Jaundice is a common illness in the world | Doctors Gang Hepatology

Jaundice:Type,Cause,Diagnosis,Prevention,and Treatment

Bilirubin is a yellow substance that is mostly yellow throughout the body. This yellow color is observed in the early stages, especially in the eyes, palms of the hands and feet and the urine is dark in color.

Jaundice types and symptoms of jaundice, HBsAg and Hepatitis virus cuase of jaundice.

HBsAg ( Hepatitis B Surface antigen) and jaundice

Jaundice is a common illness that most people get at some point in their lives. When there is inflammation or severe damage to the hepatocyte or liver, the amount of a substance called bilirubin in the blood increases at an abnormal rate. Bilirubin is a yellow substance for which the whole body turns yellow, especially in the eyes, palms of the hands and feet. This yellow color is observed in the early stages and the urine is dark in color.

If the liver is infected by the virus, if there are stones in the gallbladder or bile duct, the disease is caused by inflammation. Other common causes of jaundice are tumors of the liver or bile ducts.

Closure by worms, cancer of the pancreas, complications of gallbladder or bile duct surgery, etc. Outbreaks appear to be exacerbated during pregnancy due to viral infections. Many types of viruses cause inflammation in the liver.

The hepatitis virus is the main cause of jaundice, but many other viruses can cause mild jaundice. So far, 

Type of Hepatitis virus : 

5 types of hepatitis viruses have been identified which are named as 

  1. Hepatitis A, 
  1. Hepatitis B, 
  1. Hepatitis C, 
  1. Hepatitis D and 
  1. Hepatitis E. 

Hepatitis A virus and Hepatitis E virus enter the body through water or food and cause illness. The other 3 hepatitis viruses such as B, C and D viruses enter the body through the blood or parental route, and sex . In general, if you use a needle used in someone else's body while giving an injection, if you take the blood of someone who has the virus in your blood, if someone's blood gets injured. Using a razor or toothbrush and toothbrush used by others. Through tattooing or tattooing needles. Having unprotected sex with an infected person, biting someone during a fight. An unborn child from an infected mother can be infected. It may be mentioned here that the deadly AIDS virus is spread in exactly the same way.

Hepatitis A and E viruses are more common during childhood. 

The A virus causes a common type of jaundice in which the patient is completely cured in a short period of time. However, jaundice caused by the E virus is often severe and often lasts a long time. The E virus often takes on complex forms, especially in adults. Inflammation in some people can lead to complete destruction of the liver. 

Most of the 3 viruses Hepatitis B, C and D  that enter the bloodstream

 are infected with the B virus. Without the B virus, the D virus cannot survive alone. Therefore, the D virus cannot enter the body alone and infect the liver. The number of cases of C virus infection is very low so the attack of B virus is mainly considered.

Once the hepatitis B virus enters someone's body, it stays dormant for a long time. During dormancy, no symptoms of the disease are observed in the body, but as a result of the virus attacking the body, the body cells secrete a substance called antibody into the blood. Which is called HBs Ag. Which can only be diagnosed through a blood test. If someone is HBs Ag positive, it is assumed that the person is infected with the hepatitis B virus and that he or she is a suitable person for infecting others with the B virus through blood. Once the B virus enters the body, it stays dormant in the early stages, but can seize the opportunity to cause disease at any time. However, the E virus can remain dormant for 6 months to many years before the disease occurs. 

There are usually three ways in which this virus can cause disease.

  1. Jaundice can cause diseases which can be very serious. Liver damage can occur until the patient dies.
  2. Hepatitis or jaundice attacks can lead to liver damage, which is called liver cirrhosis. Liver cirrhosis is also a very complex disease, which does not have much treatment. Both of the above conditions can be treated with liver transplantation. However, liver transplantation is a very expensive medical procedure and quite risky.
  3. As a complication of the above two conditions, the affected person develops liver cancer. It goes without saying that there is no such treatment and the patient dies in a very short time.

The symptoms of the disease have been discussed earlier. In the initial stage, the patient may suffer from fever for several days. There may be body aches, loss of appetite, nausea or vomiting, but not everyone has such symptoms. Then the symptoms of jaundice are observed. In the early stages of jaundice, the urine becomes darker, the palms of the hands and feet turn yellow, the eyes turn yellow, and so on. With it the pain in the upper abdomen may be felt as the liver gets bigger. Some people may have itching in their body. How long the jaundice lasts will depend on what type of virus the person has been infected with. The longer jaundice lasts, the more likely the patient's condition will be complicated. In severe cases the patient may die.

How to do diagnosis of jaundice 

Jaundice can diagnose by following criteria.

  1. Jaundice+Fever+Anorexia+High ALT(>400)= Acute Viral Hepatitis
  2. Jaundice+Itching+Dark pale stool= Obstructive Jaundice
  3. Jaundice(Long standing)+Itching+Skin Pigmentation+Positive AMA= Primary Billiary Cirrhosis
  4. Jaundice(Recurrent)+Young patient= Gilbert Syndrome
  5. Jaundice+High grade fever+Urinary complains= Leptospirosis
  6. Jaundice+Itching+Pregnancy= Cholestatic Jaundice
  7. Jaundice+Huge Ascites+Nodule formation in Liver+Easy bruishing+Portal HTN= Cirrhosis of Liver
  8. Jaundice(Fluctuating)+Abdominal pain= Bile duct stone
  9. Jaundice(Progressive)+Palpable Gallbladder+Old age= Carcinoma of head of the pancreas
  10. Jaundice+Anemia+Splenomegaly= Hereditery Hemolytic Anemia
  11. Jaundice+Cataract= Galactosemia/Intrauterine infection
  12. Jaundice+Cystic mass below Liver= Choledochal cyst
  13. Jaundice+Ascites+Bile stained hernia= Spontaneous perforation of bile duct
  14. Jaundice+Systolic murmur+Abnormal facies+ Butterfly shaped vertebra= Arterihepatic dysplasia(Alagille Syndrome)
  15. Jaundice+Cutaneous hemangioma= Hepatic hemangioma
  16. Jaundice+Situs inversus= Extrahepatic biiary atresia
  17. Jaundice+Optic nerve hypoplasia= Septo-optic dysplasia
  18. Jaundice+Psychosis+Neurological abnormality= Wilson's disease
  19. Jaundice+CLD features+COPD features= Alpha1-Antitrypsin deficiency
  20. Jaundice+Long time Ulcerative colitis+Itching+Steatorrhoea= Primary sclerosing cholangitis
  21. Jaundice+DM+Skin pigmentation+Hepatomegaly+Arthritis+Erectile dysfunction= Hemochromatosis 
  22. Jaundice+Fever+Right upper quadrent abdominal pain= Ascending Cholangitis
  23. Jaundice+Palmar erythema+Spider nevus+Ascites+Leuconychia= Chronic Liver Disease(CLD)
  24. Jaundice+CLD features+Dysphagia+ Hemoptysis =Esophageal Varices
  25. Jaundice+CLD features+Bleeding per-rectum= Hemorrhoids

Prevention of jaundice : 

Be careful not to drink outside food and water as all of these can be infected by A and E viruses. Before taking blood, taking injections, using someone else's razor, toothbrush, making sure that there are no bruises anywhere on your hand before touching someone else's bodily injuries and blood. Abstain from illicit sexual intercourse. Get vaccinated against the B virus, especially as a child, before being infected with the B virus. In this case, make sure that the B virus does not attack the body before vaccination. Because once infected with the B virus, there is no cure for the disease. Blood tests can be done to determine if someone is infected with the B virus. If you have HBs Ag positive in your blood you are already infected with B virus so there is no benefit to your vaccine but if your blood test is HBs Ag negative then you are not infected with B virus and you can protect yourself from B virus attack .

Treatment of Jaundice  : 

There are currently several effective anti-viral drugs available. People who are infected with hepatitis B (HBs Ag positive) can get rid of the disease by taking regular treatment for a long time. However, only an experienced doctor can help you in this regard. However, it is better to refrain from ill-treatment. Because it is more likely to harm you than good.

Author :

1.Aninda kumar dey (MBBS,Rangpur Medical College) 

2.Noman Islam Nirob (MBBS Student, Rangpur Medical College) 

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