What is chronic jaundice. How does jaundice manifest itself? Symptoms of jaundice depending on the type

Jaundice is a disease that cannot be overlooked: in a sick person, the skin, mucous membranes, sclera (whites of the eyes) acquire yellow. This has an explanation: as a result of a series pathological disorders bilirubin begins to accumulate in the body, which, in a normal state of health, is produced by the spleen, participates in metabolic processes and is actively excreted from the body, while maintaining its required level.

If this metabolic chain is broken, bilirubin begins to accumulate in the blood, which gradually manifests itself in the form of a yellow color of the mucous membranes and skin. Hepatic insufficiency and violation of the outflow of bile are also observed.

Jaundice is a disease that cannot be overlooked

Jaundice is a fairly common disease, mainly referring to its viral form. It is very easy to get infected. To avoid this, you should be careful and know how jaundice is transmitted.

Jaundice is Hepatitis

The pseudonym "jaundice" usually means Botkin's disease, or. This disease is characterized by a violation of the functionality of the liver, a large accumulation of toxins in the blood.

However, this is not a complete answer to the question "What is jaundice?" It can be other hepatitis (B, C), toxic, bacterial, autoimmune, dosage forms diseases.

Signs of the disease

With some features, depending on the species, there are common symptoms of jaundice, signs varying degrees intensity by which jaundice is determined in an adult:

yellowish skin tone
the liver and spleen are enlarged
blood test shows increased content erythrocytes
venous network appears in the abdomen
allergic skin lesions with severe itching
discoloration of urine, it becomes dark
stool becomes grayish
paroxysmal or constant pulling pain on the right under the ribs
poor appetite.

What is the cause of the disease

Jaundice of any kind is often not an independent disease, but a consequence or incidental disorder in the body. The impetus for the development of the disease can be:

You need to know how jaundice is transmitted in order to understand what to avoid in order not to become infected. Main routes of transmission:

sexual intercourse with a person who has the virus or has jaundice
family members who already have the disease
drug use
travel or stay in the region with a high percentage incidence of jaundice.

Jaundice, so different...

Jaundice is different in that it has to be treated differently, depending on the intensity and duration of the disease. Since there are many factors that can provoke a disease, pathology can take various forms. Different types of jaundice are diagnosed and treated separately.

Jaundice is Hepatitis

conjugation

Occurs more often in infants metabolic processes are still at the stage of development and therefore may acquire the character of a deviation from the norm.

Such jaundice in adults occurs when long-term exposure on the liver, for example, the use of certain medications. A disease of this etiology can also be a consequence congenital anomalies organism.

Hemolytic

It is not an independent disease, it develops as a result of pathologies that provoke the destruction of red blood cells with difficult removal of bilirubin from the body. The most common reasons are:

By name, you can understand that the liver tissue is affected - the parenchyma. Liver cells cease to function normally. As the pathology develops, their structure changes, which also affects the performance of the liver.

Most often, parenchymal jaundice develops against the background of the liver, and viral jaundice is also accompanied by this form of the disease.

The symptoms of jaundice of this form resemble the standard signs: the liver enlarges, the skin gives off yellowness. But besides this, the skin acquires a reddish tint. Spider veins begin to form on the body - capillary-venous formations.

Since parenchymal jaundice damages liver cells, treatment is aimed primarily at slowing down and stopping the processes of their degeneration. When contacting a doctor immediately after the onset of symptoms and following the instructions, the prognosis is favorable.

Hepatic

Hepatic jaundice, in turn, has a number of varieties, depending on the cause of its occurrence. Possible prerequisites include:

viral hepatitis
hepatitis due to alcohol abuse
drug intoxication of the liver
malignant tumors in the liver.

This disease is also manifested by a yellowish skin color, in addition, there are such signs of liver-type jaundice:

nausea
loss of appetite
pain right under the ribs
grayish color of stool
dark urine.

Treatment of jaundice of this type is prescribed only after determining the cause of its occurrence, usually hepatic jaundice and the disease that caused it are treated together. The prognosis is usually positive.

Mechanical

Otherwise, this form of the disease is called obstructive jaundice.

Obstructive jaundice is a violation of the outflow of bile of varying degrees. If the obstructed movement of bile is caused by the presence of stones in the ducts, then this type of jaundice is considered benign. The patient is cured by removing the stones.

There is obstructive jaundice more dangerous kind. If malignant tumors interfere with the outflow of bile, it is carried out surgical intervention aimed at normalizing the amount of bile entering the small intestine. Obstructive jaundice can be very acute, it depends on how blocked the bile ducts, in the absence of immediate measures is a threat to life.

There are other types of jaundice that only occur in young children.

physiological jaundice

Occurs in newborns in the presence of problems with adaptation to a new environment. Causes may also be related to an underdeveloped metabolic and bilirubin system. Weak and premature babies get sick more often. Pathology is manifested by jaundice skin, mucous. The child has drowsiness.

neonatal jaundice

A dangerous form of jaundice, characterized by rapid rise concentration of bilirubin in the blood. Occurs immediately after birth, is a danger to the development of the child's brain. It must be treated quickly and effectively.

How is jaundice diagnosed?

If there are signs of jaundice, even slightly similar to those described above, you should immediately consult a doctor. With timely treatment, the pathology is eliminated quite quickly, without loss of quality of life.

To make an accurate diagnosis, studies are carried out:

blood test for and general
blood test for bilirubin
examination of the liver to determine the degree of functionality
liver - with its help determine the cause of the disease and the degree of damage to the organ.

How is the disease treated

The treatment regimen is prescribed by the doctor after a comprehensive examination and identification possible cause occurrence of the disease. Each form has its own most effective ways of healing.

Held conservative treatment jaundice, surgery can be used only in case of serious neglect of the disease, then an organ transplant is performed.

In conventional therapeutic treatment, medications and drugs:

steroids
phototherapy, a technique for treating tissues by exposing them to light waves of different lengths (laser, sunlight, etc.)
plasmapheresis, a method of blood purification by filtering it
strict diet
If one of the most severe and dangerous forms- autoimmune - a course of treatment with corticosteroids can be carried out.

All these activities are aimed at:

preservation and, if possible, restoration of liver function
prevention of liver cirrhosis
protection of other people from infection with viral forms of the disease (the doctor will tell you in detail how jaundice is transmitted).

One of the main conditions for a successful cure is a timely visit to a doctor. It is impossible to allow the pathological process to develop so much that the destruction of tissues becomes irreversible. In this case, the only way to save the patient is organ transplantation.

With Botkin's disease () in most cases, the body heals itself.

The doctor prescribes medicines and preparations that help the recovery processes that occur independently in the human body, such as the removal of toxins, the reduction of the level of harmful substances:

vitamins, glucose
for the speedy restoration of liver functionality are prescribed ("Liv 52", "Essentiale Forte", "Heptral", "Karsil")
antispasmodics are recommended ("No-shpa", "Papaverine", etc.).

The success of the treatment of jaundice depends on the patient, on the exact following of the doctor's recommendations.

Important! You need to know that the liver is the only organ whose functionality, with the right and regular treatment and cleansing is able to recover almost to normal levels.

You just need to help your body on your own, follow the doctor's instructions, take medicines in the indicated doses exactly for the specified period of time.

An important part of the liver healing process is diet. The doctor will recommend a diet plan that will help reduce the load on the liver, and at the same time will be nutritious, high-calorie and healthy. The main rules of nutrition:

There are many special diets and diets, following which, you can create ideal conditions for your liver to recover.
There should be a lot of protein foods: meat, fish, poultry, dairy products (while it is better to give preference to fermented milk products). This will provide the body with protein - a building material for recovery processes, iron, vitamins and trace elements. The use of the liver will provide right amount folic acid - it is needed for hematopoiesis.
Dried fruits, especially dried apricots, are very useful for the liver and digestion in general. You can cook compotes, eat a little steamed.
Bread is better if slightly stale.
Vegetables are an indispensable part of the diet for the liver. Cabbage, zucchini, carrots, tomatoes - all this should be eaten raw or boiled. Also great importance have fruits and natural juices.
You will have to give up alcohol, fatty, fried foods, hot spices and spices. The liver is weakened by disease, and additional load she has nothing to do.
As with most diseases of the gastrointestinal tract, you need to eat small portions, several times a day.

In the East, the liver is considered the center of human life, and its importance in the state of the body can hardly be overestimated. Therefore, you need to pay attention to any symptoms that deviate from the norm, do not be too lazy to visit a doctor - then even with the onset of the disease, it will be possible to maintain the normal state of the organ and happy life healthy person.

Jaundice – disease state, characterized by the accumulation of bilirubin in the blood and its deposition in tissues with yellow staining of the skin, mucous membranes, and sclera of the eyes. This is not an independent disease, but a consequence of a number of diseases of the liver and biliary tract.

Causes of the disease

Blockage bile ducts through which bile salts and pigments are removed to the intestines. Bile mixes with blood, which causes yellow skin.

Clogging of the bile ducts occurs due to the appearance of stones or liver inflammation in viral hepatitis, less often in typhoid, malaria, and tuberculosis.

Symptoms of jaundice

The main symptoms of jaundice:

prostration,
irritability,
headache,
fever,
loss of appetite,
constipation,
nausea,
characteristic yellow tint of the skin and eyes,
dark urine,
dull pain in the region of the liver.

Treatment of jaundice

The first step in the treatment of jaundice- the use of drugs from the group of hepatoprotectors. The drugs of choice may be:

Means based on milk thistle - Karsil, Silymarin, Silimar.
Thioctic acid - Berliotin.
Phospholipids - Essentiale, Livenciale.
Ursodeoxycholic acid - Ursolit, Ursosan, Ursofalk.
Heptral.

Despite belonging to the same pharmacological group, the active components of the drugs have various influences. The choice of medicine is mandatory carried out by the attending physician, taking into account the manifestations of the disease. Self-administration in this case is contraindicated, since it may be ineffective and lead to the development of serious complications.

In addition to hepatoprotectors, the patient is prescribed:

Antispasmodic drugs: Drotaverine (No-Shpa).
Enterosorbents to reduce itching - Enterosgel.
Rifampicin and Metronidazole in order to influence the metabolism of bile acids, reduce their synthesis, and, accordingly, itching.
Antihistamines - Tavegil, Suprastin.
In severe intoxication of the body, an intravenous infusion of Ringer's solution is required.
External treatment of itching is carried out using drugs that include novocaine and anesthesin.

Against the background of jaundice, the absorption of calcium and vitamin D3 can be disrupted. In order to prevent the development of osteoporosis, vitamin-mineral complexes are prescribed: Vitrum Calcium, Calcemin.

With the development of obstructive jaundice (excessive, persistent increase in bile acid, bilirubin and cholesterol in the blood plasma), drug treatment does not have the desired effect and is required surgical intervention.

Treatment with folk remedies

Birch (buds). 50 g of birch buds are infused in 0.5 liters of vodka for 10 days. Take 1 teaspoon with water 3 times a day 20 minutes before meals.
Immortelle. 25 g of immortelle grass pour 1 liter of water and boil over low heat until the volume is halved, strain. Take 50 ml 3 times a day 30 minutes before meals with jaundice until complete recovery.
Cornflower blue. Pour a teaspoon of blue cornflower flowers with a glass of boiling water, leave for 30-40 minutes, strain. Drink 1/4 cup 3 times a day 20-30 minutes before meals as a choleretic agent for jaundice.
Joster laxative. For 1-1.5 cups of boiling water, take 1 tablespoon of laxative joster berries (buckthorn buckthorn), brew them and infuse, wrapped, for 2 hours. Take an infusion of 1 tablespoon 3-4 times a day 30 minutes before meals.
Calendula. Choleretic action has an infusion of calendula. Pour 2 teaspoons of inflorescences with 2 cups of boiling water, leave for 1 hour, strain. Take 0.5 cup 4 times a day.
Corn (columns). Pour a tablespoon of corn columns with stigmas with 1 cup of boiling water, leave for 1 hour, strain. Infusion drink 1 tablespoon every 3 hours as a choleretic agent for hepatitis, cholecystitis, cholangitis.
Potentilla goose. A tablespoon of goose cinquefoil herb brew a glass of boiling water like tea and strain. Take 1-2 glasses a day for cholangitis, cholecystitis.
Peppermint. As a choleretic agent, take an infusion of peppermint at the rate of 5 g of dry crushed leaves per 1 glass of water. Drink 1 tablespoon every 3 hours.
Plantain large. For inflammation of the gallbladder, take an infusion of plantain leaves. Pour a tablespoon of leaves with 200 ml of boiling water, leave for 10 minutes, strain. Drink the resulting infusion in small sips for an hour (daily rate).
wheatgrass. Take a decoction of wheatgrass creeping 1 tablespoon 4-5 times a day.
Horsetail. Take a decoction of 50 g of horsetail herb 3 tablespoons 3-4 times a day or 0.5 teaspoon pharmacy extract horsetail. Tincture: 30 g of herb per 100 ml of alcohol.
Horseradish. 0.5 kg of peeled horseradish root is ground on a grater, the gruel is poured into 1 liter of boiling water, tightly closed with a lid and infused for 24 hours. Then the infusion is squeezed, filtered and drunk 1/4 cup 3 times a day before meals. The course of treatment is 6-7 days. Horseradish root is contraindicated in gastritis, nephritis and enterocolitis.
Salvia officinalis. 2 teaspoons of crushed sage leaves pour 2 cups boiling water, leave for 30 minutes, strain. Infusion drink 1 tablespoon every 2 hours with inflammation of the liver and gallbladder.
Barley. Boil a cup of barley in 3 liters of water and leave for 3 hours. Drink several times a day.

Fees for the treatment of jaundice

At the initial stage, infusions of barberry, birch leaves, yarrow, wild rose, juniper or wormwood can help. A teaspoon of any of the herbs is poured into 200 ml of boiling water, insisted for 30 minutes and drunk 1 glass in the morning and evening.
After jaundice, to maintain liver function, mix mint, chamomile inflorescences, yarrow grass and buckthorn bark in equal proportions. Pour a tablespoon of the prepared mixture with a glass of boiling water. Insist 30 minutes. Take at night and in the morning on an empty stomach 1/2 cup.
Prepare a mixture of peppermint leaves, dill seeds, wormwood and yarrow, taking 2 parts of each herb, and 3 parts of sand immortelle. Prepare an infusion of 2 teaspoons of the mixture in 2 cups of water. Insist 8 hours. Take during the day.
Mix a three-leaf watch leaf (15 g), chamomile flowers (15 g), centaury herb (15 g), knotweed grass (15 g), dandelion root (40 g), St. John's wort herb (40 g). Pour three teaspoons of the mixture with a glass of water, boil for 7-10 minutes, strain. Take a glass in the morning and evening.
Collect the ingredients in the indicated proportions: common chicory root, large celandine herb, walnut leaf - equally. Pour a tablespoon of the mixture with a glass of water, boil for 30 minutes, cool and strain. Take a glass 3 times a day.
Collect the ingredients in the indicated proportions: lemon balm leaf - 30 g, centaury herb - 30 g, Polish bitter grass - 25 g. Pour a tablespoon of the mixture with a glass of water, boil for 20 minutes, leave for 10 minutes and strain. Take a glass 3 times a day.
Collect the ingredients in the indicated proportions: dandelion officinalis (roots) - 2 parts, common chicory (roots) - 2 parts, brittle buckthorn (bark) - 1 part. Pour a tablespoon of the mixture with a glass of water, boil for 30 minutes, strain. Take a glass of decoction in the evening with cholecystitis, cholangitis.
Collect the ingredients in the indicated proportions: sandy immortelle flowers - 40 g, three-leaf watch leaves - 30 g, peppermint leaves - 20 g, coriander seeds - 10 g. To prepare a decoction of 10 g of the collection, pour a glass of boiled water, heat in a water bath 30 minutes, refrigerate room temperature 10 minutes, strain, bring the volume of the broth boiled water up to 200 ml. Take 1/2-1/3 cup 3 times a day 30 minutes before meals as a choleretic agent for jaundice.
Mix centaury grass, calamus rhizome, sandy immortelle flowers equally. Pour a teaspoon of the mixture with 2 cups of water, leave for 10-12 hours in a warm place, boil for 5-7 minutes and strain. Drink one glass on an empty stomach, the rest - during the day for 4 doses, an hour after eating.

Folk remedies for the treatment of jaundice in newborns

Dodder. Bathe the child in dodder (Cuscuta europaea) decoction.
Castor oil. It is only necessary to give a laxative: anoint the nipple with castor oil and give it to the child. At artificial feeding you can lubricate the rubber nipple with castor oil.
goldenflower. In the summer, you can use a simple remedy: cook 2-3 handfuls yellow flowers garden plant merigold (chrysalis) and bathe the child in this decoction. It is better to take flowers of a high grade of a plant, and not a low one, known as "marigolds".
Compresses. A remedy tested by Vanga is also cold dressings on the liver with various squeezed juices, camphor and sandalwood. This remedy can eliminate jaundice on the same day and give the urine a normal color.
Eye wash. Rinse eyes with jaundice with rose water with coriander juice and salt water. You can also use water in which Venus hair, marjoram, dubrovnik polium (white felt dubrovnik), medicinal chamomile, and dill were boiled.

diet for jaundice

First of all, you need to take a laxative to cleanse the intestines.
Then you should endure the juice fast for several days. Cup tomato juice in the morning with a pinch of salt and pepper - good remedy from jaundice.
The next few days you need to eat only fruits 3 times a day with an interval of 5 hours.
You can then go to simple easy carbohydrate foods that do not contain fat, as well as eat fruits and vegetables.
Digestive disorders should be avoided, as well as intestinal blockage (exclude legumes).
Drink more fluids such as mineral water, and there are lemons, onions and pomegranates.

Most people are used to understanding the term "jaundice" or Botkin's disease. In fact, this word is used to denote a number of pathological changes that can affect not only the liver, but also other organs. However, the appearance of jaundice is always associated with a violation of bilirubin metabolism, which can occur for various reasons.

What is jaundice?

Jaundice is a series of symptoms that manifest as yellow discoloration of the skin, sclera and mucous membranes, which is associated with excessive accumulation bilirubin in the body. Normally, this substance is released during the breakdown of red blood cells, which occurs in the spleen. Then bilirubin moves to the liver and, after participating in metabolic processes, leaves the body.

If any stage is violated, bilirubin accumulates in the blood, which leads to staining of the sclera and mucous membranes in yellow. Why is this happening? During the breakdown of hemoglobin in the body, a yellow pigment is produced. In the normal state, it leaves the body in the process of defecation. With the development of jaundice, which is accompanied by liver failure and obstruction of the biliary tract, quite. At the same time, a small amount of this substance is excreted through the skin or kidneys.

This disease is one of the most common. Especially often jaundice occurs in countries with a warm climate and unfavorable sanitary conditions. For example, in Central Asia, almost every child manages to get sick with this disease. In countries of Eastern Europe prevalence viral form disease is 250 people per 100,000 population per year.

Jaundice is what hepatitis?

Most often, jaundice is popularly called, or Botkin's disease. This is a viral pathology, which is accompanied general intoxication body and liver dysfunction. In addition, there are and, as well as autoimmune, toxic, bacterial, dosage forms of the disease.

Incubation period with the development of jaundice, it can last for several months. Depending on the duration, the disease can be acute, protracted or chronic.

Symptoms of jaundice

Common signs of the disease in adults include the following:

yellowness of the skin;

an increase in the size of the liver and spleen;

an increase in the content of red blood cells in the blood;

occurrence vein network in the abdomen.

In adulthood, jaundice can manifest itself as a strong, change in the shade of urine and feces. By virtue of high concentration bilirubin in the body, the feces acquire a grayish tint, and the urine becomes very dark. A person loses his appetite and often experiences severe pain in the right hypochondrium, which may be spasmodic or pulling in nature.

There are quite a few factors that can trigger the appearance of jaundice in an adult:

formations in the liver of a benign or malignant nature;

congenital pathologies of the structure of the biliary tract;

pathology of the liver and gallbladder;

postoperative complications;

the use of certain groups of drugs.

If we talk about the threat of infection with viral hepatitis A, then the following categories of the population are at risk:

people whose close relatives are infected with the virus;

people who have had sexual contact with an infected person;

people who are going to visit a country with a high prevalence of this virus;

people who use drugs.

Types of jaundice

Symptoms and methods of treatment of jaundice directly depend on the type and stage of the disease. There are many forms of this pathology, which differ depending on the cause of occurrence.

Conjugative jaundice

This form of jaundice does not act as an independent disease - it is associated with a violation of the transformation of direct bilirubin, that leads to sharp increase its content in the body. This phenomenon is more typical for newborns, since their metabolic processes are still imperfect. However, sometimes this form of jaundice is diagnosed in adults. It usually develops as a result of exposure to the liver. negative factors For example, the use of drugs. Also, conjugative jaundice can be the result of congenital pathologies, among which it is worth highlighting the Gilbert-Meulengracht syndrome.

Hemolytic jaundice

The pathological destruction of red blood cells, the accumulation of excess amounts of bilirubin and the difficulty in removing it from the body lead to the development of this form of disorder. This condition can be caused various violations and pathologies - lymphocytic leukemia, lymphosarcoma. Hemolytic jaundice can also result from toxic effect drugs to the body.

Physiological jaundice

This type of jaundice is typical for newborns and is associated with the child's adaptation to new conditions of existence. Most often, the physiological form of the disease develops due to the immaturity of the enzyme system. In addition, it may be associated with impaired bilirubin metabolism. In most cases, jaundice occurs in premature and debilitated babies. This condition is characterized by yellowness of the skin and mucous membranes, as well as high drowsiness of the baby.

neonatal jaundice

This type of jaundice also occurs immediately after birth and is associated with the accumulation high quantity bilirubin in the blood. This violation occurs very often and may be due to enzymatic immaturity of hepatocytes, increased production of bilirubin and insufficient serum ability to bind this substance. In some cases, the pathology needs immediate treatment. Indirect bilirubin is a neurotoxic poison, and sometimes it can lead to damage to the cerebral cortex and subcortical nuclei.

Parenchymal jaundice

This type of disease is considered very common. It is associated with a violation of the structure and functioning of hepatocytes - liver cells. The main diseases that provoke the appearance of parenchymal jaundice are acute viral hepatitis and . As a result, the size of the liver increases in the patient, the skin first becomes yellow, and then acquires a reddish tint. At the same time, telangiectasias appear on the body, which are spider veins.

Hepatic jaundice

This disease is a consequence of a malfunction of the liver cells, which can be triggered by an increase in the volume of direct bilirubin in the blood. Viral hepatitis can lead to the development of hepatic jaundice, drug lesions liver, cirrhosis, malignant formations in the liver. Most often, this form of the disease is accompanied by icteric staining of the skin, loss of appetite, nausea, pain in the right hypochondrium, discoloration of urine and feces. The choice of tactics of therapy is carried out depending on the cause that provoked the development of hepatic jaundice.

If symptoms of the disease appear, you should immediately consult a doctor. Thanks to the means of modern medicine, this violation can be quickly eliminated.

To put accurate diagnosis, the specialist will prescribe the following studies:

General and biochemical analysis blood.

Tests to determine the content of bilirubin in the blood.

Liver studies.

Liver biopsy - allows you to determine the nature of the disease and assess the severity of organ damage.

Treatment of jaundice

Treatment methods for pathology directly depend on its form and stage of development. For therapy to be as effective as possible, it is necessary to establish the cause of the development of the disease. In any case, to eliminate the symptoms of jaundice, conservative treatment can be used to help cope with the underlying disease, and surgical intervention is usually required in advanced cases and consists of liver transplantation.

Conservative therapy includes the following components:

The use of drugs - antihistamines, steroids.

Plasmapheresis.

Phototherapy.

Dieting.

The goal of treatment is to get rid of the virus, prevent cirrhosis of the liver, and reduce the risk of infecting others. If a person develops a chronic form, he is treated with corticosteroids.

If therapy is not started on time, pathological process can develop so strongly that doctors fail to achieve a period of remission. In this case, there are dangerous complications, the elimination of which is impossible without liver transplantation.

Sometimes a person develops obstructive jaundice, which is associated with a violation of the outflow of bile. If it is benign and appears as a result of the formation of stones in the bile duct, endoscopic papillosphincterotomy is used - this procedure helps to remove about 90% of the stones in the bile duct. If obstructive jaundice is associated with malignant tumors, the patient is shown radical treatment. Typically, such patients undergo palliative surgery, which is aimed at reducing the level of cholestasis.

Jaundice is more likely not a disease, but a symptom that clearly indicates liver damage, as well as some blood diseases.

Bilirubin in jaundice accumulates in excess in the blood and is not excreted in the usual way, which leads to yellowing of the skin and sclera. As an independent disease, jaundice is not isolated. Doctors perceive yellowing of the sclera and skin as a dangerous signal, which is always a reason for high-quality diagnostics.

What is bilirubin?

The reason for the yellowness of the skin is a yellow pigment, which is a breakdown product of hemoglobin. In a healthy person, bilirubin is successfully excreted from the body through the digestive tract along with feces. If a person suffers from liver failure and obstruction of the biliary tract, bilirubin begins to accumulate in the blood. Its excess is partially excreted through the kidneys, creating an excessive load on them, as well as through the skin, which causes its yellowness.

Where does the symptom come from?

Causes of jaundice - a violation of the liver and biliary tract. The root cause of this phenomenon may be different. If a doctor notices yellowed skin and sclera in a patient, he may suggest the following reasons:

Hepatic jaundice. For some reason, hepatocytes (structural units of the liver) stop converting bilirubin into bile. An example of such a disease is viral hepatitis.
Hemolytic jaundice. Such jaundice occurs if the cause is a lack of work hematopoietic system. In infants, almost always after birth, there is "newborn jaundice", associated precisely with the hematopoietic function of the liver. This phenomenon is not dangerous, however, in some cases, hemolytic jaundice can also occur in adults. Some poisonings, lymphomas, autoimmune diseases, different types anemia.
Obstructive jaundice. In this case, we are talking about violations of the gallbladder and stagnation in the bile ducts. They can become clogged with bile accumulations or stones, causing bilirubin to pass into the blood.

The symptoms of jaundice are fairly easy to recognize.

The disease is always accompanied by where the liver is located. Also, jaundice is often accompanied by chills, fever, headache. A sick person begins to lose weight, dyspeptic disorders, loss of appetite are observed.

If cholecystitis is the cause of jaundice, bilious eructation may also occur. Jaundice is characterized by general symptoms of intoxication of the body (nausea, muscle pain, and so on).

The most striking signs of jaundice are the characteristic yellow hue of the skin, mucous membranes, and sclera (the whites of the eyes). Sometimes false jaundice occurs, when only the skin turns yellow due to excessive use of carotene.

In order to distinguish real jaundice, it is necessary to track the presence of other symptoms, as well as make sure that the patient's sclera and mucous membranes have turned yellow. Also, true jaundice is always accompanied by dark urine, which takes on the color of strongly brewed tea and begins to foam. The stool, on the contrary, becomes discolored, becoming almost white.

If you notice symptoms of jaundice, contact your doctor immediately. modern medicine allows you to identify the cause of this symptom quite quickly and eliminate any disease.

For an accurate diagnosis, the doctor prescribes a general and biochemical blood test, tests for bilirubin in the blood are mandatory, and liver function tests are also carried out. Sometimes a liver biopsy is prescribed, the results of which allow the doctor to make a conclusion about the nature of the disease and the severity of liver damage.

The method of treating jaundice directly depends on its underlying cause. Depending on what caused the jaundice, the doctor prescribes drug therapy aimed at destroying excess bilirubin in the blood. It is not uncommon for jaundice to be treated with phototherapy, as bilirubin is effectively broken down by exposure to ultraviolet light. Jaundice in newborns is not treated with drugs. Usually, in young children, liver function recovers on its own, and physiological jaundice disappears without a trace after a while.

It is also important to follow the right diet: a diet for jaundice should be soft and gentle on the liver and gallbladder. It is useful to eat low-fat dairy products, vegetable dishes, lean fish and meat. It is not recommended to eat vegetables containing coarse raw fiber during the period of illness.

Consequences of jaundice

Usually with modern techniques Treatment of jaundice in the patient passes without consequences. AT rare cases at severe course in newborns, jaundice reduces the blood supply to tissues, as it causes hemolytic anemia. The consequence of this may be a deterioration in the mental development of the child.

Complications of jaundice

Why is jaundice dangerous? By itself, it has no complications, however, the neglected course of diseases that cause this phenomenon can lead to serious violations work of the liver, gallbladder, and other body systems.

Bilirubin is a poison to the body. In high concentrations, it creates serious intoxication, poisons the blood, and negatively affects the state of the nervous system. If the symptom is neglected in a small child, then the complications of jaundice are expressed in mental retardation.

Prevention of jaundice is the prevention of diseases that cause it. The easiest way to avoid the appearance this disease carefully monitoring personal hygiene.

Do not eat in unsanitary conditions, wash your hands more often, follow the rules of safe sex, avoid contact with unfamiliar piercing and cutting objects (especially needles, syringes, scalpels, razor blades).

Jaundice is not vaccinated: do not forget that we are talking about a symptom, and not about the disease itself. Exist effective vaccines from viral hepatitis, which in some cases is the root cause of jaundice.

Jaundice in adults and children is common. It is easy to deal with it, but it is always worth remembering that it is more important to eliminate the root cause that caused the yellowing of the skin. Only after the elimination of the root cause can we say that the person has recovered from the disease.

Is jaundice contagious? This question cannot be answered unambiguously. The contagiousness of jaundice depends only on the disease that caused its appearance.

Yellow coloration of the mucous membranes, sclera and skin, due to the deposition of bile pigments in them as a result of an increase in their concentration in the blood. Yellowness of the sclera appears when the level of bilirubin in the blood is about 35 µmol/l, and the skin and mucous membranes - about 50 µmol/l.

Jaundice ordinary people strongly associated with Botkin's disease - it is contagious infectious disease in which the skin and sclera of the eyes turn yellow. In fact, hepatitis A (Botkin's disease) is not the only reason to turn yellow. The skin can change color for other reasons: other viral and autoimmune hepatitis, cholelithiasis, toxic and alcoholic poisoning. In each of these cases, the diseases are completely different nature, but yellowing of the skin and mucous membranes - their characteristic symptom which is hard to miss.

Jaundice is a yellow coloring of the skin and mucous membranes and sclera, associated with an increase in the amount of bilirubin in the blood and tissues of the body. There are three reasons for the accumulation of bilirubin:

excessive destruction of red blood cells and increased production of bilirubin (prehepatic jaundice)
violation of the utilization of bilirubin by liver cells gives signs of liver-type jaundice
mechanical obstruction to the outflow of bile containing bilirubin into the intestine (subhepatic form)

It is easy to diagnose jaundice - yellowing of the skin, mucous membranes and sclera is visible to the naked eye. But to establish the reason why the color of the skin has changed is more difficult. To do this, you need to examine the patient for the presence of diseases that may be accompanied by yellowing of the skin.

Treatment of jaundice involves the therapy of the diseases that caused it. So, hepatitis A is very contagious, it requires bed rest and inpatient treatment with the use of drugs for detoxification, hepatoprotectors, vitamins. Autoimmune jaundice is treated with hormones. Severe cases of cirrhosis require a liver transplant.

Jaundice disease can be congenital and not have unpleasant health consequences - for example, Gilbert's syndrome is accompanied by yellowish skin coloration due to increased levels of indirect bilirubin in the blood, but pathological disorders in the liver do not occur.

Jaundice in adults

Jaundice in women

Jaundice in pregnancy

Causes of jaundice in pregnant women are of several types. For example, it may arise due to problems that a woman faced even before she decided to become a mother - chronic diseases of the liver and biliary tract, hemolytic anemia, hyperbilirubinemia. Also, jaundice can occur due to diseases that have arisen or worsened during pregnancy - viral and drug-toxic, bacterial infections, cytomegalovirus.

The disease of jaundice, which is caused by the pathology of pregnancy, can proceed as follows:

Intrahepatic cholestasis.

Bile stagnates in the tissues of the liver due to the fact that it is not released into the intestines. It is believed that the cause of the violation is estrogens, which slow down the evacuation of bile from the liver.

Acute fatty degeneration.

Rare and severe liver damage, the causes of which are not fully understood. It is noticed that the risk of dystrophy is increased in those pregnant women who were treated with antibiotics from the tetracycline group. The disease begins with heartburn, vomiting and abdominal pain, later the skin turns yellow and fever appears. At the same time, kidney and liver failure develops, a violation of blood clotting, internal bleeding occurs. The prognosis for acute fatty degeneration is poor - mortality reaches 80-85%, a significant improvement in the condition of patients occurs only after an emergency caesarean section.

Jaundice with gestosis.

Extreme forms of preeclampsia, preeclampsia and eclampsia, are accompanied by lesions small vessels liver (angiopathy). Patients complain of abdominal pain, vomiting, nausea. Gradually, liver failure develops, yellowness of the skin and sclera appears. As in the case of fatty degeneration, the main method of treatment is an emergency caesarean section.

Jaundice with early toxicosis.

The constant vomiting that some pregnant women experience during the first trimester causes emaciation and dehydration. Because of this, the amount of bilirubin in the blood rises, but with improved nutrition and the cessation of vomiting, it returns to normal.

Jaundice in breastfeeding mothers

Jaundice in adults can be the result of infectious and other diseases. Doctors often forbid women from breastfeeding with any type of jaundice. Is it justified? It all depends on the cause of jaundice: hepatitis, a mechanical obstruction in the path of bile, mononucleosis, etc.

If the mother's skin turned yellow due to obstruction (clogging) of the biliary tract with a stone, this does not pose a threat to the baby. Viral hepatitis C is also not dangerous for breastfeeding, since transmission of the virus through milk in this case is impossible. As for hepatitis B, it is believed that in some cases it is possible to contract it through feeding, but if the child is vaccinated, the risk is reduced to a minimum.

The most "contagious" causes of jaundice, the causative agents of mononucleosis and hepatitis A, can be transmitted through breastfeeding. Therefore, many doctors prefer to forbid feeding while the mother is sick. However, WHO and AKEV (Association of Adherents of Natural Feeding) think differently: with a mild form of the disease, you can feed if the mother follows the rules of hygiene - she wears a mask, washes her hands, and the house is cleaned daily. In addition, getting jaundice due to an infection means that the mother was contagious for several days before the first ones appeared. visible signs. Therefore, the child, most likely, also became infected, and the best way to protect him is to feed, in which, together with milk, antibodies will get to him to fight the disease.

Jaundice in men

The course of jaundice in men and women is not fundamentally different. But the reasons for which it arose are sometimes different. Unfortunately, men are much more likely to abuse alcohol, and this is a direct path to the development of chronic alcohol intoxication and then cirrhosis. In fact, cirrhosis, expressed in the replacement of the parenchyma with connective tissue, completely destroys the liver, while jaundice becomes only a visible symptom of the disease. The complications that accompany the disease are very severe: bleeding, ulcers in the duodenum, edema, jaundice that cannot be treated.

The consequences can be expressed in the development of liver cancer - hepatocellular carcinoma, the prognosis of life in which, in combination with cirrhosis, is very unfavorable. The number of patients who survived five years after diagnosis is only 20-25%. If the patient can undergo a liver transplant (when cancer is diagnosed at an early stage), then about 60-70% of patients live for five years or more.

Jaundice in children

Jaundice in newborns, which occurs on the 3-14th day of life, is usually a variant of the norm and is explained by the physiology of infants. Physiological neonatal jaundice does not require treatment and resolves on its own by about the end of the first month of life.

But sometimes the skin remains yellow and later. The reasons may be as follows:

hemolytic disease or other diseases in which the active breakdown of red blood cells occurs constantly.
violations in the work of the liver itself - parenchymal jaundice, when liver cells are affected by toxins or viruses (for example, due to hepatitis).
violation of the outflow of bile from the liver due to a cyst, pathology of the bile ducts or an annular shape of the pancreas.

In the event that the physiological jaundice of newborns should have passed in all terms, and the yellowness of the skin has not disappeared, the baby's parents should consult a doctor to determine the causes of the disease and prescribe treatment.

Symptoms of jaundice

Symptoms of jaundice in adults

Jaundice in adults, as a rule, accompanies various lesions of the liver and biliary tract, and may also be indirect sign hemolytic anemia or other blood diseases (lymphosarcoma, leukemia). Symptoms of jaundice vary depending on the form of the disease:

suprahepatic type of jaundice is characterized by light yellow skin, pallor and lack of blush, dark stool color, enlarged spleen.
the hepatic form is characterized by the following features: saffron-yellow skin and mucous membranes, vascular "asterisks", as well as red palms and colorless stools.
subhepatic jaundice is expressed in discolored stools and dark urine, dull or acute (with colic) pain in the abdomen with “recoil” to the shoulder blade, arm or chest, yellowing of the skin on the second or third day after the onset of pain.

Sometimes there is false jaundice that occurs after ingestion of certain medications or the use of a large amount of yellow fruits and vegetables (carrots, tangerines, etc.). In people with false jaundice, the skin turns yellow, but the mucous membranes and the membrane of the sclera do not stain, the feces do not discolor.

Jaundice in children most often occurs during the neonatal period. The reason for its occurrence is the restructuring of the functioning of the baby's organs and systems after birth. Fetal hemoglobin breaks down and bilirubin enters the bloodstream. The liver is not able to quickly and without residue utilize bilirubin, so yellowing of the skin may occur. Physiological jaundice resolves without treatment within 2-4 weeks. There are other causes of yellowing of the skin that cannot be attributed to the norm:

hepatitis A, which is called the disease dirty hands. Symptoms of this type of hepatitis are nausea, heat, fever, pain in the right hypochondrium and a bitter taste in the mouth, diarrhea and vomiting are possible.
with hepatitis B, jaundice in children rarely occurs, but lasts a long time, up to 3 weeks, and has a pronounced character (the skin is brightly colored).
hepatitis C is most often accompanied by decreased appetite and fatigue, slight yellowing of the skin and sclera, short-term discoloration of feces and dark urine.
a mechanical obstruction to the outflow of bile also leads to jaundice. The cause may be a pathological narrowing of the bile ducts and an annular pancreas. Symptoms of obstructive jaundice in children are a pronounced yellow color of the mucous membranes, eye sclera and skin, pain in the right side, white clay-like stools and urine of a pronounced dark hue.

Symptoms of jaundice in newborns

Jaundice in newborns is usually physiological in nature and resolves without treatment by the end of the first month. It is expressed only in the yellowness of the skin, while bilirubin in the blood is kept on acceptable level- from the third to the seventh day of life, its value does not exceed 200 µmol / liter. Physiological jaundice of newborns occurs from the 2-3rd to the 15th day of life. If the change in skin color of the baby does not fit into these intervals or is accompanied by other signs, we are talking about a pathology that requires examination and treatment. Symptoms of pathological jaundice in newborns are:

Protracted course of the disease.
An increase in the size of the liver and spleen on palpation or ultrasound.
Enlarged lymph nodes.
Changes in the biochemical and general blood tests, a decrease in hemoglobin numbers in the blood.
Darkening of the urine and discoloration of the stool.
Sluggish state of the baby, monotonous crying, tilting the head.

Symptoms of hemolytic jaundice

Hemolytic jaundice occurs when there is a violation of the breakdown of red blood cells, when the decomposition of blood cells occurs much faster than normal. As a result, the liver cannot cope with the processing of a large amount of bilirubin. Most often hemolytic jaundice accompanied hemolytic anemia. The symptoms are:

Pale skin, lack of blush.
Yellow tint of the skin, sclera and visible mucous membranes.
The chair is dark in color, in the laboratory analysis of feces, an increase in stercobilin is expressed.
With a slight increase in the liver and a strong increase in the spleen, arching pains appear in the right side.
A complete blood count shows a decrease in the level of red blood cells in comparison with the norm, pathological changes their forms (poikilocytosis), an increase in the number of reticulocytes.

How else does hemolytic anemia and jaundice manifest? Symptoms are often similar to those of normal iron deficiency anemia- weakness, drowsiness, fatigue, headaches, shortness of breath with little physical exertion.

Hepatic jaundice occurs due to damage to liver cells, as a result of which they become unable to process bilirubin. The causes of cellular damage are different - hepatitis, mononucleosis, toxic or alcohol poisoning, cancer or cirrhosis. How does hepatic jaundice manifest itself? The symptoms are usually:

Staining of the skin, mucous membranes and sclera in a bright lemon-yellow color. In the future, the yellowness is replaced greenish tint due to the conversion of bilirubin to biliverdin.
Feces may have a light shade due to a decrease in the amount of stercobilin.
Hepatic jaundice is always accompanied by a visible increase in the size of the liver.
There may be pain in the right side.
A characteristic feature is vascular "asterisks" and "liver palms" (with red spots).
If hepatic jaundice accompanies a long-term liver disease, there is varicose veins of the stomach and esophagus, a bright venous pattern on the abdomen, ascites (accumulation of fluid inside the peritoneum).

Symptoms of obstructive jaundice

Obstructive jaundice is associated with a violation of bile excretion due to blockage of the ducts. As a result, bilirubin from bile is absorbed back into the blood, causing intoxication of the body and discoloration of the skin. Common signs of jaundice due to a mechanical obstruction are as follows:

Darkening of the urine and discoloration of the stool.
Dull pain in the right side (if jaundice is associated with a stone in the duct, the pain can be very sharp, "give" to the shoulder blade or chest, and be a symptom of hepatic colic).
Yellow hue of the skin, eye sclera and mucous membranes, eventually turning into an earthy color. Yellowness usually appears on the second day after renal colic or occurrence dull pains in the side.
Severe itching of the skin that does not respond to conventional means often accompanies jaundice caused by tumors.
Nausea, sometimes with vomiting, is also characteristic of neoplastic jaundice.
Weight loss, lack of appetite - more typical for tumors in the bile ducts or pancreas.
An increase in temperature in most cases is due to an infection of the biliary tract, sometimes - the collapse of the tumor.
Sometimes (after jaundice for a long time) there is an increase in the size of the liver - due to stagnation of bile in it, an increase in the gallbladder
Occasionally there are cholesterol deposits on the eyelids in the form of yellowish islands.

Hemolytic (prehepatic) jaundice

Hemolytic or adrenal jaundice is associated with impaired breakdown of red blood cells and utilization of bilirubin in the liver. She can be like independent disease, and a symptom of other disorders in the body, and also be a consequence of toxic poisoning of the body. Diagnosis of hemolytic jaundice is to confirm the shortened life cycle of red blood cells - this can be found in the general and special analyzes blood. It is also necessary to examine the shape of red blood cells and conduct a Coombs test, which shows the presence of antibodies to red blood cells. As for functional diagnostic methods, an ultrasound of the liver and spleen is performed to establish the diagnosis. Sometimes a bone marrow puncture helps to clarify the situation with hemolytic anemia and jaundice.

Treatment of jaundice depends on what origin it has. If the cause of the disease is a defect in red blood cells, the removal of one of the hematopoietic organs, the spleen, can improve health. Effective is the appointment of enzymes that replace those absent in erythrocytes. autoimmune anemia treated with hormone therapy and immunosuppressants.

Hepatic (hepatocellular) jaundice

Hepatocellular jaundice is caused by infection or viral infection liver tissue (parenchyma). As a result of impaired cell function, the ability to release bilirubin from the blood into the bile ducts is significantly reduced. Therefore, it remains in an unprocessed form, causing yellowing of the skin.

What is hepatocellular jaundice? Symptoms may be:

Lemon color of the skin, subsequently acquiring a greenish tint.
Light cal.
Pain in the right hypochondrium.
Vascular "asterisks" on the body, red spots on the palms.

Hepatocellular jaundice is diagnosed using blood tests: there is an increase in direct and indirect bilirubin, changes in all liver tests. In feces, there is a decrease in the amount of stercobilin, in urine - an increase in bilirubin.

Treatment of hepatic jaundice is to treat the underlying disease that caused it. To maintain liver function, amino acids, B vitamins, and lipoic acid preparations are prescribed.

Mechanical or subhepatic jaundice is associated with blocking the outflow of bile from the liver to the intestine. Because of this, bilirubin, having no way out, begins to be absorbed into the bloodstream and causes yellowing of the skin. The cause of blockage (obstruction) of the biliary tract can be:

Gallbladder and duct stones.
Polyps of ducts and bladder.
Inflammatory diseases.
Tumors.
Adhesions and scars.

You can suspect jaundice of this type on your own, because it has characteristic signs - pain in the right side (sometimes very strong), extending to the shoulder, shoulder blade, arm or lower back. The next day after the onset of pain, the urine turns dark in color, and the feces turn white. This happens because the coloring pigment - stercobilin, synthesized from bilirubin, does not enter the feces. Urine darkens due to the fact that the amount of urobilinogen excreted with it increases. Appropriate laboratory tests can confirm changes in the composition of urine and stool. A blood test shows an increase in the level of total and direct bilirubin.

The treatment of jaundice caused by a mechanical obstruction is to normalize the outflow of bile and eliminate the cause of blockage of the ducts. To do this, first drain the bile ducts, and then remove stones, polyps, tumors that interfere with the normal circulation of bile.

Physiological jaundice

Physiological jaundice is a normal condition that is typical for most newborns. Its essence lies in the fact that the fetal hemoglobin, which was in the blood of the baby in utero, changes to normal hemoglobin of the HbA type. Since the children's liver has not yet adapted to new conditions immediately after the birth of a child, its utilization of the decay product of fetal hemoglobin - bilirubin - does not keep pace with the decay process itself. Due to the high level of bilirubin in the blood, the skin turns yellowish.

The peak, which accounts for physiological jaundice, is the second or third day of life; at the beginning of the second week of life, the yellowness of the skin decreases or completely disappears. The period of excretion of bilirubin up to 3-4 weeks is considered normal. To reduce its level, phototherapy is used - it has been proven that ultraviolet radiation decomposes bilirubin into non-toxic compounds that are excreted in urine and stool.

If physiological jaundice does not go away for a long time, yellowness of the skin appeared on the first day after birth or two weeks later, which means that the amount of bilirubin in the blood increases, and the baby needs additional examination and treatment, since such manifestations of jaundice do not fit into the norm.

Causes of jaundice

Depending on what form jaundice has, its causes differ:

Suprahepatic, in which the breakdown of red blood cells is ahead of the utilization of bilirubin in the liver. This is due primarily to hemolytic anemia (congenital or acquired), autoimmune disorders, hereditary defects in the structure of hemoglobin and red blood cells.
Hepatic - the liver cells themselves are affected, their ability to bind free bilirubin in the blood is lost. Most often, the cause is viral and infectious diseases (hepatitis, mononucleosis), alcohol abuse, the use of certain medications.
Subhepatic - the evacuation of bile from the liver and biliary tract to the intestine is disrupted. The causes of jaundice in this case are associated with mechanical blockage of the bile duct by stones, a tumor, an inflamed head of the pancreas, and polyps.

Causes of jaundice in children

Jaundice in children is due to many reasons. The most common is hepatitis A, better known as Botkin's disease. This form of hepatitis is called the disease of dirty hands because of the high degree of contagiousness. Children often get sick after eating badly washed fruit or being in close contact with another sick child. The disease occurs with abdominal pain, fever, fever, nausea. In addition to hepatitis A, children can become infected with other types - B and C. Infection with them most often occurs during medical procedures.

The reasons depend on what kind of violation in question. Physiological jaundice is a consequence of adaptation child's body to new living conditions. Fetal hemoglobin, which was in circulatory system baby, after birth is replaced by ordinary hemoglobin. The process of breakdown of fetal hemoglobin is proceeding at a rapid pace, and the liver cannot cope with the utilization of bilirubin resulting from the decomposition of hemoglobin molecules. Because of this, the level of bilirubin in the child's blood rises, and his skin turns yellow. Physiological jaundice resolves within a few weeks, the only way treatment in this case high level hemoglobin) - ultraviolet irradiation.

The causes of jaundice in newborns are not always explained by physiology, and sometimes they are very serious:

Congenital hemolytic anemias
Incompatibility with the mother by blood type or Rh factor
Infection with viral hepatitis from a sick mother
Anomalies in the structure of the biliary tract and pancreas (for example, its annularity)
Hormonal disorders

Causes of hemolytic jaundice

Hemolytic jaundice is explained by the excess of the rate of decay of red blood cells over the ability of the liver to utilize the hemoglobin formed as a result of the breakdown. The reasons for this may be:

Anemia of various types - associated with abnormal destruction of red blood cells, a lack of vitamin B12 and an abnormal structure of hemoglobin.
Infections (including malaria).
Malignant tumors and oncological diseases blood (lymphosarcoma, lymphocytic leukemia).
Autoimmune disorders in which the body produces antibodies against its own cells.
Hereditary violation of the structure of erythrocytes.
Alcoholic, medicinal or otherwise toxic injury.

Causes of hepatic jaundice

With parenchymal jaundice, liver cells are affected, because of which they lose the ability to capture unbound bilirubin in the blood and convert it into a straight line. At the same time, even that small amount of bilirubin, which has turned into direct, cannot enter the bile capillaries and is again absorbed into the blood, causing yellowing of the sclera. The causes of jaundice are mainly associated with infectious or toxic lesions of the liver, which adversely affect its cells and bile capillaries:

Viral acute or chronic hepatitis all types.
Mononucleosis.
Leptospirosis.
Alcohol, toxic or drug poisoning.
Cirrhosis and liver cancer.

Causes of subhepatic (mechanical) jaundice

Obstructive jaundice occurs when the normal outflow of bile from the liver is disrupted due to an obstruction in its path. The obstruction can be benign or malignant in nature. The main causes of obstructive jaundice are as follows:

A common cause of jaundice is hepatitis. It is caused by viruses different types: for example, the causative agent of Botkin's disease is virus A. It enters the body through the fecal-oral route and infects the human liver. The result of exposure to the virus is that in the acute period, the human skin turns completely yellow, the urine darkens, and the feces become discolored. The disease has other symptoms - fatigue, fever, headache, itchy skin. Other types of hepatitis, B and C, have similar symptoms, but the yellowness of the skin may not be as intense as in Botkin's disease, and it appears in the later stages.

Diagnosis of jaundice

Jaundice disease has several varieties:

suprahepatic - violation of the breakdown of red blood cells
hepatic - damage to the tissues of the liver itself
subhepatic - a violation of the outflow of bile through the ducts from the liver.

Depending on the type of jaundice, deviations in the analysis of blood and urine are also different:

with suprahepatic jaundice in the blood, the content of young forms of erythrocytes is increased - reticulocytes, indirect bilirubin. The amount of hemoglobin in the blood is reduced. Urine contains large amounts of urobilinogen.
the hepatic form is characterized high content bilirubin in the blood, a violation of other biochemical parameters- an increase in ALT and GGT, a decrease in albumin. In the urine, a large amount of urobilinogen is determined, sometimes bilirubin can be detected.
obstructive jaundice (subhepatic) manifests itself high values direct bilirubin in the blood test, elevated levels of GGT and alkaline phosphatase, a slight increase in ALT and AST. Urinalysis demonstrates the absence of urobilinogen and a significant amount of bilirubin.

Fecal analysis

Diagnosing jaundice with fecal analysis makes it possible to assess why the disease has arisen. The absence of stool-coloring pigment, stercobilin, in the stool indicates mechanical cause yellowing of the skin and mucous membranes. Stercobilin is formed by splitting bilirubin in the intestine - first, urobilinogen is formed in it, then it turns into stercobilinogen, and then it is oxidized to stercobilin.

When the bile ducts are closed by a stone or squeezed by a tumor, bilirubin does not enter the intestine, and the chain of its transformation into stercobilin is broken. It is sometimes possible to understand that a mechanical blockage of the bile ducts has occurred without analysis - the feces become grayish-white. In addition, discolored stools are usually accompanied by other visible signs of jaundice and obstruction of the ducts - yellowing of the skin, eye sclera and mucous membranes, dark urine.

Diagnosis of jaundice includes ultrasound examination of the liver and biliary tract. First of all, the doctor examines the common bile duct. Depending on whether there is a blockage (obstruction), and where it is located, it is possible to determine the causes of jaundice. If an obstruction is found in lower sections, at the place where the duct flows into the duodenum, this indicates cholelithiasis, a tumor, or another reason for the narrowing of the duct itself, chronic pancreatitis tumors of the head of the pancreas.

When there is an obstruction at the hilum of the liver, ultrasound shows an increase in the intrahepatic ducts, and the common bile duct is not changed. If neither the common nor the internal ducts are changed, and diffuse changes in the liver tissue are visualized during the study, this indicates a hepatic form of jaundice.

Tomography and MRI

Diagnosis of jaundice using tomography provides much more opportunities than ultrasound. Tomography allows you to make a layered cut with a step of only about 1 mm, and this increases the chance not to miss any formation in the tissues of the liver, biliary tract and pancreas. The absorption of X-rays by different tissues is not the same, and therefore MRI and CT can clearly visualize the liver and bile ducts. Additionally, the image can be improved by contrasting with special substances that are injected into the patient's blood. With the help of CT and MRI, it is possible to diagnose exactly how the liver is affected (jaundice is mechanical, suprahepatic or parenchymal). The images will show diffuse tissue changes, stones, polyps, and narrowing of the ducts. In addition, the study makes it possible to see cysts, hematomas, tumors and purulent lesions.

Treatment of jaundice

Treatment of jaundice in adults

Treatment of hemolytic jaundice

Depending on the causes and form of the disease, the treatment of jaundice also differs. If the violation is associated with a genetically determined defect in the breakdown of red blood cells, then removal of the spleen, in which blood elements are formed, can help. Sometimes a blood transfusion helps, but in this case it should be carried out regularly.

The autoimmune form is treated with glucocorticoids. When the cause of the condition is another disease, and jaundice is only a symptom of it, treatment of the underlying disease will help. Benign hyperbilirubinemia, which has a favorable prognosis, does not require special therapy. Patients are prescribed only choleretic agents, vitamins and diet number 5 during an exacerbation.

Jaundice in adults can be hepatic, when the liver cells themselves are affected, and the level of bilirubin in the blood rises significantly. Since this type of jaundice is mainly a consequence of other diseases, treatment consists in the treatment of these diseases:

cirrhosis
viral hepatitis
infectious mononucleosis
toxic liver damage.

All types of treatment can be divided into two groups: conservative and radical. Radical (liver transplantation) is used in severe cases when other means have already been tried. Conservative therapy is aimed at healing from diseases that caused jaundice: if it is viral hepatitis, then antiviral treatment; autoimmune diseases require the appointment of hormones; liver toxicity is treated with detoxification measures, hepatoprotectors, lipotropic drugs and amino acids.

In addition to the main treatment, liver-type jaundice requires the appointment of drugs that improve liver metabolism: B vitamins, amino acids, vitamin C. If the patient's condition cannot be corrected for a long time, then they can help hormonal preparations(glucocorticoids). Phototherapy is sometimes prescribed to destroy excess bilirubin.

Treatment of obstructive jaundice

This type of jaundice is treated with a two-stage operation:

first relieve pressure on the biliary tract through endoscopic or percutaneous drainage. The endoscopic method involves drainage using an endoscope through the major duodenal papilla duodenum. Percutaneous drainage means that access to the bile ducts is through a puncture of the skin and tissues with special needles.
after drainage, it is necessary to remove the cause due to which obstructive jaundice arose. Basically, blockage (obstruction) of the ducts occurs due to stones that get there from the gallbladder, therefore, to prevent recurrence of jaundice gallbladder are removed. If the cause of the obstruction cannot be eliminated (for example, with an inoperable tumor), stents are placed in the ducts - they allow for a normal outflow of bile.

Treatment of jaundice in a newborn

Jaundice in newborns usually manifests itself within the first three days of life and does not require any treatment, as it is a variant of the norm. But treatment is needed if:

baby is not full term
jaundice occurred almost immediately after birth or after 15 days of life
the level of bilirubin in the blood, even in a mature child, significantly exceeds the norm (5-10 times or more), and over time it does not decrease.

Previously, jaundice in children required mainly blood transfusions. Today, instead of transfusion, phototherapy is successfully used - exposure to ultraviolet destroys bilirubin and converts it into a non-toxic form that is easily excreted by the child's body.

Complications and consequences of jaundice

Jaundice in children during the neonatal period is mostly harmless and physiological. But there are times when it requires treatment, and if it is not carried out, then complications may arise, life threatening and the health of the baby. The main danger lies in the damage to the central nervous system and brain by bilirubin, which is poisonous at high concentrations. Bilirubin encephalopathy leads to the death of brain cells and has a detrimental effect on health. It has 4 stages:

at first the child screams monotonously on one note, refuses to eat, he is tormented by belching and vomiting, muscle tone reduced.
symptoms appear in the second stage brain disorders, which are expressed in pathological flexion of the limbs in the joints (they cannot be unclenched), tight clenching of the palms into a fist, screaming during an attempt to tilt the head to the chest. There may be episodes of respiratory arrest and fever.
a false improvement in well-being during the period of 10-12 days of a child's life, when muscle stiffness disappears.
in the fourth stage, which occurs towards the end of the second month of life, symptoms appear similar to cerebral paralysis. The child lags behind in mental development.

If jaundice in newborns has gone beyond the physiological, you should urgently contact a pediatrician to identify its causes and adequate treatment.

Jaundice and liver

The consequences that cause diseases can be very serious. So, if the cause of jaundice is hepatitis B or C, then it can lead to cirrhosis. This is an irreversible replacement of the liver parenchyma with connective tissue. The degeneration of tissues leads to the fact that the liver ceases to cope with its cleansing functions. The same thing happens with chronic alcohol intoxication - a person who abuses alcohol is expected to have cirrhosis and liver failure. And if the cause of jaundice is hemolytic anemia, the consequences can be kidney and heart failure, rupture of the spleen and anemic coma.

If we consider Negative influence bilirubin itself, it is worth noting that an increase in its level to significant numbers in adults leads to impaired body functions and damage to the central nervous system. If it is not possible to reduce the amount of bilirubin in the blood, hepatic encephalopathy develops - disturbances in the functioning of the brain, up to the onset of coma.

kidney failure

Jaundice in adults accompanies liver disease, which can be quite severe. They are usually accompanied by the development liver failure. When the body is not able to compensate for disorders associated with liver dysfunction, manifestations of insufficiency become obvious and dangerous - after jaundice or simultaneously with it, edema and manifestations of portal hypertension increase, speech and perception of reality become difficult, consciousness is confused. Liver failure at the terminal stage is accompanied by disturbances in the work of the kidneys, as a result, poisonous substances that are not excreted in the urine increase the intoxication of the body. The reasons why renal and liver failure occurs are different - these can be alcohol, drug and other toxic poisoning, severe hepatitis (fulminant).

Liver failure is a violation of liver function due to damage to its tissue (parenchyma). Dysfunction accompanies many severe liver diseases. Most diseases are accompanied by yellowing of the mucous membranes and skin. Depending on the cause of jaundice, the mechanism of its appearance differs - for example, with cirrhosis of the liver, it occurs as a result of the fact that connective tissue, which is replaced by the parenchyma, cannot utilize bilirubin. Tumors of the liver or surrounding tissues, growing into the ducts, do not allow bile to flow into the duodenum, because of this, bilirubin is reabsorbed into the blood, and the skin turns yellow.

The development of liver failure has 4 stages:

compensated when the body copes with the violation. During this period, the patient complains of weakness, loss of appetite and nausea, increased emotionality.
decompensated, in which the body can no longer adapt to violations. At this stage, edema and ascites, skin itching appear, the skin turns yellow, speech and consciousness are disturbed.
the terminal stage is characterized deep sleep, exhaustion, degeneration of organs, metabolic disorders and ends with a transition to a hepatic coma.
hepatic coma expressed as a lack of response to external stimuli, deceleration heart rate. The pupil does not react to light.

Hepatic encephalopathy

Jaundice disease means that a person has problems with the liver. Over time, this can lead to the development of hepatic encephalopathy, which is expressed in a number of reversible symptoms of damage to the brain and central nervous system. The reason for the development of encephalopathy is the toxic effect on the brain of ammonia accumulated in the liver. The accumulation of ammonia is due to the fact that the liver ceases to cope with the utilization of a substance that normally accompanies metabolism. The development of encephalopathy has 4 stages:

sleep is disturbed, attention decreases, aggression, irritability, bad mood appear.
deterioration of all disorders that arose in the first stage - strengthening mental disorders(delusions, aggression, senseless actions), increased drowsiness, the appearance of apathy and spatial disorientation. Handwriting is disturbed, speech worsens, trembling of the limbs appears.
in the third stage, drowsiness reaches a maximum, confusion and motor disturbances are observed. The patient is not oriented in space and time, cannot speak.
the fourth stage is coma, in which the reaction to light and pain disappears, reflexes fade away.

Jaundice in adults, which is a symptom of liver disease, can lead to the development of acute liver failure, followed by encephalopathy. To prevent this, the main liver diseases should be treated by an infectious disease specialist and a hepatologist.

Treatment of jaundice, or rather all liver diseases, accompanied by yellowness of the skin and mucous membranes, requires a mandatory diet. The main table for patients is No. 5 according to Pevzner. Diet suggests normal amount proteins and carbohydrates, limiting vegetable fats to 30 g per day, animal - up to 10 g.

Allowed cooking methods are stewing, boiling and baking. Frying is prohibited not only because it uses fat in large quantities - fat itself is harmful, oxidized during processing. Preference should be given to dishes warm, mashed or chopped. In order not to burden the liver affected by the disease, jaundice means the exclusion of foods that contain cholesterol, extractives, oxalic acid and purine. Meals are welcome large quantity lipotropic components, fiber and pectin.

Prevention of jaundice

Is jaundice contagious?

Jaundice is the general name for the symptoms that may be associated with various diseases. Yellowing of the mucous membranes and skin occurs due to the fact that bilirubin is not excreted by the liver. The reasons for this may be different:

infectious diseases
cholelithiasis
cirrhosis of the liver
intoxication
tumors
immaturity of hepatic tissue in infants.

The disease is considered contagious only if jaundice is a symptom of infectious diseases:

hepatitis A viral origin
infectious mononucleosis
some exotic diseases for Russia - those who have been in Africa can become infected with them (yellow fever)
leptospirosis.

The most famous diseases in which "contagious" jaundice occurs are hepatitis types A, B and C. Of these, hepatitis B and C are transmitted mainly through blood and sexual contact. But hepatitis A (Botkin's disease) and E are spread by the fecal-oral route, and you can protect yourself from them by observing personal hygiene.

Widespread in Russia and mononucleosis, which is spreading by airborne droplets and very contagious. Its symptoms are disguised as a common ARVI, and yellowness of the skin and mucous membranes is not always the case. Prevention of the disease is very simple - you need to use someone else's dirty dishes as little as possible, since saliva is the main method of infection.

Obviously, after jaundice, a person can expect unpleasant consequences - after all, it is not an independent disease, but only other ailments, sometimes very severe. Therefore, it is easier to prevent diseases than to treat their consequences. Exist following methods prevention of jaundice:

not to get infected infectious hepatitis, which are transmitted by airborne droplets, you need to wash your hands before eating and after using the toilet, rinse vegetables and fruits well, if possible, do not drink raw water.
to prevent infection with hepatitis B and C, contact with the blood of other people should be avoided. So don't use someone else's manicure accessories and razors, and cosmetic and medical manipulations should be carried out only in proven places where sterilization is monitored.
Considering that hepatitis B and C can rarely be transmitted sexually, random connections better to use a condom
to prevent jaundice that occurs with infectious mononucleosis, you need to limit kissing and using someone else's dishes, as they may contain saliva. It is through saliva that the pathogen is often transmitted.