefore, there are always two main fractions of bilirubin in the blood - direct bilirubin and indirect bilirubin. These two fractions together make up the total blood bilirubin. Indirect bilirubin accounts for about 75% of total bilirubin. The reference (limiting) values ​​​​of the concentration in the blood of total bilirubin are 8.5 - 20.5 μmol / l.

An increase in the concentration of total bilirubin above 30 - 35 µmol / l leads to the appearance of jaundice in the patient (

yellowing of the skin and sclera of the eyes

). This happens because at such concentrations it (

bilirubin

) diffuses (

penetrates

) into peripheral tissues and stains them yellow. There are three degrees of severity of jaundice (

that is, the severity of jaundice

). With a mild degree, the concentration in the blood of total bilirubin reaches 86 µmol / l. With an average degree in the blood of a patient, the level of bilirubin is in the range from 87 to 159 μmol / l. With a pronounced degree of severity, its concentration in blood plasma is higher than 159 µmol / l.

Causes of yellowing of the sclera of the eyes

Cause The mechanism of formation of yellowness of the whites of the eyes
Liver disease In liver diseases, there is a violation of the binding of indirect (not associated with glucuronic acid) bilirubin from the blood and the release of direct bilirubin from it, due to damage to hepatocytes (liver cells). Slowing down the excretion of indirect bilirubin from the blood and the entry of direct bilirubin into it (it enters the blood as a result of damage to liver cells) leads to its accumulation in it. When it reaches high concentrations, it leaves the vessels and penetrates into the sclera of the eyes, where it is deposited. Such deposition is accompanied by staining of the albuginea of ​​the eyes in yellow.
Blood diseases In blood diseases, pronounced hemolysis (destruction) of erythrocytes (red blood cells) is observed, which leads to an increase in the concentration of hemoglobin in the blood (a protein that transports oxygen), which is contained in a large number of erythrocytes. Subsequently, this hemoglobin undergoes decay and indirect bilirubin is formed from it. Since in case of blood diseases, indirect bilirubin is formed much more (due to the breakdown of a large amount of hemoglobin in the blood) than the liver can neutralize, it gradually accumulates in the blood, and then penetrates into the sclera of the eyes, staining them yellow.
Diseases of the biliary tract Yellowing of the whites of the eyes in diseases of the biliary tract is associated with the accumulation of a significant amount of direct bilirubin in the blood. With these pathologies, the outflow of bile from the liver into the duodenum is disturbed. As a result, there is a rupture of the intrahepatic bile ducts, through which bile is removed from the liver. Because of this, the components of bile penetrate into the blood. Since one of its main components is direct bilirubin, its concentration in the blood plasma increases significantly. Then this bilirubin penetrates the sclera of the eyes and stains them yellow.
Violation of metabolic processes in the body There are at least three types of metabolic disorders that lead to yellowing of the whites of the eyes (impaired metabolism of metals, bilirubin and proteins). In case of violation of the metabolism of iron (hemochromatosis) or copper (Wilson-Konovalov's disease), they accumulate in the liver, which leads to damage to its tissues (since these metals are toxic to body tissues in high concentrations) and the development of liver cirrhosis. With cirrhosis, the detoxification function of the liver is disrupted, as a result of which it does not remove indirect bilirubin from the blood. As the disease progresses, it accumulates in the skin and sclera of the eyes and stains them yellow. In some hereditary liver diseases (Gilbert's disease, Crigler-Najjar syndrome, Dubin-Johnson syndrome), there is a violation of bilirubin metabolism, and it accumulates in the blood and peripheral tissues (skin and sclera of the eyes). With amyloidosis (a pathology associated with a violation of protein metabolism), amyloid (abnormal protein) is deposited in the liver, which causes a violation of its structure and function, as a result of which it gradually loses the ability to remove indirect bilirubin from the blood, as a result of which it accumulates in the skin and tunica eyes, giving them a yellow tint.
Acute or chronic pancreatitis In acute or chronic pancreatitis (inflammation of the pancreas), an increase in the size of the pancreas is often observed due to its inflammatory edema. Since there is a common bile duct near the pancreas, in such cases it is quite often mechanically compressed from the abdominal cavity by an enlarged pancreas. Mechanical blockage of the common bile duct is accompanied by stagnation of bile in the biliary tract and rupture of the intrahepatic bile capillaries, as a result of which the components (including direct bilirubin) of bile enter the bloodstream. Therefore, in acute or chronic pancreatitis, patients have an increased level of direct bilirubin in the blood and there is jaundice (yellowing of the skin and sclera of the eyes).

In the liver, indirect bilirubin, which circulates in the blood, is detoxified and direct bilirubin is formed. Therefore, when it is damaged in the blood, the concentration of total bilirubin immediately increases and yellowing of the whites of the eyes occurs. Yellowing of the eyes can be triggered by various liver pathologies that are of infectious and non-infectious origin. Infectious diseases of the liver include viral, bacterial

hepatitis

inflammation of the liver tissue

amebiazechinococcosis

liver. Non-communicable diseases of the liver can be toxic hepatitis, cirrhosis,

liver cancersarcoidosis

liver, Ziwe syndrome.

Hepatitis is a disease of the gastrointestinal system in which there is inflammation of the liver parenchyma (

). Hepatitis can appear as a result of penetration into the liver of various

hepatitis A, B, C virus, cytomegalovirus, Epstein-Barr virus, yellow fever virus, etc.

bacteria

leptospirosis, syphilis, tuberculosis, etc.

amoebiasis, echinococcosis, ascariasis, schistosomiasis, etc.

toxins

ethyl alcohol, chlorpromazine, tetracycline, methyldopa, methotrexate, dichloroethane, phenol, benzene, etc.

). Therefore, depending on the etiology (

origin reasons

) all hepatitis are divided into viral, bacterial, toxic (

or medicinal

All of these listed factors

viruses, bacteria, etc.

) cause damage to liver cells, resulting in their gradual destruction, which is accompanied by the appearance of inflammation in the liver. This is accompanied by a violation of its full function and the loss of the ability to neutralize the indirect bilirubin that comes from the blood to the liver for processing. In addition, with hepatitis, direct bilirubin also accumulates in the blood (

since the liver cells are destroyed, and he is thrown out of them into the surrounding space

). The accumulation of direct and indirect bilirubin in the blood contributes to their deposition in various tissues and, in particular, in

and mucous membranes. Therefore, with liver damage, yellowing of the skin and albuginea occurs (

Ziwe syndrome is a rare syndrome (

set of pathological features

), which is characterized by the appearance of jaundice in the patient (

yellowing of the sclera and skin

), enlarged liver, hemolytic anemia (

), hyperbilirubinemia (

increase in blood bilirubin

) and hyperlipidemia (

increased levels of fat in the blood

). This syndrome is observed in people who abuse alcohol. Yellowing of the whites of the eyes in Zieve syndrome is caused by an increase in the level of bilirubin (

mainly through indirect

) in the blood, due to the destruction of red blood cells and impaired liver function. In most cases, these patients develop fatty liver (

dystrophy

) of the liver, i.e. pathological deposition within the parenchyma (

) liver fat.

Cirrhosis of the liver is a pathology in which liver damage occurs and its normal tissue is replaced by pathological connective tissue. With this disease, connective tissue begins to grow in the liver, which gradually replaces the usual hepatic tissue, as a result of which the liver begins to function poorly. It loses the ability to neutralize various compounds harmful to the body (

ammonia, bilirubin, acetone, phenol, etc.

). Violation of the detoxifying ability of the liver leads to the fact that these toxic metabolic products begin to accumulate in the blood and have an adverse effect on the organs and tissues of the body. Bilirubin (

indirect

), circulating in large quantities in the bloodstream, is gradually deposited in the skin, the white of the eyes, the brain and other organs. The deposition of bilirubin in the tissues gives them a yellow color, therefore, with cirrhosis of the liver, icterus is noted (

yellowing

) sclera and skin.

Cirrhosis of the liver is usually the most unfavorable complication of various hepatitis (

inflammation of the liver

). The most common causes that lead to the development of cirrhosis of the liver are

alcoholism

Hepatitis B, C and D viruses, congestive venous insufficiency (

for example, heart disease, Budd-Chiari disease, etc.

), primary sclerosing

cholangitis

inflammation of the lining of the bile ducts

), drug-induced hepatitis (

against the background of long-term use of antibiotics, cytostatics, immunosuppressants, etc.

), hemochromatosis (

a disease in which iron accumulates in tissues

), Wilson-Konovalov disease (

pathology associated with the accumulation of copper in tissues

For liver cancer

hepatocellular carcinoma

e.g. at work

) with pesticides, heavy metals and those who eat poorly processed plant foods that may contain aflatoxins.

In liver cancer, tumor-like formations that appear in the liver are characterized by rapid, aggressive growth, due to which they quickly reach large sizes. In the process of increasing in size, the tumors crowd out the normal liver tissue, which is why the liver soon loses its normal functions, one of which is the neutralization of indirect bilirubin circulating in the blood. Therefore, in the later stages of liver cancer, hyperbilirubinemia occurs in the blood (

increased levels of bilirubin in the blood

). With a high level of bilirubin in the blood, it begins to be deposited in the skin and the white of the eyes, as a result of which the patient develops jaundice (

yellowing of the skin and sclera

Echinococcus granulosus

), which is a type of tapeworm (

). Human infection with echinococcosis occurs by eating food or water contaminated with the eggs of these worms or by contact with infected animals (

dogs, horses, pigs, cows, etc.

). Therefore, this disease is observed mainly in hunters, shepherds, slaughterhouse workers and their families. When hit in

intestines

eggs of this helminth, they penetrate through its wall into the portal vein, through which these eggs reach the liver. Getting stuck in it, they transform into a cyst, which is a small volumetric formation in the form of a bubble filled with liquid with numerous echinococcus embryos.

If the disease is not treated for a long time, then the echinococcal cyst begins to gradually increase in size and compress the surrounding liver tissues, causing them to die (

atrophy of the liver parenchyma

). As a result of this, there is a mechanical replacement of normal hepatic tissue, in place of which a cyst appears. At a certain point, when the cyst reaches a large size, the liver loses its ability to bind and neutralize indirect blood bilirubin, as a result of which it accumulates first in it, and then in the skin and in the white of the eyes, giving them a characteristic yellow color.

Sarcoidosis is a chronic disease in which various tissues and organs (

lungs, liver, kidneys, intestines, etc.

) granulomas appear. A granuloma is a collection of

lymphocytes

macrophages and epithelioid cells. Granulomas in sarcoidosis appear as a result of an inadequate immune response of the body to certain antigens (

foreign particles

). This is facilitated by various infectious (

viruses, bacteria

) and non-infectious factors (

genetic predisposition, human contact with toxic substances, etc.

As a result of the impact of such factors on human tissues, the functioning of the immune system is disrupted. If it detects some antigens in tissues, then hyperimmune (

excessive immune

) response and in the places of localization of such antigens cells of the immune system begin to accumulate, resulting in small foci of inflammation. These foci visually look like nodules (

or granulomas

), different from normal tissues. Granulomas may vary in size and location. Inside such foci, the cells of the immune system, as a rule, act inefficiently, so these granulomas persist for a long time, and in some cases they can increase in size. In addition, new granulomas constantly appear in sarcoidosis (

especially if left untreated

The constant growth of already existing granulomas and the appearance of new pathological foci in various organs disrupts their normal architectonics (

structure

) and work. Organs gradually lose their function as granulomatous infiltrates replace their normal parenchyma (

). If, for example, sarcoidosis affects the lungs (

and they are most often damaged in this disease

), then the patient has

cough, shortness of breath, chest pain

Excessive fatigue due to lack of air. If the liver is damaged, then, first of all, its detoxifying and protein-synthetic (

in the liver, the synthesis of blood proteins is disrupted

) functions.

In case of violation of the detoxifying function of the liver, various metabolites accumulate in the blood, which must be absorbed and neutralized by the liver. This explains the fact that patients with liver sarcoidosis have high levels of bilirubin in the blood. The accumulation of bilirubin in the bloodstream then leads to its deposition in various tissues. Its accumulation in the skin and sclera of the eyes leads to their yellowing.

Entamoeba histolytica

inflammation of the intestinal mucosa

). This form of amoebiasis is called intestinal amoebiasis. There is also extraintestinal amoebiasis. It appears under certain conditions (

for example, with dysbacteriosis, immunodeficiency, poor nutrition, etc.

), when amoeba can penetrate through the damaged wall of the large intestine into the blood, and then through it mix into various tissues and organs (

liver, lungs, heart, brain, etc.

The main manifestation of extraintestinal amebiasis is liver damage. When pathogenic amoebas enter the liver, they cause damage to its tissues there. Hepatitis occurs first

inflammation of the liver tissue

). Some time later, in the absence of a proper immune response, the patient at the site of injury (

and inflammation

) can form inside the liver

abscesses

cavities filled with pus

). There may be a large number of such abscesses. In the absence of treatment for liver amoebiasis, its various functions are violated, including the neutralization of bilirubin in the blood (

indirect bilirubin

In addition, due to massive damage to liver cells by amoeba, there is a significant release of bilirubin associated with glucuronic acid (

direct bilirubin

) back into the blood. Therefore, with liver amoebiasis in a patient in the blood, an increase in the concentration of total bilirubin can be observed (

due to both fractions of bilirubin

). The accumulation of bilirubin in the blood often leads to its deposition in the skin and sclera of the eyes, causing them to turn yellow.

Erythrocytes (

red blood cells

protein that delivers oxygen to tissues

). In its chemical structure, it is a chromoprotein (

), which consists of four polypeptides (

protein

) chains and heme (

protoporphyrin IX in complex with iron

). All red blood cells that are produced in the bone marrow have a limited lifespan (

about 125 days

). When this period comes to an end, the destruction of red blood cells occurs. The hemoglobin contained in them is released into the surrounding space and then decomposes into protein and heme parts. Heme further turns into indirect bilirubin, which must be neutralized in the liver.

In blood diseases (malaria, erythrocyte membranopathies, erythrocyte enzymopathies, erythrocyte hemoglobinopathies, autoimmune hemolytic anemias, babesiosis, poisoning with hemolytic poisons), massive hemolysis (destruction) of erythrocytes is observed, resulting in a sharp increase in the amount of indirect bilirubin in the blood. Under such conditions, the liver does not have time to neutralize it. Therefore, this bilirubin penetrates tissues (for example, the whites of the eyes) and stains them yellow.

Plasmodium vivax, Plasmodium ovale, Plasmodium falciparum, Plasmodium malariae

). Infection occurs when a person is bitten by mosquitoes of the genus Anopheles (

malarial mosquitoes

), which are a kind of carriers and distributors of this infectious disease. Entering the human blood

tissue schizogony

), after which merozoites are formed (

mononuclear plasmodia

These merozoites then enter the bloodstream and invade red blood cells and begin to divide there again (

erythrocyte schizogony

). At the end of the erythrocyte schizogony, the infected erythrocytes are completely destroyed and release a large number of proliferating merozoites, which again penetrate into new erythrocytes for reproduction. Thus, this process proceeds cyclically. Each new destruction of erythrocytes is accompanied by the release into the blood of not only new populations of malarial merozoites, but also the rest of the contents of erythrocytes and, in particular, the protein - hemoglobin. When this protein breaks down, bilirubin is formed (

indirect

), which must be detoxified in the liver.

The problem is that with malaria, a very significant number of red blood cells are destroyed and a huge amount of indirect bilirubin is formed in the blood, which the liver does not have time to process. Therefore, patients with malaria develop hyperbilirubinemia (

an increase in the level of bilirubin in the blood

) and jaundice (

yellowing of the skin and eyes

), which occurs due to the partial deposition of bilirubin in the tissues.

Erythrocyte membranopathies are a set of hereditary pathologies based on congenital defects in the genes encoding proteins (

glycophorin C, alpha-spectrin, etc.

), which are part of the membranes of erythrocytes. Such defects lead to a disruption in the production of membrane proteins during the formation of red blood cells in the bone marrow, as a result of which the membranes of older red blood cells circulating in the blood change their shape. In addition, with these pathologies, their membranes become defective, they have incorrect permeability for various substances and low resistance to damaging factors, and therefore such erythrocytes are quickly destroyed and do not live long.

The best-known erythrocyte membranopathies are Minkowski-Chauffard disease, hereditary elliptocytosis, hereditary stomatocytosis, hereditary acanthocytosis, and hereditary pyropoykylocytosis. All these pathologies are characterized by a triad of clinical signs - jaundice, hemolytic anemia (

a decrease in the number of red blood cells as a result of their destruction

) and splenomegaly (

enlargement of the spleen

). The appearance of jaundice in such patients is explained by the fact that with erythrocyte membranopathies there is a frequent destruction of defective erythrocytes in the blood, which is accompanied by the release of a large amount of hemoglobin, which then turns into indirect bilirubin. The liver cannot immediately process huge amounts of indirect bilirubin and remove it from the blood. Therefore, this metabolite (

product of exchange

) accumulates in the blood and subsequently settles in the tissues, causing yellowing of the whites of the eyes and skin.

Erythrocyte enzymopathies are a group of hereditary diseases in which the production of enzymes is impaired in red blood cells (

proteins that speed up biochemical reactions

) that control the course of metabolic reactions (

exchange reactions

). This leads to inferiority of energy metabolism, accumulation of intermediate reaction products and energy deficiency in the erythrocytes themselves. Under conditions of energy deficiency in erythrocytes, the transport of various substances through their membrane slows down, which contributes to their wrinkling and destruction. There are also certain erythrocyte membranopathies in which there may be a deficiency in the enzymes of the antioxidant systems of erythrocytes (

e.g. pentose phosphate cycle, glutathione system

), which often leads to a decrease in their resistance to free oxygen radicals and rapid degradation.

In any case, enzyme deficiency in erythrocyte enzymopathies leads to a decrease in the life span of erythrocytes and their rapid death, which is accompanied by the release of a large amount of hemoglobin into the blood and the appearance of hemolytic anemia (

a pathology in which there is a deficiency of erythrocytes and hemoglobin in the blood resulting from the destruction of erythrocytes

) and jaundice. The appearance of the latter is due to the fact that the liver does not have time to quickly process and remove indirect bilirubin from the blood, which was formed in large quantities during the breakdown of hemoglobin. Therefore, indirect bilirubin is deposited in the skin and whites of the eyes and causes them to turn yellow.

Erythrocyte hemoglobinopathies are a group of congenital diseases, the origin of which is genetically mediated defects in the formation of hemoglobin in erythrocytes. Some of the most common hemoglobinopathies are sickle cell anemia, alpha thalassemia, and beta thalassemia. With these pathologies, red blood cells contain abnormal hemoglobin, which does not perform its function well (

oxygen transport

), and the erythrocytes themselves lose their strength and shape, as a result of which they quickly undergo lysis (

destruction

) and have a short life span in the blood.

Therefore, patients suffering from one of these diseases often have hemolytic anemia (

decrease in the level of erythrocytes in the blood, due to their destruction

), jaundice and oxygen deficiency (

due to impaired oxygen transport by hemoglobin

). The occurrence of jaundice can be explained by the fact that with erythrocyte hemoglobinopathies there is a significant release of pathological hemoglobin into the blood from collapsing erythrocytes. This hemoglobin is subsequently broken down and converted into indirect bilirubin. Since with these pathologies there is a destruction of a large number of red blood cells, then, accordingly, there will be a lot of indirect bilirubin in the blood, which the liver is not able to quickly neutralize. This leads to its accumulation in the blood and in other tissues and organs. If this bilirubin penetrates the skin and whites of the eyes, they turn yellow. Yellowing of the whites of the eyes and skin is called jaundice.

Autoimmune hemolytic anemia is a group of pathologies in which erythrocytes in the blood are damaged due to their binding to autoimmune (

pathological

) antibodies (

protective protein molecules circulating in the blood and directed against the body's own cells

). These antibodies begin to be synthesized by the cells of the immune system when its proper functioning is disrupted, which can be caused by genetic defects in immunocytes (

cells of the immune system

). Dysfunction of the immune system can also be triggered by external environmental factors (

e.g. viruses, bacteria, toxins, ionizing radiation, etc.

When normal erythrocytes bind to autoimmune (

pathological

) antibodies destroy them (

). The destruction of a large number of red blood cells leads to the appearance of hemolytic anemia (

that is, a decrease in red blood cells, due to their sudden intravascular destruction

). This anemia is fully called autoimmune hemolytic anemia (

). Depending on the type of autoimmune antibodies that cause destruction of red blood cells in the blood, all autoimmune hemolytic anemias are divided into types (

for example, AIHA with thermal hemolysins, AIHA with incomplete cold agglutinins, Fisher-Evans syndrome, etc.

). All autoimmune hemolytic anemias are accompanied by an increase in the concentration of indirect bilirubin in the blood (

due to increased release of hemoglobin from damaged erythrocytes

). Being deposited in the tissues, this chemical metabolite causes them to turn yellow, therefore, with these pathologies, patients often have yellow skin and sclera of the eyes.

Babesiosis is an infectious disease resulting from human infection with protozoa of the genus Babesia (

). Transfer mechanism

infections

transmissible, that is, a person acquires this disease when bitten by ticks (

genera Dermacentor, Hyalomma, Rhipicephalus

). People who are constantly in contact with pets and have a fairly pronounced immunodeficiency (

for example, patients with HIV infection, infections, etc.

). person with normal

immunity

may also become infected with babesiosis, but the disease will be asymptomatic.

The infection enters the human blood during tick feeding (

through his saliva

destruction

) a large number of red blood cells. During their destruction, a lot of hemoglobin enters the bloodstream, which breaks down and turns into bilirubin (

indirect

). Significant concentrations of this bilirubin in the blood cause yellowing of the whites of the eyes and skin.

Hemolytic poisons are a group of chemical compounds that, when ingested, cause pronounced hemolysis (

destruction

) red blood cells, resulting in anemia (

deficiency of red blood cells and hemoglobin in the blood

) and jaundice (

yellowing of the skin and eyes

). Hemolytic poisons include various chemicals of natural or artificial origin. Poisons of natural origin include snake venoms, venoms of scorpions, spiders, bees, poisons of some mushrooms, berries, etc.

Most of the hemolytic poisons are artificially synthesized chemicals (

benzene, phenol, aniline, nitrites, chloroform, trinitrotoluene, phenylhydrazine, sulfapyridine, hydroquinone, potassium bromate, arsenic, lead, copper, etc.

), which are used in various industries (

chemical, medical, fuel, etc.

). Therefore, most of the poisoning with hemolytic poisons occurs in industrial workers who are constantly in contact with these toxic substances.

Under the influence of hemolytic poisons, the membranes of erythrocytes are deformed, as a result of which they are destroyed. There are also some hemolytic poisons that block the flow of enzymatic processes inside red blood cells, due to which they disrupt energy metabolism or their antioxidant capacity (

resistance to oxygen free radicals

), causing them to collapse. Certain chemicals are able to change the structure of red blood cell membranes in such a way that it becomes unrecognizable and foreign to cells of the immune system. This is how acquired autoimmune hemolytic anemia occurs. With them, the immune system destroys the patient's own red blood cells, so their number in the blood is significantly reduced.

Thus, in case of poisoning with hemolytic poisons, due to various mechanisms, massive destruction of erythrocytes inside the vessels occurs. This is accompanied by the release of a large amount of hemoglobin into the blood, which is subsequently converted into bilirubin (

indirect

). High concentrations of this bilirubin in the blood lead to its deposition in the skin and sclera of the eyes, which is accompanied by their yellowing.

Bile is a yellow-brown body fluid that is produced in the liver and secreted into the duodenum. Bile plays an important role in the digestive processes in the intestines. Also, along with bile, various harmful substances that are unnecessary to the body are excreted (

direct bilirubin, cholesterol, bile acids, steroids, metals, etc.

). Before reaching the intestines, bile passes through the bile ducts (

intrahepatic and extrahepatic

). With diseases of these pathways, it becomes difficult to transport bile to the duodenum, due to their partial or complete blockage. This is accompanied by an increase in pressure in the bile ducts located above the blockage. In those places where the wall of these ducts is the thinnest, it breaks, and part of the bile enters the bloodstream. Therefore, in diseases of the biliary tract (

primary sclerosing cholangitis, cholelithiasis, tumors of the organs of the biliopancreatoduodenal zone, opisthorchiasis

) the level of direct bilirubin in the blood rises and jaundice is observed.

Primary sclerosing cholangitis is a disease of unknown nature, in which chronic inflammatory processes are observed in the walls of the intrahepatic and extrahepatic bile ducts. Due to constant inflammation, the walls of these ducts undergo pathological changes, they thicken, narrow, coarsen and deform. As the disease progresses, the lumen of the affected biliary tract is completely obliterated (

closes

). Such pathways become completely non-functional, bile does not move along them from the liver to the duodenum. The more such ducts are affected, the more difficult it is for bile to be transported to the intestines. When a large number of bile ducts are damaged, bile stasis occurs inside the liver (

cholestasis

), which is accompanied by its partial penetration into the blood. Since bile contains direct bilirubin, it gradually accumulates in the skin and sclera of the eyes, causing them to turn yellow.

Gallstone disease is a pathology in which stones appear in the gallbladder or in the biliary tract. The reason for its occurrence is a violation of the ratio of substances (

cholesterol, bilirubin, bile acids

) in bile. In such cases, some substances (

such as cholesterol

) becomes larger than all the others. Bile is oversaturated with them, and they precipitate. Sediment particles gradually stick together and overlap each other, resulting in the formation of stones.

The development of this disease can contribute to the stagnation of bile (

congenital anomalies of the gallbladder, biliary dyskinesia, scars and adhesions in the bile ducts

), inflammatory processes in the bile ducts (

inflammation of the lining of the gallbladder or bile ducts

), diseases of the endocrine system (

diabetes mellitus, hypothyroidism

obesity

Wrong diet (

excessive consumption of fatty foods

pregnancy

Certain medications (

estrogens, clofibrate, etc.

), liver disease (

hepatitis, cirrhosis, liver cancer

), hemolytic anemia (

pathology associated with a decrease in the number of red blood cells due to their destruction

Stones formed during gallstone disease can be located in the so-called blind spots in the biliary system (

for example, in the body or the bottom of the gallbladder

). In such cases, this disease does not manifest itself clinically, since the stones do not clog the bile ducts, and the outflow of bile through the biliary system is preserved. If these stones suddenly fall from the gallbladder into the bile ducts, then the movement of bile through them slows down sharply. Bile accumulates in large volumes in the sections of the biliary system located above the obstacle. This leads to an increase in pressure in the bile ducts. Under such conditions, intrahepatic bile ducts are destroyed inside the liver, and bile enters directly into the bloodstream.

Due to the fact that bile contains a large amount of bilirubin (

), then its concentration in the blood increases. Moreover, such an increase is always proportional to the duration of blockage of the bile ducts by a stone. At a certain concentration in the blood of direct bilirubin, it penetrates the skin and whites of the eyes and stains them yellow.

The organs of the biliopancreatoduodenal zone include the extrahepatic bile ducts, gallbladder, pancreas, and duodenum. These organs are very close to each other in the upper floor of the abdominal cavity. In addition, they are functionally interconnected, so the tumors of all these organs have similar symptoms. With tumors of the organs of the biliopancreatoduodenal zone, yellowing of the skin and sclera of the eyes is very often noted. This is explained by the fact that in their presence there is a mechanical blockage of the extrahepatic bile ducts (

or gallbladder

) and the bile entering them (

into the ducts

) from the liver stagnates. Such stagnation is observed not only in the extrahepatic ducts, but also in the intrahepatic ducts, which are very thin and fragile. Intrahepatic ducts with stagnation of bile in them are able to break, as a result of which it penetrates into the blood. Bilirubin (

), which is part of its composition, gradually accumulates in the skin and the white of the eyes and stains them yellow.

pancreatic cancer

Which accounts for 50% of all tumors of the biliopancreatoduodenal zone, mechanical obstruction (

blockage

) of the biliary tract occurs outside, that is, a growing tumor of the pancreas from the side of the abdominal cavity compresses the main extrahepatic bile duct. Cancer of the bile ducts of the extrahepatic ducts and the gallbladder accounts for approximately 30% of all cases of tumors of the organs of the biliopancreatoduodenal zone. Cancer of these organs is accompanied by internal blockage of their lumen. With cancer of Vater's nipple (

) and duodenum (

occur in 15% of cases

) blocking the outflow of bile occurs in the area of ​​​​emission into it (

) bile from the main bile duct.

cat fluke

). This infection is transmitted by food, most often through the use of thermally improperly cooked fish of the carp family (

crucian carp, carp, tench, vobla, bream, ide, etc.

they grow connective tissue

), their lumen narrows. All this (

accumulation of worms in the bile intrahepatic tract and deformation of the walls of the bile ducts

) leads to difficulty in the outflow of bile from the liver. Bile stasis provokes rupture of the smallest bile capillaries, as a result of which bile begins to flow into the blood, which leads to the accumulation of bilirubin in it (

) and its partial deposition in the skin and the white of the eyes (

), which is accompanied by their yellowing.

There are certain pathologies

hemochromatosis, Wilson-Konovalov disease, Gilbert's disease, Crigler-Najjar syndrome, Dubin-Johnson syndrome, amyloidosis

), in which there are violations of metabolic processes in the body. Such disorders may be associated with the metabolism of bilirubin, proteins, and certain metals (

iron, copper

Hemochromatosis is a congenital disease in which there is a violation of iron metabolism in the body, and it accumulates in large quantities in various tissues and organs. With this disease, too much iron is absorbed in the intestines from the food that a person normally consumes. After the intestines, this iron is absorbed into the blood and through it is transported to various organs. With hemochromatosis, cirrhosis of the liver quite often develops, since this organ is one of the first where the accumulation of excess amounts of iron entering the body occurs.

The occurrence of cirrhosis of the liver with hemochromatosis is due to the fact that this chemical element, penetrating into the liver, causes free radical oxidation reactions in it, as a result of which the membranes of hepatocytes are damaged (

liver cells

). Damage to the membranes of hepatocytes subsequently leads to their destruction. Liver cells die. Connective tissue appears in their place. Such substitution is a characteristic morphological sign of liver cirrhosis. With the development of cirrhosis, the liver loses the ability to neutralize toxic elements circulating in the blood and, in particular, bilirubin, which, as this pathology develops, accumulates in the blood and then penetrates the skin and sclera of the eyes, turning them yellow.

Wilson-Konovalov disease is a chronic hereditary disease associated with impaired copper metabolism in the body. The reason for its development is a defect in the gene that encodes the synthesis of a transport protein (

), which regulates the binding of copper to ceruloplasmin in the liver (

blood plasma protein

), as well as removing excess copper that enters it from the intestines. Violation of the synthesis of this protein leads to the accumulation of copper in the liver. Since this element is toxic, under conditions of its excess, damage to the liver tissues occurs, as a result of which their inflammation develops, and then their replacement with connective tissue. Therefore, one of the main manifestations of Wilson-Konovalov's disease is cirrhosis of the liver.

With cirrhosis of the liver, a decrease in its detoxification function is observed (

as her cells are destroyed

), therefore, various metabolites accumulate in the blood of such patients (

which the liver must normally detoxify

), including bilirubin (

indirect

). An increase in the concentration of this substance in the blood leads to its deposition in the skin and sclera of the eyes, which is accompanied by their yellowing. It should be noted that in Wilson-Konovalov disease, copper accumulation is observed not only in the liver, but also in other organs, such as the brain, kidneys, and eyes. Deposition of copper in the region of the Descemet's membrane of the eyes, accompanied by the appearance of yellowish-green pigmentation along the periphery of the irises (

on the border between the sclera and cornea of ​​each eye

). This pigmentation is called Kaiser-Fleischer rings.

Gilbert's disease is an inherited disease of the liver in which liver cells (

hepatocytes

) are unable to bind indirect bilirubin circulating in the blood, as well as transport it intracellularly to microsomes (

elements of the endoplasmic reticulum - one of the cell organelles of hepatocytes

), in which it binds to glucuronic acid. As a result of these disorders, the liver loses the ability to neutralize indirect bilirubin, and it gradually accumulates in the blood. If its concentration in the blood plasma reaches high values, then it begins to migrate into the skin and sclera of the eyes, as a result of which they turn yellow.

Jaundice (

i.e. yellowing of the whites of the eyes and skin

) in Gilbert's disease is practically the main and only manifestation. However, this symptom is not permanent. It usually occurs under the influence of certain provoking factors. These include starvation,

Crigler-Najjar syndrome is an inherited liver disease in which there is a defect in the gene encoding the amino acid sequence of the enzyme (

uridine-5-diphosphate glucuronyltransferase

) liver cells involved in the neutralization and binding of indirect bilirubin with glucuronic acid inside hepatocytes (

liver cells

). As a result of this defect, the excretion of indirect bilirubin from the blood is impaired. It accumulates in the blood, and then in the skin and sclera of the eyes, as a result of which they turn yellow.

There are two types of Crigler-Najjar syndrome. The first type is characterized by severe clinical symptoms and severe jaundice. With it, the enzyme is completely absent in the liver cells (

uridine-5-diphosphate glucuronyl transferase

), which binds indirect bilirubin. This type of Crigler-Najjar syndrome usually results in the death of patients at a very early age.

In the second type, which is also called Arias syndrome, this enzyme is present in hepatocytes, but its amount, compared with the norm, is much lower. In this type, the clinical symptoms are also quite pronounced, but the survival rate in such patients is much higher. Clinical symptoms appear in patients with the second type of Crigler-Najjar syndrome a little later (

during the first years of life

). The clinical course of this type is chronic, with periods of exacerbations and remissions (

asymptomatic course

). Exacerbations in patients with Crigler-Najjar syndrome are observed much more often than in patients with Gilbert's disease.

Dubin-Johnson syndrome is also an inherited liver disease. With this pathology, the release process is disrupted (

into the bile ducts

) from liver cells of detoxified bilirubin (

), as a result of which it first accumulates in them (

in liver cells

), and then enters the bloodstream. The cause of this disorder is a hereditary defect in the gene responsible for the synthesis of direct bilirubin carrier proteins localized on the membrane of hepatocytes (

liver cells

). The accumulation of direct bilirubin in the blood gradually leads to its retention in the skin and whites of the eyes, which causes them to turn yellow.

The first signs of Dubin-Johnson syndrome in patients usually appear at a young age (

predominantly in men

). Jaundice is almost always permanent and is often associated with various dyspeptic (

nausea, vomiting, abdominal pain, poor appetite, diarrhea, etc.

) and asthenovegetative (

headache, dizziness, weakness, depression, etc.

) symptoms. This syndrome does not affect life expectancy, however, in such patients, its quality is significantly reduced (

due to persistent symptoms

). If the disease goes into remission (

asymptomatic course

), then it can quickly worsen if the patient is exposed to various provoking factors (

heavy physical exertion, stress, alcohol consumption, fasting, injuries, viral or bacterial infections, etc.

Amyloidosis is a systemic disease resulting in various organs (

kidneys, heart, esophagus, liver, intestines, spleen, etc.

) accumulates an abnormal protein - amyloid. The reason for the appearance of amyloid is a violation of protein metabolism in the body. There are purchased

for example, ASC1 amyloidosis, AA amyloidosis, AH amyloidosis, etc.

) and hereditary (

AL amyloidosis

) forms of this pathology. The chemical structure of amyloid and its origin depend on the form of amyloidosis. For example, in AL-amyloidosis, amyloid consists of clusters of light chains (

fragments

) immunoglobulins (

protective molecules that circulate in the blood

). In AH-amyloidosis, amyloid deposits are composed of beta-2 microglobulin (

one of the plasma proteins

Amyloid itself is not toxic to the body, but its deposition in organs causes a violation of their structure and function. This happens due to the fact that amyloid is deposited in the tissues, displacing them. As a result, inside the organs, normal functional tissue is gradually replaced by non-functional tissue. This results in multiple organ failure

functional insufficiency of several organs

). If amyloid is deposited in the liver, then its function is also impaired. The more amyloid accumulates in it, the more pronounced

liver failure

With this insufficiency, the liver does not neutralize indirect bilirubin circulating in the blood. This leads to its accumulation in the blood plasma and its deposition in the skin and sclera of the eyes, which causes them to turn yellow.

Pancreatitis is a disease of the pancreas characterized by inflammation of its parenchyma (

). The mechanism of development of this pathology is associated with the activation of enzymes (

chymotrypsin, trypsinogen, proelastase, phospholipase, etc.

) within the gland itself, resulting in autolysis (

self-digestion or self-destruction

With pancreatitis, an increase in the pancreas in size is almost always observed, due to its edema (swelling is associated with inflammatory processes occurring inside this organ). An enlarged pancreas often compresses the common bile duct (choledochus), which transports bile from the gallbladder to the duodenum. This is accompanied by difficulty in the outflow of bile from the liver to the intestines and its stagnation in the bile ducts (gall bladder, intrahepatic and extrahepatic bile ducts). Violation of the outflow of bile, in the end, leads to rupture of the bile capillaries (due to high pressure in the bile ducts) and the penetration of bile into the blood.

Since one of the main components of bile is bilirubin (

), then its level in the blood increases sharply. A large amount of bilirubin in the blood plasma contributes to its penetration and retention in peripheral tissues (

especially in the skin and in the sclera of the eyes

), which leads to their yellowing. Jaundice (

yellowing of the skin and whites of the eyes

) can be observed in both acute and chronic pancreatitis.

To diagnose the causes of yellowness of the eyes, various types of studies can be used (

clinical, radiation, laboratory

). The main clinical diagnostic methods are the collection of anamnesis (

clarification of the entire history of the development of the disease

) in the patient and his examination. Of the radiation methods of research, doctors most often prefer ultrasound and

computed tomography

abdominal organs (

in case of suspicion of any pathology of the liver, pancreas or biliary tract

). In the diagnosis of yellowness of the eyes, various types of blood tests are also used (

complete blood count, biochemical blood test, immunological and genetic tests, toxicological blood test

stool tests

urine tests

The main symptoms of liver diseases are pain in the right hypochondrium, increased

temperature

Feeling of bitterness in the mouth, loss of appetite, jaundice (

yellowing of the eyes and skin

), headache, general weakness, decreased performance, insomnia, nausea, vomiting, liver enlargement,

flatulence

Also, depending on the disease, these patients may experience additional symptoms. For example, with liver echinococcosis, various allergic reactions on the skin are often observed (

skin rashes, itching, skin redness, etc.

). In liver sarcoidosis, there may be

in the chest, joints, muscles, shortness of breath, cough, hoarseness, an increase in the size of peripheral lymph nodes (

inguinal, occipital, elbow, cervical, axillary, etc.

joint inflammation

), deterioration

visual acuity

In patients with liver amoebiasis, pain syndrome often begins in the central part of the abdomen, which is associated with the preliminary entry of harmful microorganisms into the intestines. In addition, they meet

diarrhea with blood and mucus

False desires, dehydration of the body, hypovitaminosis. Patients with cirrhosis often experience

nosebleeds bleeding gums

Skin itching, palmar erythema (

small red rash on palms

), gynecomastia (

an increase in the size of the mammary glands in men

), spider veins on the skin,

In addition to symptoms in patients with liver disease, it is important to conduct a qualitative collection of anamnestic data that the doctor receives in the process of questioning the patient. These data will allow the attending physician to suspect a certain pathology of the liver. This is especially true of medicinal, alcoholic, infectious, toxic hepatitis (

inflammation of the liver

), Zieve syndrome, liver amoebiasis, liver echinococcosis. So, for example, if a patient in a conversation with a doctor mentions that before the onset of symptoms of the disease, he used certain types of drugs for a long time (

paracetamol, tetracycline, chlorpromazine, methotrexate, diclofenac, ibuprofen, nimesulide, etc.

), which can adversely affect the functioning of the liver, the doctor concludes that the possible pathology due to which the patient turned to him is drug-induced hepatitis.

The most common CBC changes in patients with liver disease are anemia (

), leukocytosis (

), increase

ESR (erythrocyte sedimentation rate) thrombocytopenia

), sometimes leukopenia (

) and lymphopenia (

). With echinococcosis and sarcoidosis of the liver, eosinophilia is possible (

). It is worth noting that based on the results of a complete blood count, a definitive diagnosis of any specific liver disease cannot be made.

In a biochemical blood test in patients with liver diseases, an increase in the content of total bilirubin, cholesterol, bile acids, globulins, an increase in activity

alanine aminotransferase (ALT), aspartate aminotransferase (AST)

Gamma-glutamyl transpeptidase, alkaline phosphatase, decrease in the amount of albumin, prothrombin index. Hypercalcemia can be seen in sarcoidosis (

increase in blood calcium

) and an increase in ACE (

angiotensin converting enzyme

An immunological blood test is most often given to patients with suspected viral hepatitis (

conduct a study on hepatitis markers - HbsAg, anti-Hbs, HBeAg, anti-Hbc IgG, etc.

), liver echinococcosis (

prescribe a test for antibodies to echinococcus

), amoebiasis of the liver (

prescribe a test for anti-amoebic antibodies

), autoimmune hepatitis (

a study for the presence of circulating immune complexes, antinuclear, antimitochondrial autoantibodies, antibodies to smooth muscles, to deoxyribonucleoprotein, etc.

), liver cancer (

study on alpha-fetoprotein - one of the oncomarkers

Infectious mononucleosis

test for antibodies to the Epstein-Barr virus

), cytomegalovirus infection (

test for antibodies to the cytomegalovirus virus

In some cases, patients with infectious liver diseases (

for example, with viral hepatitis, amoebiasis, cytomegalovirus infection, etc.

) appoint

PCR (polymerase chain reaction)

- one of the methods of laboratory diagnostics, which allows to identify DNA particles (

genetic material

) harmful pathogens in the blood. One of the most important methods for diagnosing liver diseases are radiation research methods - ultrasound (

) and computed tomography (

The main pathological changes that detect radiation methods of research in liver diseases

Name of the pathology Characteristic pathological changes for this pathology
Hepatitis An increase in the size of the liver, heterogeneity of the internal structure of the liver, a decrease in the echogenicity (density) of its parenchyma, impoverishment of the vascular pattern.
Ziwe syndrome The same as with hepatitis.
Cirrhosis of the liver Enlargement of the liver and spleen in size, the presence of ascites (accumulation of fluid in the abdominal cavity) is possible. The liver has an uneven, nodular surface. Directly inside the liver, a significant violation of its structure (architectonics), focal sclerosis (replacement of normal connective tissues), depletion of the vascular pattern, expansion of the portal vein can be detected.
Liver cancer Enlargement of the liver in size. The presence inside the liver of one or more large, focal formations that have an irregular shape and zones with increased and decreased echogenicity (density).
Echinococcosis of the liver An increase in the size of the liver, deformation of its structure, the presence inside it of one or more spherical pathological formations with clear boundaries, smooth contours, an anechoic structure inside and different sizes. On the periphery of these formations, fibrosis of the adjacent hepatic tissue is possible.
Sarcoidosis of the liver Enlargement of the liver in size, significant deformation of its internal architectonics (structure), diffuse fibrosis of its parenchyma, depletion of the vascular pattern, expansion of the portal vein. Ascites (accumulation of fluid in the abdominal cavity) and splenomegaly (enlargement of the spleen in size) are also sometimes present.
Amoebiasis of the liver Enlargement of the liver in size. In its parenchyma (liver tissue), one or more pathological rounded formations (abscesses) with fuzzy contours and different sizes, which contain liquid with gas bubbles, can be detected.

According to certain indications (

for example, enlargement of the liver and spleen of unclear etiology, conflicting laboratory results, etc.

) in patients with liver disease, a percutaneous liver biopsy is performed (

insertion through the skin into the liver of a needle under local anesthesia

), which allows you to take a piece of liver tissue from them for histological examination (

examining tissue under a microscope in a laboratory

). Most often, a liver biopsy is performed in order to confirm the presence of a malignant tumor in the liver, liver sarcoidosis, to establish the cause of hepatitis (

or cirrhosis of the liver

), its stage, severity.

In addition to yellowing of the albuginea (

) eyes and skin with blood diseases, there may also be an increase in the liver and spleen, fever,

General weakness, fatigue, shortness of breath, palpitations, dizziness, possible development

thrombosis

Nausea, vomiting, drowsiness, dark urine and stool,

convulsions

In case of poisoning with hemolytic poisons, the clinical picture depends entirely on the type of hemolytic poison, on the route of its entry into the body and concentration. Therefore, it is quite difficult to predict what kind of symptoms a patient will have in such cases.

Important information for the diagnosis of blood diseases is provided by the collection of anamnesis, in which doctors quite often establish their possible causes of development. Anamnestic data are especially important in the diagnosis of malaria or babesiosis (

for example, the patient's stay in endemic foci of these infections

), poisoning with hemolytic poisons (

work with toxic substances, constant use of certain medications, etc.

). With hereditary pathologies (

erythrocyte membranopathies, erythrocyte enzymopathies, erythrocyte hemoglobinopathies, congenital autoimmune hemolytic anemias

) yellowness of the sclera of the eyes in patients appears periodically, often from birth and is often associated with various provoking factors (

for example, physical activity, medication, stress, alcohol consumption, hypothermia, etc.

In a general blood test for blood diseases that cause yellowing of the eyes, a decrease in the number of erythrocytes and hemoglobin, an increase in ESR (

erythrocyte sedimentation rate

), reticulocytosis (

an increase in the content of reticulocytes in the blood - young erythrocytes

), thrombocytopenia (

). Microscopy of blood products can reveal poikilocytosis (

change in the shape of red blood cells

) and anisocytosis (

change in the size of red blood cells

). For the diagnosis of malaria and babesiosis, a thick drop and thin smear method is used to identify the causative agents of these diseases inside red blood cells.

In a biochemical blood test in patients with blood diseases, an increase in the content of total bilirubin is most often detected (

due to fraction of indirect bilirubin

), free hemoglobin, iron, increased activity of lactate dehydrogenase (

), a decrease in the content of haptoglobin. With erythrocyte enzymopathies, a decrease in the concentration or complete absence of some enzymes can be detected (

for example, glucose-6-phosphate dehydrogenase, pyruvate kinase, etc.

) inside erythrocytes. In case of poisoning with hemolytic poisons, a toxicological study of blood is carried out to identify toxins in its plasma that can damage red blood cells.

Immunological examination of blood in blood diseases is also no less important. It helps to detect antibodies against pathogens of malaria and babesiosis, to detect autoantibodies to erythrocytes in autoimmune hemolytic anemia (

AIHA with thermal hemolysins, AIHA with incomplete cold agglutinins, Fisher-Evans syndrome, etc.

). Genetic research methods are mainly used in the diagnosis of congenital blood pathologies (

erythrocyte membranopathies, erythrocyte enzymopathies, erythrocyte hemoglobinopathies

), which cause yellowing of the eyes. These methods help to establish the presence of defects in various genes encoding membrane proteins or erythrocyte enzymes. As an additional study for erythrocyte hemoglobinopathies,

electrophoresis

hemoglobin (

oxygen-carrying protein in red blood cells

). This study allows you to detect the presence of pathological forms of hemoglobin.

Enlargement of the spleen and liver in patients with blood diseases is confirmed by ultrasound or computed tomography. In some cases, they are prescribed a puncture of the ilium or sternum to take the bone marrow. In the bone marrow, all the erythrocytes that circulate in the blood are formed, so this study allows us to assess the state of the hematopoietic system and identify various disorders in the production of erythrocytes.

For diseases of the biliary tract, yellowing of the sclera of the eyes and skin, skin itching, pain in the right hypochondrium are characteristic,

weight loss

Fever, heaviness in the abdomen, flatulence, nausea, vomiting, general malaise, myalgia (

muscle pain

), arthralgia (

joint pain

), hepatomegaly (

liver enlargement

), splenomegaly (

enlargement of the spleen

), headache.

These patients often show anemia on a complete blood count (

decrease in the number of red blood cells and hemoglobin in the blood

), leukocytosis (

an increase in the number of leukocytes in the blood

), an increase in ESR (

erythrocyte sedimentation rate

), eosinophilia (

an increase in the number of eosinophils in the blood

). The most common pathological changes in the biochemical analysis of blood in patients with diseases of the biliary tract are an increase in total bilirubin (

mainly due to direct bilirubin

), bile acids, cholesterol, triglycerides, increased activity of alkaline phosphatase, alanine aminotransferase (

), aspartate aminotransferase (

), gamma-glutamyl transpeptidase.

Esophagogastroduodenoscopy (

) allows you to detect a tumor in the duodenum, assess the functional state of the papilla of Vater (

place in the wall of the duodenum where the common bile duct opens into it

). Also, with the help of this study, a biopsy can be performed (

select a piece of pathological tissue for cytological examination

) duodenal tumors. To assess the condition of the bile and pancreatic ducts, endoscopic retrograde cholangiopancreatography is performed. With opisthorchiasis, primary sclerosing cholangitis, tumors of the organs of the biliopancreatoduodenal zone, these ducts are often damaged.

The main methods of diagnosing cholelithiasis are cholecystography (

x-ray method of examination of the gallbladder

) and ultrasound. These methods most accurately detect the presence of stones in the gallbladder and blockage of the bile ducts. In addition, these two methods make it possible to assess the correct functioning of the gallbladder and biliary tract, their shape, structure, size, to identify the presence of tumors and foreign bodies in them. Ultrasound is also often prescribed to patients with suspected pancreatic tumor, opisthorchiasis.

Computed tomography and magnetic resonance imaging are commonly used in the diagnosis of tumors of the organs of the biliopancreatoduodenal zone (

extrahepatic bile ducts, gallbladder, pancreas and duodenum

). These methods allow to determine with high accuracy the presence of a tumor, its size, localization, stage of cancer, as well as to identify the presence of various complications.

The main symptoms of pathologies associated with impaired metabolic processes in the body are jaundice (

yellowing of the eyes and skin

), pain in the right hypochondrium, in the joints, weakness, lethargy, decreased ability to work, enlarged liver and spleen, nausea, vomiting, poor appetite, diarrhea, headache, dizziness, bleeding gums, nosebleeds, skin sensitivity disorders, convulsions, tremor of the extremities , peripheral edema, mental retardation, psychosis. It is important to note that in most of these pathologies (

amyloidosis, Wilson-Konovalov disease, hemochromatosis, Crigler-Najjar syndrome, Dubin-Johnson syndrome

) affects not only the liver, but also other organs (

brain, heart, kidneys, eyes, intestines, etc.

). Therefore, the list of the above symptoms can be significantly expanded (

depending on the number of affected organs and the severity of their damage

Since almost all pathologies associated with impaired metabolic processes in the body are hereditary (

with the exception of some forms of amyloidosis

), their first symptoms appear in early childhood or adolescence. Yellowing of the eyes is more often the first sign of Crigler-Najjar syndrome, Dubin-Johnson syndrome, or Gilbert's disease than amyloidosis, hemochromatosis, and Wilson-Konovalov disease. Jaundice in these last three pathologies appears later. In pathologies associated with impaired bilirubin metabolism (

Crigler-Najjar syndrome, Dubin-Johnson syndrome, Gilbert's disease

), the eyes usually begin to turn yellow due to various provoking factors - starvation, stress, heavy physical exertion, drinking excess alcohol, mechanical injuries, taking medications (

antibiotics, glucocorticoids, cytostatics, hormones, anticonvulsants, etc.

), smoking. With hemochromatosis, Wilson-Konovalov's disease and amyloidosis, yellowness of the sclera of the eyes is most often constant. Transmission of all hereditary diseases (

Crigler-Najjar syndrome, Dubin-Johnson syndrome, Gilbert's disease, amyloidosis, hemochromatosis, Wilson-Konovalov's disease

) comes from parents, so the presence of any genetic disease in one of them can serve as an important diagnostic sign. The doctor takes these features into account when taking an anamnesis (

questioning the patient

In the general blood test in patients with pathologies associated with impaired metabolic processes in the body, leukocytosis is most common (

an increase in the number of leukocytes in the blood

), anemia (

decrease in the number of red blood cells and hemoglobin in the blood

), an increase in ESR (

erythrocyte sedimentation rate

), lymphopenia (

decrease in the number of lymphocytes in the blood

), thrombocytopenia (

decrease in the number of platelets in the blood

), sometimes leukopenia (

decrease in the number of leukocytes in the blood

). In a biochemical blood test in such patients, a decrease in the amount of ceruloplasmin, cholesterol, an increase in the amount of copper, total bilirubin, globulins, glucose, an increase in the activity of aspartate aminotransferase (

), alanine aminotransferase (

), alkaline phosphatase, gamma-glutamyl transpeptidase, decrease in the amount of albumin, prothrombin index.

Based on the results of ultrasound or computed tomography, one can only suspect liver damage in a patient. Therefore, in order to more accurately confirm the presence of pathologies associated with metabolic disorders, patients usually undergo a biopsy (

taking a piece of tissue for histological examination

). In parallel with the histological examination, a genetic examination is carried out, which is mainly used in the diagnosis of Crigler-Najjar syndrome, Dubin-Johnson syndrome, Gilbert's disease and hemochromatosis. This study identifies mutations characteristic of these pathologies (

) in the genes.

The diagnosis of pancreatitis is made on the basis of complaints, certain data from instrumental and laboratory studies. The main symptoms of acute or chronic pancreatitis are severe pain in the middle of the abdomen, often of a girdle character, nausea, vomiting, loss of appetite,

belchingheartburn

Diarrhea with steatorrhea

feces fetid, mushy, sticky, with a greasy sheen

), weight loss. In a general blood test, leukocytosis can be detected (

an increase in the number of leukocytes in the blood

) and an increase in ESR (

erythrocyte sedimentation rate

), in severe clinical cases, anemia is possible (

decrease in the number of red blood cells and hemoglobin

In a biochemical blood test in such patients, an increase in the activity of certain enzymes can be detected (

alpha-amylase, lipase, elastase, trypsin

), an increase in the concentration of total bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, glucose, a decrease in albumin, calcium and an increase in the concentration of acute phase proteins (

C-reactive protein, orosomucoid, etc.

). Instrumental research methods (

ultrasound, computed tomography

) make it possible to detect certain pathological changes in the pancreas (

proliferation of connective tissue, the presence of cysts, an increase in size, etc.

), their localization and various complications (

including compression of the extrahepatic bile ducts

), which cause jaundice in these patients.

In the vast majority of cases, yellowness in the eyes occurs as a result of one or another pathology of the digestive system (

liver, pancreas, biliary tract

). Therefore, when this symptom appears, it is better to seek help from a gastroenterologist. In some cases, yellowing of the eyes can be triggered by blood diseases, which are treated and diagnosed by a hematologist. If the patient does not have access to these highly specialized doctors, then you can simply go to see a family doctor or therapist. It is important to understand that in order to get rid of yellowness in the eyes, you need to choose the right treatment, which differs for different groups of pathologies (

diseases of the liver, diseases of the biliary tract, blood diseases, pancreatitis, metabolic disorders

Treatment of liver diseases includes the use of conservative and surgical methods. Patients with hepatitis, liver cirrhosis, Ziwe syndrome, amoebiasis, liver sarcoidosis are most often treated with conservative methods. Surgical intervention is more often prescribed for patients with cancer, liver echinococcosis.

Ziwe syndrome The main treatment for Ziwe syndrome is complete abstinence from alcohol. Also, with this syndrome, hepatoprotective agents are prescribed that strengthen the wall of hepatocytes (liver cells).

Cirrhosis of the liver If cirrhosis of the liver has arisen on the background of alcoholism, then such patients are prescribed ursodeoxycholic acid (accelerates the outflow of bile from the liver and protects its cells from damage). With viral cirrhosis of the liver, patients are prescribed antiviral agents. With autoimmune cirrhosis, immunosuppressants are prescribed, that is, agents that reduce the activity of immune reactions in the body. If cirrhosis appeared on the background of Wilson-Konovalov disease (a pathology associated with the accumulation of copper in tissues) or hemochromatosis (a disease in which iron accumulates in tissues), then such patients are prescribed a special diet and detoxifying agents that form complexes with copper (or iron) and excrete it from the body through the kidneys with urine.

In primary sclerosing cholangitis, bile acid sequestrants are prescribed - drugs that bind bile acids. With cirrhosis of the liver caused by taking drugs, stop treatment with these drugs. In Budd-Chiari disease (

pathology in which blockage of the hepatic veins occurs

) patients are prescribed anticoagulants and thrombolytic agents. These drugs speed up the absorption

in the liver tissues and improve venous outflow from the liver.

Liver cancer Liver cancer is a rather serious disease, which is more effectively treated only in the very early stages. In the later stages, this pathology is practically incurable. A variety of methods are used to treat liver cancer, which may include surgical (mechanical removal of the tumor, liver transplantation, cryodestruction, etc.), radiation (irradiation of the tumor with ionizing radiation, radioembolization, etc.) and chemical methods (introduction of acetic acid, ethanol and etc.).

Sarcoidosis of the liver Sarcoidosis of the liver is treated with immunosuppressants and cytostatics. These drugs suppress immune reactions in the body, reduce the formation of inflammatory granulomatous infiltrates, inhibit the reproduction of immunocytes (cells of the immune system) and the release of inflammatory cytokines (substances that regulate the functioning of immune system cells). In severe cases, with liver failure, a new liver is transplanted.

Amoebiasis of the liver With amoebiasis of the liver, amebocides are prescribed (drugs that destroy harmful amoebae). Most often they are metronidazole, emetine, tinidazole, ornidazole, etofamide, chloroquine. These drugs also have anti-inflammatory and antibacterial effects. With the formation of abscesses inside the liver, surgical treatment is also sometimes performed, which consists in draining its cavity and removing necrotic masses (dead liver tissue).

Blood diseases that cause yellowing of the eyes are most often treated conservatively. Some of them (

malaria, babesiosis, hemolytic poisoning

) can be cured by prescribing etiotropic drugs to the patient that can eliminate the cause of the disease. Other pathologies (

erythrocyte membranopathies, erythrocyte enzymopathies, erythrocyte hemoglobinopathies, autoimmune hemolytic anemias

) cannot be completely cured, therefore, symptomatic treatment is prescribed for such patients.

Malaria Malaria is treated with antimalarial drugs (chloroquine, quinine, artemether, halofantrine, mefloquine, fansidar, etc.). These drugs are prescribed according to special therapeutic treatment regimens, which are selected depending on the type of malaria, its severity and the presence of complications. In severe cases, in the presence of complications, detoxifying, rehydrating (normalize the total volume of fluid in the body), antibacterial, anticonvulsant, anti-inflammatory drugs, infusions of erythrocyte mass (drugs containing donor erythrocytes) or whole blood, hemodialysis, oxygen therapy are prescribed.

Erythrocyte membranopathies Patients with erythrocyte membranopathies are prescribed symptomatic treatment, which most often consists of splenectomy (removal of the spleen), red blood cell infusions (a preparation containing donor red blood cells), administration of vitamins B12 and B9. In some cases, whole blood is transfused, and steroidal anti-inflammatory drugs and cholekinetics (drugs that speed up the excretion of bile from the liver) are also prescribed.

Erythrocyte enzymopathies Currently, there is no treatment method that would allow the patient to get rid of any kind of erythrocyte enzymopathy, so these pathologies are treated only symptomatically. They are usually given transfusions of red blood cells (a preparation containing donor red blood cells) or whole blood for severe hemolytic crises (that is, periods characterized by massive destruction of the patient's red blood cells). In severe cases, bone marrow transplantation is performed.

Erythrocyte hemoglobinopathies Treatment of erythrocyte hemoglobinopathies should be aimed at correcting the deficiency of hemoglobin, erythrocytes in the blood, iron deficiency in the body, the treatment of oxygen deficiency and the avoidance of provoking hemolytic crises (periods of breakdown of erythrocytes in the blood) factors (smoking, alcohol consumption, certain drugs, ionizing radiation, severe exercise, drugs, etc.). To compensate for the deficiency of red blood cells and hemoglobin in the blood, all patients are prescribed infusions of whole blood or red blood cells (a drug containing donor red blood cells), as well as vitamins B9 and B12. Iron supplements are prescribed to correct iron deficiency. In some cases, according to certain clinical indications, patients with erythrocyte hemoglobinopathies may undergo surgical bone marrow transplantation or removal of the spleen.

Autoimmune hemolytic anemias Autoimmune hemolytic anemias are treated with immunosuppressants and cytostatics, which suppress the immune system and interfere with the production and secretion of autoimmune red blood cell autoantibodies. To make up for the deficiency of destroyed red blood cells, patients are infused with red blood cells (a preparation containing donor red blood cells) or whole blood. To neutralize harmful products released from hemolyzed erythrocytes, detoxification therapy is carried out (gemodez, albumin, rheopolyglucin, plasmapheresis are prescribed). To prevent thrombosis, which often occurs in such patients, anticoagulants (anticoagulants) are prescribed.

Poisoning with hemolytic poisons Poisoning with hemolytic poisons is treated with various antidotes (antidotes), which are selected depending on the type of substance that caused intoxication. Also, such patients are prescribed detoxifying substances and hemodialysis (blood purification using a special device), which are designed to remove both the poisons themselves and the decay products of their own red blood cells from the blood. Washing the gastrointestinal tract is carried out only if the poisoning happened after eating the poison.

The main objective of the treatment of diseases of the biliary tract is to eliminate congestion in the biliary tract. This is achieved through etiotropic and / or symptomatic treatment. Etiotropic treatment is aimed at eliminating the very cause of blockage of the biliary tract. It is used for opisthorchiasis, tumors of the organs of the biliopancreatoduodenal zone, cholelithiasis. With these pathologies, etiotropic treatment is often prescribed together with symptomatic treatment, which improves the outflow of bile through the biliary tract, but does not neutralize the very cause of bile stasis. Symptomatic treatment is usually prescribed for primary sclerosing cholangitis.

Primary sclerosing cholangitis Primary sclerosing cholangitis is a rapidly progressive disease that usually leads to the development of biliary cirrhosis. Etiotropic treatment against this disease has not yet been developed, since no one knows its cause. Therefore, these patients are treated symptomatically. Therapy is mainly aimed at preventing stagnation of bile inside the liver. For this purpose, anticholestatics are used (cholestyramine, ursodeoxycholic acid, bilignin, etc.). These same drugs have a hepatoprotective property, that is, they protect liver cells from damage.

Cholelithiasis Gallstone disease is treated with various methods. First of all, such patients are prescribed a diet with the exception of very fatty and high-calorie foods. Secondly, they are prescribed medicinal substances (chenodeoxycholic and ursodeoxycholic acids), which can dissolve stones directly in the gallbladder. However, these drugs are usually not prescribed for all patients. Drug therapy is indicated only in cases where the function of the gallbladder and the patency of the bile ducts are preserved (that is, the stones do not clog the bile ducts). According to the same indications, lithotripsy is performed - the destruction of stones under the action of specially created shock waves. With blockage of bile duct stones, the presence of jaundice and cholecystitis (inflammation of the mucous membrane of the gallbladder), surgery is often performed to remove the gallbladder.

Tumors of the organs of the biliopancreatoduodenal zone The main method of treatment of tumors of the organs of the biliopancreatoduodenal zone is surgery. Radiation therapy and chemotherapy in such cases are less effective.

The main direction of treatment of such pathologies is the appointment of all patients with detoxifying agents capable of removing various metabolites (

metabolic products

) from body tissues. Detoxifying therapy is performed in patients with hemochromatosis, Wilson-Konovalov's disease, Gilbert's disease, Crigler-Najjar syndrome, Dubin-Johnson. With amyloidosis, such treatment is not performed, since amyloid deposits are firmly deposited in the liver tissues and cannot be removed from the body by detoxifying methods.

Hemochromatosis In the presence of hemochromatosis, the patient is prescribed detoxifying drugs (deferoxamine), which are able to bind iron well in the blood and excrete it through the kidneys. In addition to drugs, such patients are often prescribed a diet that excludes the intake of foods containing large amounts of iron, as well as bloodletting, through which it is possible to quickly remove a certain amount of iron from the body. It is believed that when bloodletting 500 ml of blood, about 250 mg of iron is instantly removed from the human body.

Wilson-Konovalov disease In Wilson-Konovalov disease, a diet is prescribed that minimizes the intake of large amounts of copper into the body with food, as well as detoxifying drugs (penicillamine, unitiol), which remove free copper from the body. In addition, such patients are prescribed hepatoprotectors (increase the resistance of liver cells to damage), B vitamins, zinc preparations (slow down the absorption of copper in the intestine), anti-inflammatory drugs, immunosuppressants (suppress immune responses in the body), choleretic drugs (improve the excretion of bile from the liver) .

Gilbert's disease During exacerbations of Gilbert's disease, hepatoprotectors are prescribed (protect liver cells from damage), choleretic agents (improve the excretion of bile from the liver), barbiturates (reduce the level of bilirubin in the blood), vitamins of group B. An important means of preventing exacerbations of this pathology is the strict maintenance of a certain lifestyle and the maximum avoidance of provoking factors (stress, starvation, heavy physical exertion, alcohol consumption, smoking, etc.), which can increase the level of indirect bilirubin in the blood.

Crigler-Najjar Syndrome With Crigler-Najjar syndrome, various methods of detoxifying the body are used (prescription of barbiturates, heavy drinking, plasmapheresis, hemosorption, albumin administration). In some cases, phototherapy is prescribed (irradiation of the skin with special lamps, resulting in the destruction of bilirubin in the body), blood transfusions, and liver transplantation.

Dubin-Johnson Syndrome Patients with Dubin-Johnson syndrome are prescribed B vitamins and choleretic agents (they help to remove bile from the liver). They are contraindicated insolation (prolonged exposure to sunlight). As far as possible, such patients are advised to avoid provoking factors (heavy physical exertion, stress, alcohol consumption, hepatotoxic drugs, starvation, trauma, viral or bacterial infections, etc.).

Amyloidosis Drug treatment for liver amyloidosis is always selected individually. The drugs of choice are immunosuppressants (suppress immune reactions in the body), cytostatics (slow down the processes of cell pressure in tissues), hepatoprotectors (protect liver cells from damage). In some forms of amyloidosis, a liver transplant is performed.

If acute pancreatitis occurs or recurs (

re-exacerbation

) of chronic pancreatitis in the first few days, fasting is prescribed, that is, at this time the patient should not eat. He is switched to parenteral nutrition (

that is, he is injected with nutrients directly into the blood through a catheter

). The next direction of treatment for pancreatitis is to reduce gastric secretion with the help of special drugs (

antacids, famotidine, pirenzepine, ranitidine, etc.

), as it increases the production of enzymes in the pancreas. Because of this, in fact, fasting is prescribed on the first day, because food is an excellent stimulant for the production of gastric juice in the stomach and pancreatic juice in the pancreas.

Painkillers are usually prescribed for all pancreatitis (

analgin, drotaverine, baralgin, morphine, etc.

) means and inhibitors of proteolysis (

gordox, aprotinin, contrical, etc.

). The latter block the work of activated pancreatic enzymes that cause autolysis (

self-digestion

) of pancreatic tissue and, thereby, reduce the intensity of inflammatory processes in it. Also, with pancreatitis, substitution therapy is prescribed, which includes drugs (

festal, pancreatin, mezim, creon, panzinorm, cholenzim, etc.

antiemetics

metoclopramide, domperidone, etc.

). These drugs have not only antiemetic properties, but also improve motility in the gastrointestinal system.

There are the following main causes of the appearance of yellow sclera of the eyes in newborns:

  • Crigler-Najjar syndrome. Crigler-Najjar syndrome is a pathology in which the liver cells lack an enzyme (glucuronyl transferase) that converts indirect bilirubin into direct bilirubin, as a result of which the former accumulates in the blood, penetrates into the sclera of the eyes and stains them yellow.
  • Dubin-Johnson Syndrome. Dubin-Johnson syndrome is a congenital disease in which the excretion of direct bilirubin from liver cells is impaired, due to which there is a violation of the removal of bilirubin from the liver and the whole organism.
  • Physiological jaundice of newborns. During intrauterine development, the fetus has a large amount of fetal hemoglobin in erythrocytes. When a child is born, this type of hemoglobin is replaced with ordinary hemoglobin (HbA-hemoglobin), which is the dominant (predominant) form in all children and adults. Such a change is accompanied by yellowing of the skin and sclera of the eyes in a newborn and lasts the first 7-8 days of his life.
  • Nuclear jaundice. Nuclear jaundice is a pathological condition in which the level of indirect bilirubin (more than 300 µmol / l) in the blood of newborns increases sharply. The reason for this increase may be incompatibility of the mother and fetus by blood groups, hereditary erythrocyte membranopathies, Hirschsprung's disease, congenital pyloric stenosis (obstruction of the pylorus), etc.
  • infectious hepatitis. Infectious hepatitis in newborns is most common in cases where their mothers during pregnancy are not observed by doctors and do not undergo various laboratory tests for the presence of infections (toxoplasmosis, herpes, cytomegalovirus, hepatitis B, etc.).

How to clean the whites of the eyes from yellowness? It is possible to clean the whites of the eyes from yellowness forever only by curing those pathologies (diseases of the liver, biliary tract, blood, etc.) that cause it. There is no other way of such purification, since yellowness is usually caused by the deposition of bilirubin in the white of the eyes, where it is brought from the blood.

Alcoholic drinks contain ethyl alcohol, which is toxic to liver cells. When it is consumed excessively, liver cells are damaged, and toxic hepatitis occurs (

inflammation of the liver tissue

). With it, part of the liver cells die, as a result of which the liver loses the ability to neutralize all the indirect bilirubin that circulates in the blood, as a result of which it accumulates in it. Also, when liver cells are damaged, direct bilirubin is released into the blood, which these cells have already managed to create from indirect bilirubin. Therefore, when taking alcohol in the blood of a person, the level of direct and indirect bilirubin rises, which leads to their penetration into the sclera of the eyes, due to which the latter turn yellow.

There are no such drops. There is simply no point in developing these drops, since they will act for a very short time, because in pathologies that cause yellowing of the whites of the eyes, bilirubin, which is in the blood in high concentrations, will constantly penetrate into the whites of the eyes and stain it yellow. Therefore, in order to get rid of the yellowness of the whites of the eyes, it is necessary to eliminate the main cause of the increase in bilirubin in the blood.

NOTE!

learn more If a person has yellow whites of the eyes, the reasons may lie in the appearance of various serious ailments, for example, diseases of the internal organs are possible. It is recommended to immediately seek help from doctors, since it is desirable to detect pathology at the initial stage of its development.

Yellowing of the whites of the eyes can mean the occurrence of diseases such as viral hepatitis, conjunctivitis, or even a cancerous tumor. A person alone will not be able to establish the exact cause, so it is better to immediately consult a doctor, conduct an examination, and begin treatment.

If the whites of the eyes turn yellow in a patient, then the following reasons for this phenomenon are possible:

  1. Most often, a change in the color of proteins in front of a person's eyes occurs with liver damage.
  2. Newborn babies may have yellow eyeballs for 3 to 5 days after birth. This phenomenon is called "jaundice in infants".
  3. If the patient has yellow eyes, the cause may lie in the development of a malignant tumor on the conjunctiva.
  4. Another option for why the whites of the eyes turn yellow is that the patient has an ailment that affects the eyes themselves. Most often, these are specific diseases that develop on the visual organs.
  5. Yellowness in the eyes may develop from fatigue after intense intellectual work. Most often, this phenomenon is observed in people who sit in front of a computer monitor for days.

    The yellowness of proteins is striking

    The yellowness of the whites of the eyes can also appear under the influence of other factors.

    In any case, the clarification of the cause and treatment of the above pathologies should occur under the supervision of a physician.

    Self-diagnosis and taking medications is unacceptable, as it can provoke serious complications.

    If the white of the eye is yellow in a person who has applied to the clinic, this may mean hepatitis or other damage to the structures of the liver.

    The body has a special enzyme that is found in red blood cells.

    It is called bilirubin and is produced by the liver. When, under the influence of microorganisms that have entered the liver structures, this substance breaks down, the whites of the eyes turn yellow. In this case, yellowness due to processes in the liver extends to the entire human body.

    Newborn jaundice passes under UV irradiation

    Symptoms of such a lesion:

    1. The whites of the eyes are yellow.
    2. The liver is enlarged.
    3. Temperature rise is possible.
    4. The whole body of the patient is covered with yellow spots or completely painted in this color.
    5. Loss of appetite, general weakness.

    If the patient has these symptoms, you should immediately call a doctor or take the person to the hospital. As a rule, hepatitis is detected, most often type A. This is a group of serious diseases. Most common in children (jaundice). Its development at the initial stage can be detected precisely with the help of yellowed eye proteins (some types of this disease do not cause complete yellowing of the patient's body).

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    This symptom is clearly manifested in such ailments as echinococcosis or opisthorchiasis. Diseases are caused by various types of worms that settle in the liver and lay eggs there. Their larvae feed in this organ, and then, having matured, move to other parts of the human body.

    Many new mothers wonder why the whites of their newly born baby are yellow. This phenomenon - jaundice - is typical for babies. It develops due to the saturation of the baby's blood with a large number of red blood cells during development in the womb. After birth, he does not need such a volume of red blood cells, so they begin to decay. Because of this, the baby's eyes and body skin turn yellow.

    Moms rush to the doctors asking what to do. There is no need to worry, usually this phenomenon disappears by itself within 7-12 days. If this does not happen, then perhaps the child has another disease that caused similar symptoms. Then you need to seek help from a doctor.

    The white of the eye may turn slightly yellowish (slightly at the edges) or completely change color due to the development of various tumor neoplasms on the conjunctiva. Most often this occurs when melanoma occurs. This disease is quite difficult to diagnose. This type of cancer can lead to serious consequences, so you need to be treated for the disease in specialized clinics. For more information about the treatment of melanoma, see this video:

    In other diseases of the eye, its protein turns slightly yellow or can completely turn into various shades of this color. Usually such signs are inherent in diseases such as pterygium or pinguecula.

    The second disease develops due to a violation of lipid metabolism, which leads to the appearance of yellow wen in the eyes.

    A pterygium is an overgrowth of the conjunctiva. If this phenomenon spreads to the pupil, the patient may lose sight in one or both eyes. Therefore, if there are problems with the eyes, you should immediately contact the specialists.

    Doctors have determined that sometimes a patient develops a yellow tint on the proteins of the visual organs due to malnutrition. In order for everything to return to normal, doctors recommend a special diet to such a patient.

    It provides for the following measures:

    1. A person should completely refrain from drinking alcohol.
    2. The patient is forbidden to eat salty or spicy food.
    3. Fried foods and various flour products should be excluded from the diet.
    4. The daily menu should include a large number of fruits and foods that are rich in ascorbic acid.

    Sometimes men or women who have yellowness on the whites of their eyes due to fatigue come to the doctor for an appointment. This usually happens if a person does not get enough sleep or sits at a computer for a long time. The problem can be provoked by the solution of some complex intellectual problem, the presence of dry air in the room. The eyes are inflamed. These people need a little rest. You can apply sedative lotions. It is recommended to walk more in the fresh air. Usually, after 2-3 days of such a rest, the eyes return to normal, and the whites of the eyes acquire a natural color. For more information about dealing with the problem, see this video:

    If none of the above reasons is suitable to explain the change in the color of the proteins, then you should urgently consult a doctor, as this may be a warning of serious systemic disorders in the body that need to be treated.

    DO YOU STILL THINK IT IS DIFFICULT TO CORRECT YOUR VISION? Judging by the fact that you are now reading these lines, victory in the fight against deteriorating vision is not yet on your side ... And have you already thought about surgical intervention? It is understandable, because the eyes are a very important organ, and their proper functioning is the key to a full, healthy and happy life. Loss of vision, redness and sharp pain in the eyes, constant wearing of lenses ... All this is familiar to you firsthand. But perhaps it is more correct to treat not the consequence, but the cause? We recommend reading the story of the host of the program "Live Healthy" - Elena Malysheva, how she restored her vision ... Read the article >>

    The white of the human eye is not absolutely white, as it is imagined by designers who process pictures of models in a photo editor for gloss. A healthy protein color is slightly yellowish, but uniform, without streaks, spots, darkening. If the proteins turn yellow or become stained, this means that a person has problems with the state of internal organs, eye diseases, or he leads an unhealthy lifestyle. Most often, this is almost certainly a signal of a disease, so you should immediately consult a doctor and diagnose the disease.

    The whites of the eyes are yellow: causes and how to treat

    Why does the sclera turn yellow

    The white membrane, which is called the sclera, turns yellow most often imperceptibly to the person himself. This process does not cause pain or discomfort, and it may take some time before a person notices yellowing when looking at himself in a mirror, or someone tells him about it. Yellowing - sclera icterus - means the presence of pathology.

    Icteric sclera

    By the way. There are people who have a yellow tunic from birth. This is due to genetics, and does not mean disease. But if the color has changed, that is, the proteins have turned yellow, or blotches, fragments, darkening have appeared on them, it is urgent to go to the doctor.

    Metabolism of bilirubin

    There are several shades of yellow in which protein can be painted - from light to ocher or almost orange. It depends on the disease itself and on what stage the disease is in, that is, how badly the body has suffered from it. Diseases and other reasons due to which the color of the albuginea changes can be divided into three groups.

    Table. Causes of yellowing of the sclera in groups.

    Gilbert's syndrome

    Internal illnesses

    As a rule, yellowness in the eyes is observed due to an excess in the blood of a substance called bilirubin. It is a multiple compound that is yellow-brown in color and is an integral part of the bile that is produced in the body.

    Important! Bilirubin is formed after the destruction of the protein structure. Hemoglobin, cytochrome, myoglobin break down, and free bilirubin remains. This is a toxin that must be neutralized. This function is performed by the liver, which contains an acid that neutralizes the toxicity of bilirubin. The direct compound, which is no longer dangerous, is then sent to the biliary tract to exit the body.

    Yellow whites of the eyes

    Hepatic pathologies

    If the liver experiences overload, there is a malfunction in its work of any nature, bilirubin rises in the blood, since the unhealthy organ cannot cope with its task. Decay occurs, but the removal of the toxin is not carried out, accumulating in the body. Because of this, all the integuments of the body turn yellow, and since yellowing occurs first on the sclera, and such a phenomenon as yellow squirrels is observed.

    Hepatitis symptoms

    Echinococcosis

    A disease resulting from penetration into the body and effects on the liver of echinococci. This is one of the modifications of helminthic infestations that can be found in worm-infected food, drink, or pass from animals.

    Echinococcus

    cirrhosis

    This pathology entails multiple lesions of the liver tissue, replacing healthy tissue with a pathologically altered one. In damaged tissue, the ability to neutralize the toxicity of bilirubin decreases and is completely canceled. It accumulates in the tissues, leaving the outer integument and mucous membranes. Cirrhosis can occur:

    • due to alcoholism;
    • as a post-hepatitis complication;
    • due to venous insufficiency;
    • a consequence of prolonged use of antibiotics;
    • due to diseases in which a suspension of heavy metals accumulates in the tissues.

    Cirrhosis of the liver

    Crayfish

    The disease is marked by the appearance and progressive growth of tissue inflammation, which develops into a tumor that destroys healthy liver cells. Because of this, the body loses the ability to function and, in particular, neutralize bilirubin.

    Cholangiocarcinoma of the liver

    Microorganisms

    These infections include:

    • worms are flat;
    • epistorchiasis;
    • opisthorchiasis;
    • echinococcosis.

    Worms in the liver

    By the way. Opisthorchiasis, characterized by cloudy yellow proteins, causes a type of worm that can appear in the body after eating insufficiently cooked fish. They, multiplying, block the walls of the liver ducts, disrupting the excretion of bile. After that, the substance enters the blood, and the appearance of yellowness on the sclera.

    Opisthorchiasis

    Blood diseases

    The internal ailments that cause the yellowness of the peripupillary zone include diseases of the circulatory apparatus. They always cause erythrocyte cancellation, which immediately increases the amount of bilirubin. The body begins to be unable to cope with its excretion, even with a healthy liver, so the toxin is deposited and gives the tissues a characteristic yellowness.

    1. Malaria.
    2. Congenital pathologies.
    3. Babesiosis.
    4. Sickle cell poisons that affect the body.

    Symptoms of malaria

    Malaria

    Gained immense popularity, but spread only in those parts of the world where malarial mosquitoes live. It is their bite that charges the blood with malarial bacteria. The infected organism transports it directly to the liver, where they multiply intensively. Having increased the population to a critical one, they again penetrate into the blood, destroying the structural bodies and causing the breakdown of erythrocytes, stimulating the hyperformation of bilirubin.

    Babesiosis in humans

    By the way. With stable and high immunity, the susceptibility to this disease in humans is very low, almost zero. But if immunity is reduced, a tick bite will certainly cause jaundice of the sclera.

    There is a whole group of hereditary diseases that pass as genetic traits and cause yellowness of the albuginea. These include the following:

    • erythrocyte membraneopathy;
    • hemoglobinopathy;
    • enzymopathy and others.

    Hereditary enzymopathies are diseases caused by hereditary disorders of biosynthesis

    All of them are characterized by an effect on blood cells, leading to their disintegration. During the process, there is an excess of bilirubin in the blood. The liver ceases to cope with it, and its cells capture the entire body, including the eye sclera.

    We are talking about letting into the blood of hemolytic poisons, called sickle-shaped. It provokes hemolysis of blood, causing a shortage of red blood cells. As a result, there is a state of anemia, and yellowness of the eyes. Poisons of this class include:

    • arsenic;
    • copper connections;
    • benzene;
    • chloroform;
    • nitrate compounds;
    • mercury and others.

    By the way. The class of these toxins also includes the venom of bees and snakes, poisonous spiders and other insects, and substances contained in poisonous mushrooms, berries and other plants.

    Since unnecessary and dangerous substances leave the body through the exit routes of bile, problems in the routes cause transportation problems. To get into the intestines, bile goes a long way, during which, in the presence of failures and narrowing of the ducts, an accumulation of a substance is formed at one point. This causes a rupture at this point, after which bile enters the bloodstream. Further, everything, as with other internal diseases - hyperbilirubin is reflected in the color of the sclera. Pathologies that trigger these processes include the following.

    1. Cholelithiasis.
    2. Cholangitis.
    3. Jaundice.
    4. Cancers of the pancreas.

    Primary sclerosing cholangitis

    Sclerosing cholangitis

    The origin of the disease is not clear. In the course of the disease, irritation of the bile ducts occurs, inflammation occurs, transformation of the walls of the passage, and blockages. It is difficult for bile to enter the intestines, instead it is absorbed by the blood. Since bile contains conjugated bilirubin, external tissues stain.

    Gallstone disease occurs due to the formation of stones, which are soldered particles of cholesterol and other solid substances and sediments. When formed, they clog the bile ducts and provoke the release of bile into the blood.

    Cholelithiasis

    Crayfish

    Not only a tumor in the liver, but also its formation in the bile duct demonstrates the yellowness of the protein. As the tumor grows, bile with bilirubin stagnates. It goes out into the break and becomes an integral part of the blood flow.

    About this disease, which has the medical name hepatitis A, it is necessary to talk in detail. Jaundice is very dangerous for humans. And yellowness of the eyes is the first in a series of signs of this disease.

    Hepatitis A

    Depending on how slowly or quickly bilirubin breaks down and is excreted (since different processes affect the output in different ways), the disease is divided into three types.

    1. Hemolytic.
    2. cholestatic.
    3. Hepatic.

    Table. Types of hepatitis A.

    Hemolytic

    Cholestatic

    Hepatic

    Facts about viral hepatitis A

    By the way. There is also jaundice diagnosed in newborns. It is not a disease or pathology. The phenomenon is explained by the fact that in the process of intrauterine formation, the embryo receives an excess amount of red blood cells from the mother. Then, in order to rid the body of it, nature arranges for the breakdown of blood cells, replacing them with bilirubin cells. One to two weeks after birth, the color indicators of the skin and sclera of the baby acquire a normal color. If this does not happen, a consultation with a pediatrician is necessary.

    Of the ophthalmic pathologies that cause yellowing of the albuginea, not so many diseases can be listed as internal ones. However, some eye problems lead to this phenomenon - icterus of the sclera.

    1. Pingueculitis.
    2. Gilbert's syndrome.
    3. Melanoma.
    4. Malignant conjunctivitis.
    5. Pterygium.

    Yellow whites of the eyes - causes

    Pinguecula formation

    In a simple way, this is a wen, which is formed on the conjunctiva, mainly due to disorders of fat metabolism. It can be large and colored in a shade of yellow. It appears for several reasons:

    • aging;
    • eye irritation from smoke or wind;
    • prolonged exposure to the sun.

    Pinguecula (fat on the eye)

    This formation does not affect vision in any way, but when it is detected, it is worthwhile to see an ophthalmologist in order to exclude yellowing of the sclera for another reason. Also, if the tissue around the wen becomes inflamed and begins to cause discomfort, an operation to remove it may be indicated.

    Wen is a benign formation, unlike melanoma, which is malignant. With it, the white membranes also turn yellow. And it can have various modifications.

    1. Flat spot.
    2. Convex or bumpy spot.
    3. Color yellow to brown.
    4. Colorless.

    Blue-eyed people are at higher risk for melanoma

    Pathology is formed in the inner corner of the eye, it is considered a rare disease that is difficult to diagnose.

    With this pathology, the conjunctiva grows. Soon it forms a rim, advancing on the albuginea. In this case, the color of the latter changes, becoming cloudy yellow. There is discomfort in the eye. Education is treated surgically, and the effectiveness of treatment depends on timely detection.

    The course of pterygium

    Important! If the growth of the conjunctiva is not stopped, it will close the entire pupil completely, and the person will stop seeing.

    This disease can be attributed to genetic. The syndrome is not even considered a pathology, rather, a physiological feature, but it can also cause yellow eyes. With this feature in the blood of a person, the concentration of bilirubin is constantly increased, as a result, his eyes are constantly yellow.

    What does Gilbert's syndrome mean and how is it treated?

    Having a syndrome, the patient must avoid situations of release of bilirubin in even greater quantities due to stress, overload or viral diseases.

    This is a serious cause of yellowing of the eyes, especially if a person has it wrong. Bad habits and addictions, abuse and processing, an insufficient amount of useful substances entering the body - all this can be the reason for the acquisition of an unhealthy yellow tint by the protein coat. What do you want in this case? Take steps to improve your lifestyle.

    1. Change the diet by removing flour, salty, spicy, fried.
    2. Exclude alcohol.
    3. Vitaminize food.
    4. Relax, sleep, walk.

    Refusal of alcohol

    As you can see, there are many causes of yellow whites of the eyes, and the main ones are serious illnesses. How to treat them?

    Depending on which group the disease belongs to, the manifestation of which was yellowing of the eyes, the treatment is prescribed either by an ophthalmologist, or a therapist, or a doctor of another narrow specification. In any case, it is necessary, having discovered the yellowness of the protein, which suddenly appeared, or the intensification of the hue from the nature of the yellowish color, immediately undergo a consultation. The first doctor is an ophthalmologist who will refer the patient to other specialists for tests and ultrasound.

    Examination by an ophthalmologist

    To prevent diseases that cause yellowing of the sclera, first of all, it is necessary to increase the level of general health and avoid infection with viral infections. The liver must be protected and supplied with all the necessary elements for uninterrupted operation, which is achieved by a balanced diet.

    Best Foods for Liver Health

    You should engage in physical activity or at least take walks. It is helpful to take a multivitamin from time to time.

    Make sure that there is rest in work, sleep remains healthy and in sufficient quantity.


The liver plays an extremely important role in the life of the body, so any failure in its work adversely affects health and can even lead to death. The sooner the diagnosis is made and treatment started, the greater the chance of a successful outcome.

For what reasons can the eye whites turn yellow?

Yellowing of the eyes is not always associated with liver disease. For example, often the cause of this phenomenon is the so-called "Gilbert's syndrome" - a hereditary benign pathology. Among European peoples, the number of people suffering from this pathology ranges from 2 to 5%, and among the peoples of Africa this figure is many times higher - up to 36%. With Gilbert's syndrome, the "transportation" of bilirubin to the liver cells, where it breaks down, is disrupted.

Also, yellowness of the eyes can be caused by natural age-related changes in the body, aged. Many people of venerable years have so-called "" - yellowish formations, mainly in that part of the eye protein that is closer to the nose. Aging of the conjunctiva, a thin membrane that covers the outside of the eye, is also often accompanied by yellowing.

In some cases, yellowing of the white of the eye can be one of the signs of melanoma - skin cancer.

As you can see, there are many reasons for this phenomenon. Therefore, we can only advise once again: do not take risks in vain, contact a specialist to establish,

Date: 09.02.2016

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  • Why do the whites of the eyes turn yellow
  • Diseases of the organs of vision that cause yellowing of proteins
  • Bad habits that affect the color of the whites of the eyes

Eyes are indicators of the health of internal organs. That is why the yellow whites of the eyes can signal some diseases located far enough from the organs of vision. All these conditions pose a serious threat not only to a person's well-being, but also to his life.

Why do the whites of the eyes turn yellow

Most often, the causes of yellowing of the sclera lie in a decrease in the functionality of the liver and biliary tract. In this case, jaundice can become the main symptom of a pathology such as hepatitis. In hepatitis A, popularly called jaundice, the sclera of the eyes are primarily stained with a yellow pigment produced in the liver cells. But such symptoms can also characterize hepatitis B, C or D.

It should be noted that staining of the whites of the eyes is often found in newborn babies. This condition is called neonatal jaundice. The reasons for the development of pathology lie in the features of the development of the embryo.

While in the womb, the baby receives a large number of red blood cells, which begin to rapidly disintegrate after the baby is born. At the same time, both the skin and the sclera of the baby are stained with a yellow pigment.

As a rule, 2-3 weeks after birth, the pigment completely disintegrates and the jaundice disappears.

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Diseases of the organs of vision that cause yellowing of proteins

Often, yellow whites of the eyes can become a formidable symptom of serious damage to the organs of vision. Here we are talking about melanomas and malignant conjunctivitis. These diseases have complex features of development and course, which sometimes complicates the methods of their treatment. In this case, an early visit to an ophthalmologist can be decisive for the success of treatment and the preservation of not only the functionality of the organs, but also the life of the patient.

But in addition to the pathologies described above, other diseases of the organs of vision are also known, in which yellow spots can appear on the white of the eye. First of all, these are pterygium and pinguecula. If the first develops on the basis of conjunctivitis, which captures most of the eyeball, then the second is characterized by a change in lipid metabolism in the body and the appearance of multiple yellowish wen on the protein.

With the development of these diseases, patients may feel discomfort, blurred vision, spots appear before the eyes. Both the first and second pathologies are almost untreatable with drug therapy.

With a late visit to the doctor in patients with pterygium, an outgrowth may form, creeping onto the cornea of ​​\u200b\u200bthe eye. A neglected disease is not always amenable to even surgical treatment. In the event of a pinguecula, early contact with a specialist also plays a significant role.

The smaller the buildup of lipids, the easier it will be to remove it with a surgical operation.

When a healthy complexion is replaced by an unhealthy yellow skin tone, it is necessary to see a doctor for further clarification of the reasons. Yellow complexion means not only the abuse of medications, excessive consumption of carrots or oranges, cumin, vinegar.

The skin can turn yellow as a result of pathological processes in the body. First of all, the hands, tongue, face, especially the eye sclera turn yellow. In addition to an unaesthetic appearance, yellowness means serious disorders of the thyroid or pancreas, liver, and the presence of oncological pathologies.

What processes in the body provoke a yellow complexion and how to deal with it, read on the site.

Yellow complexion: common causes

When there is an excess of bilirubin in the bloodstream, the skin begins to turn yellow. Bilirubin is a breakdown product of the protein (iron-containing) hemoglobin. Bilirubin does not accumulate in the body, but is excreted in the stool. And yellow spots will fall in the process of accumulation of this product in the body.

Another reason for yellowing of the face: an increase in the amount of carotene in the blood. Carotene enters the body with such foods.

What foods are a source of carotene

  • sea ​​​​buckthorn;
  • celery;
  • carrot;
  • rose hip;
  • apricots;
  • mango;
  • broccoli;
  • pumpkin.

Excess beta-carotene has been linked to excessive consumption of these foods.

Yellowness, pallor and dullness of the skin on the face can provoke:

  • excessive physical activity, or lack thereof;
  • enough sleep;
  • depression and stress;
  • emotional stress.

If, nevertheless, the yellow complexion is associated with the accumulation of bilirubin in the blood, then we are talking about jaundice as a pathology. There are three types or types of jaundice.

Hemolytic jaundice occurs in the process of accelerating the breakdown of hemoglobin and excess bilirubin, the liver cannot cope with the load and does not have time to process bilirubin. This type of jaundice is characterized by an increase in the amount of indirect bilirubin.

Hepatic jaundice is associated with liver damage, the development of hepatitis, or the influence of alcohol. This type is associated with an increase in direct bilirubin in the blood stream. Cholestatic jaundice is characterized by dysfunction of the bile ducts, which are blocked and this prevents the excretion of bilirubin.

During liver damage, yellowing of the skin is accompanied by the following whole complex of changes.

What changes in appearance accompany the symptom of yellowing of the skin

  • dark urine (like beer);
  • pale stool;
  • abdominal pain;
  • chills;
  • weight loss and appetite;
  • vomit.

With such symptoms, you should immediately call an ambulance.

If yellowness borders on pallor, and in addition, the whites of the eyes turn yellow, cholecystitis develops in the body. With the oncological development of the disease, the skin becomes not just yellow, but becomes "waxy". In the case of an orange tint of the skin, we can talk about hypothyroidism - a malfunction of the thyroid gland and malfunctions in the production of hormones.

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