What are diseases similar to jaundice. Jaundice: symptoms in adults, how it is transmitted, treatment features

But in fact, under this concept are hidden various pathological changes affecting the liver and other organs.

Jaundice is always caused by a violation of bilirubin metabolism. As a result of the development of liver failure and impaired patency of the biliary tract, its accumulation in the blood begins.

It is accompanied by staining of the sclera and mucous membranes in yellow. Only a small amount of bilirubin is excreted through the skin or by the kidneys.

The disease "jaundice" is one of the most common. It is most often found in countries with a warm climate, where there are no normal sanitary conditions. It can occur at any age: in adults and children. The most common jaundice in infants.

The onset of symptoms

In the development of jaundice incubation period may take several months. The disease is acute, protracted or chronic, depending on its duration.

Symptoms of jaundice are yellow staining of the skin, sclera and mucous membranes. This is due to an excess of bilirubin in the body. The size of the liver and spleen may also increase. The number of red blood cells in the blood increases.

Jaundice may appear as a change in the color of urine and stool. High concentration bilirubin in the body leads to dark urine, and feces become gray. Another symptom of the disease is the appearance of itching on the skin.

Also, the patient has spasmodic or pulling pain in the right hypochondrium and loss of appetite.

What are the symptoms of jaundice?

By jaundice, people usually understand Botkin's disease, which in medicine is called hepatitis A. Such a viral pathology leads to general intoxication of the body and disrupts the liver. Other types of hepatitis accompanied by jaundice are also known: and. In addition, jaundice can occur in a toxic, bacterial, medicinal, autoimmune, mononuclear form.

Anemia and cirrhosis due to the development of hepatitis or alcoholism often lead to disorders in the liver and gallbladder. Also, jaundice often occurs due to the formation of stones. big size v gallbladder and malignant formations in the pancreas.

Obstructive jaundice occurs due to a violation of the removal of bile from the ducts due to the occurrence malignant tumors, cysts or stones. The patient develops a yellow-green complexion and a fever.

Also often there is inflammation of nearby lymph nodes and appear severe pain in the region of the liver. With this type of jaundice, the patient develops severe itching on the skin, so he combs it to wounds. The stool becomes lighter and the urine becomes darker.

Newborns often develop conjugative jaundice, which is caused by sharp rise bilirubin content in the body. In some cases given form jaundice is also observed in adults. This is due to the influence of various negative factors on the liver. One of them is the use of drugs. V rare cases conjugative jaundice refers to congenital pathologies, in particular, to the Gilbert-Meulengracht syndrome.

Diseases such as lymphocytic leukemia, anemia, lymphosarcoma and tropical malaria lead to the development of hemolytic jaundice. As a result of violations of bilirubin metabolism and immaturity of the enzyme system, many premature and debilitated newborns develop physiological jaundice. It manifests itself in yellowness of the skin, mucous membranes and drowsiness.

Sometimes, a baby develops neonatal jaundice right after birth. It may be related to the accumulation high quantity bilirubin in the blood and insufficient serum ability to bind it. Another cause of such jaundice is the enzymatic immaturity of hepatocytes. This pathology may require immediate treatment, since indirect bilirubin is a neurotoxic poison. It can cause damage to the cerebral cortex and subcortical nuclei.

Violation of the structure and functioning of hepatocytes can lead to parenchymal jaundice. This disease occurs due to acute viral hepatitis and cirrhosis of the liver. The patient is usually diagnosed with an enlarged liver. In this case, the skin acquires a yellow, and subsequently a slightly reddish tint. Spider veins appear on the patient's body - telangiectasias.

The disease can be caused by drug-induced liver damage, cirrhosis, viral or alcoholic hepatitis, the presence of malignant liver tumors. As a result of the development of the disease, there is a loss of appetite, nausea, pain in the right hypochondrium, discoloration of urine and feces, icteric coloration of the skin. Drug therapy is selected depending on the cause that led to the development of liver-type jaundice.

Prehepatic jaundice in adults develops due to the rapid breakdown of red blood cells in the body - hemolysis. In human blood, bilirubin levels quickly rise to a maximum. The liver does not have time to process the pigment and it quickly enters the bloodstream, while staining the skin, mucous membranes and whites of the eyes yellow. This jaundice is usually the result of hereditary diseases or poisoning the body with certain poisons.

Among the symptoms of the disease can also be noted:

pallor of the skin;
darkening of feces;
a significant decrease in the levels of red blood cells and hemoglobin;
an increase in the size of the liver and spleen;
appearance pain in the right hypochondrium.

Carotene jaundice does not pose a risk to human health. It is caused by the consumption a large number foods with carotene, such as pumpkin or carrots. With this type of jaundice, the feet and palms are usually stained. It is very easy to cure such jaundice. With a decrease in the consumption of these products, the body is cleansed and quickly gets rid of pigmentation.

Conclusion

Jaundice in adults is a common group of pathological disorders. They can be associated with a wide variety of diseases.
The appearance of icteric coloration of the skin and pain in the right hypochondrium are a serious reason that should force the patient to urgently consult a doctor. This will help to avoid negative consequences and quickly cure the disease.
In case of violations in the work of some organs, bilirubin accumulates in the liver and is absorbed again into the blood. It is called indirect bilirubin and has a toxic effect on the entire human body. With the accumulation of bilirubin in tissues and mucous membranes, they turn yellow and jaundice occurs. This process can take several months.
The pathogenesis of the disease can only be determined by a doctor through the use of various diagnostic methods.

Gastroenterologist, Hepatologist, Infectionist

Engaged in diagnostics, prevention and treatment of stomach ulcers, gastritis, hepatitis, dysbacteriosis, diarrhea, esophagitis, pancreatitis, flatulence, constipation, colitis and other diseases of the gastrointestinal tract.

A person who does not have a medical education and knows little about scientific terminology is unlikely to know that jaundice is a dependent disease. It would be more correct to say that this is a series of clinical manifestations in Botkin's disease, hepatitis or pathological conditions. internal organs, including the liver. Before us stands important task — in plain language talk about the varieties, provoking factors, manifestations and therapy of this unpleasant disease.

Introductory part

To begin with, we give a brief description of the syndrome. Jaundice is a discoloration (staining) of the proteins of the eyes, skin and mucous membranes due to an increased concentration in the blood plasma of a certain pigment - bilirubin. Symptoms, course and severity will directly depend on true reason that caused the syndrome. As we found out, the main culprit that changes the color of body parts is bilirubin. It is synthesized from used hemoglobin.

An excess of indirect pigment (not combined with acid) is very toxic to the tissues and organs of our body. It brings a lot of trouble and anxiety to newborns and their parents. Physiological jaundice in children infancy formed as a result of the breakdown chemical reactions and erythrocytes, then accumulates in the tissues. In some cases, treatment is not required - the symptom complex disappears on its own after a few weeks.

Types of jaundice and their features

In the process of carefully studying the violation of the metabolism of the pigment substance, experts decided to classify the pathology by type. Each form has individual signs and treated in a specific way. We will understand all the nuances.

obstructive, or mechanical

According to medical workers, often occurs against the background of malignant formations of the biliary tract, also with cholelithiasis, hypernephroma, and helminthic invasion. Obstructive jaundice stains the skin and sclera of the eyes almost immediately. Treatment is minimally invasive and medical method. If you do not take action, then there is a blockage of the biliary tract.

There is a high chance that they will break. If this happens, then all the bile will enter the bloodstream. As a result, the liver with the spleen enlarges, the feces become discolored. With prolonged exposure, liver cells are deformed, their functional activity is disrupted.

cholestatic jaundice

It develops after a bacterial or infectious disease. Cholestatic jaundice is equally diagnosed in adults and children. A blood test shows a significant increase in bilirubin, while pigment metabolites are absent in feces and urine. By external changes in the skin (colored yellow), the doctor can determine the disease.

Hemolytic type

The type is caused by the breakdown of red blood cells - erythrocytes. The disease jaundice of this form develops instantly: the patient is disturbed by edema, fainting, anemia. According to statistics, the hemolytic type is more common in newborns. It is explained by the presence in the body of bilirubin, which poisons the baby. On palpation and ultrasound, an enlargement of the spleen is noticeable. This disease is transmitted at the genetic level - from and ancestors. In the absence of proper therapy and medical supervision, the consequences are extremely unfavorable.

Parenchymal or hepatic form

Decayed erythrocytes (free bilirubin) are transported to the blood and bile capillaries due to impaired functioning of liver cells. From a huge dose of pigment, the body experiences tremendous stress and fails. It is differentiated by the method and liver parenchymal jaundice.

This helps doctors make a diagnosis (besides blood and urine tests). During palpation, compaction and an increase in internal organs are noticeable. The patient experiences pain and discomfort. Be sure to conduct complex therapy. The prognosis is favorable, provided that the requirements of the doctor are met.

food grade carotene jaundice

According to doctors, one should distinguish between such concepts as true and false jaundice. What kind of ailment the patient has, you can find out only at the doctor's appointment. The carotene form is false. It appears as a result of frequent eating of orange-colored foods, such as carrots or oranges. A clinical blood test reveals an abundance of beta-carotene (vitamin A), which gives the skin, eye membranes and mucous membranes an orange color.

This is not a pathology and does not require medical supervision. To eliminate the unnatural color of the skin, it is enough to exclude products containing enzymes from the menu. However, it must be understood that it may take 12 months to completely cleanse the body of carotene. To avoid this phenomenon, control your diet.

Can you get jaundice?

The danger to humans is hepatitis B and C. The disease is transmitted through sexual contact, through blood, placenta (transfusion, medical instruments, toothbrush, manicure devices). Another no less threatening disease is viral hepatitis A (Botkin's disease). You can catch a pathological condition through poorly purified water, unwashed food, contaminated objects, and a handshake.

There are three stages of the course of the disease: mild, moderate and severe (epidemic). In each case, viral hepatitis A proceeds differently. The most dangerous form is epidemic. The patient has CNS disorders, the risk of fever increases. Hospitalization and constant medical supervision are required.

General clinical manifestations

We found out which jaundice is contagious and life-threatening. Now we will describe the manifestations that are identical in all types of the disease. Knowing the clinical symptoms, a person will be able to prevent the disease in a timely manner by seeking help from the Home distinguishing feature pathology - yellowness of the whites of the eyes, mucous membranes and skin.

However, each form has a different shade. At mechanical the surface of the skin acquires a yellow-olive color with a brown tint. The hepatic form is characterized by a bright orange color, and the hemolytic form is lemon yellow. The disease is accompanied by itching, enlargement of the liver, spleen, the appearance of spider veins, fever.

At the same time, the color of the urine changes - it becomes dark. There are violations on the part nervous system: tormented by apathy, irritability, weakness, insomnia. The presence of similar symptoms should prompt you to contact your local therapist.

Diagnostic measures

It is not difficult and difficult to accurately establish the pathology. According to history, outward signs, liver biopsy and clinical research(blood, feces, urine) it is easy to determine the cause of the syndrome. Additional diagnostic methods are required: MRI, ultrasound, liver scan, duodenal sounding, tomography.

Therapy Methods

Infectionists, hematologists, therapists and surgeons are authorized to prescribe treatment after complete medical examination and making the correct diagnosis. The main methods of dealing with the disease: medical and surgical methods, as well as phototherapy and endoscopy. Surgical intervention (elimination of adhesions, gallbladder, formations, crushing of calculi) is carried out if obstructive jaundice is present.

Treatment of a disease of an infectious origin is carried out only in a hospital - maintenance therapy is prescribed for liver function. Blood transfusion is indicated for the hemolytic type. Combined therapy helps a lot. Positive dynamics is shown by phototherapy, which promotes the processing of the pigment and its removal from the body. It is prescribed for both adults and infants. Also, the methods of treatment include the use of dietary supplements. Supplements help restore liver cells, metabolic processes, and detoxify. Patients are prescribed hepatoprotective drugs (medicines that protect the liver), antispasmodic drugs. There are many treatment options. The choice of therapeutic technique remains with the doctor.

Diet will speed up recovery

Right balanced menu is an essential attribute in the treatment of this pathological condition(liver damage). Along with taking medication, the patient must adhere to a diet (as recommended by a specialist). Babies under the age of one receive only breast milk or an adapted formula.

Completely excluded from the diet fatty varieties meat, egg yolk, preservation, seasonings, harmful sweets (buns, chocolate, sweets). All dishes should be served only boiled, stewed, steamed, baked. In small doses, butter, natural marshmallow, honey, marshmallows are allowed. Need to add more fresh fruit, vegetables, greens. Required plentiful drink: mineral water, tea, herbal infusions, compotes, jelly.

In combination with traditional treatment can be used herbal ingredients facilitating the excretion of bile. Decoctions and infusions of dandelions, yarrow, plantain, calendula have proven themselves well. Proportions - half a glass three times a day. It does not hurt to consume salt-free sauerkraut brine and beetroot syrup - alternate drinks every other day (250 ml twice a day).

Negative consequences

All types of jaundice can cause irreparable harm and provoke terrible complications. Do not let pathology take its course. Toxic pigments have a detrimental effect on all internal organs, cause Crigler-Najjar syndrome, neuropsychiatric disorders, acute pancreatitis, hemolysis, oncology, cirrhosis.

So, we introduced readers to dangerous state, which does not know the age limits and causes dangerous consequences. To avoid infection, be vigilant: avoid points fast food, do not drink tap water, wash food thoroughly, do not come into contact with street animals. We will not mention safe sexual contact - everyone should know about it. The one who is aware and takes preventive measures is armed.

Symptoms of jaundice are manifested due to excessive accumulation of bilirubin in the body. Erythrocytes, decaying, release bilirubin in case of improper functioning of the liver or violation of the outflow of bile from the biliary tract. Treatment of pathology is carried out taking into account its form and individual features patients.

Definition of the type of jaundice

There are many causes of the disease, so therapy should be carried out taking into account the severity of its course and form. In medicine, there are 3 forms of jaundice:

After an external examination of the patient, the specialist must establish the root cause of the problem. For this, the patient is prescribed a set of diagnostic measures:

donation of blood, feces and urine;
ultrasonography.

Ultrasound allows you to determine the condition of the biliary tract, liver and spleen. In severe cases of the disease, patients are prescribed the passage of splenoportography and celiacography. The success of recovery, as well as the prevention of negative consequences, depends on the accuracy of the diagnosis.

Medicines for parenchymal jaundice

The parenchymal type of pathology is also called true jaundice. An ailment develops when a viral pathogen enters the body, weakened by infectious diseases or severe intoxication.

Characteristic signs: skin staining yellow, darkening of urine and lightening of feces. In case of toxic damage to the liver, the patient is urgently taken to the hospital, where they subsequently provide the necessary medical care.

The main goal of therapy in this case is to get rid of the toxins produced by the body and restore its functioning.

With pain symptoms, patients are prescribed antispasmodics - Dibazol, Papaverine or No-shpa
In case of a disease complicated by cholecystitis or cholangitis, ursodeoxycholic acid is recommended.
If obstructive jaundice develops against the background of tumors of the stomach and pancreas, then the therapy is supplemented with chemotherapy drugs.

For supporting immune system and restoration of the cells of the affected organ, other drugs are prescribed:

Vikasol;
B vitamins;
Trental;
intravenous glucose.

Medicines for hemolytic jaundice

Therapy is carried out taking into account the patient's condition and his age, as well as the cause of the disease. Among the drugs for jaundice of this form are used:

glucocorticosteroids - Dexamethasone, Prednisolone;
diuretics - saline solutions;
immunosuppressants - Cyclophosphamide, Imunar.

Therapy of the hemolytic type of the disease is carried out using large dosages hormonal drugs.
With the transition of the disease to the stage of remission, the dosage is reduced by 2 times.

Taking hormonal drugs at the stage of remission of jaundice is performed in courses - 2-3 weeks per month. Treatment is carried out until the level of bilirubin in the analyzes decreases. The intake of this group of medicines should be carried out under the supervision of a physician, otherwise, in the fight against the underlying disease, medicinal jaundice may occur.

Medicines for children

Jaundice is a common occurrence in newborns. Symptoms of the disease can be observed from the first days of life and persist for several weeks and even months. If the symptoms of the pathology do not disappear, then the child is prescribed drug therapy.

Toxins and waste products of viruses are excreted using ascorbic acid, glucose or Phenobarbital. To remove bilirubin from the body, children, like adults, are prescribed drugs with a choleretic effect.

Enterosorbents - Polysorb, Smecta, Filtrum, White Coal - allow you to quickly eliminate the clinical picture of the disease. The activity of the pathogen is suppressed by taking antiviral drugs.

Self-treatment of a child for jaundice is impossible. The reaction of the body to drugs should be monitored by a specialist. After treatment, children are advised to adhere to a certain diet and lifestyle: limit physical activity, consume enough fluids, refuse soda, convenience foods and canned foods.

Traditional medicine for jaundice

Hepatitis D cannot occur as an independent disease. It manifests itself against the background of type B pathology, so its treatment is the same as for hepatitis B, but for a longer time.

With hepatitis E, medication is not required, since the pathology in most cases resolves on its own. Drugs may be prescribed to suppress the symptomatic picture of the disease - painkillers, enterosorbents and anti-nausea drugs.

Medicines for jaundice are prescribed based on the individual characteristics of the patient (age, state of health), as well as the form of the disease - mechanical, suprahepatic and subhepatic.

In the first case, it is advisable to take medication only to alleviate the symptomatic picture, since the main method of dealing with the problem is surgical intervention. With hemolytic and subhepatic jaundice, patients are most often prescribed sorbents, hepatoprotectors, and diuretics. The treatment of adults differs significantly from the fight against the disease in children.

Jaundice- This is a syndrome characterized by an increased concentration of bilirubin in the blood, which is visually manifested in the staining of the skin and mucous membranes in yellow. The color of the skin with jaundice can vary from dark orange to bright lemon. Jaundice is not independent disease, but only clinical manifestation various pathologies.

This pathology is typical not only for the adult generation, but also for children. Thus, neonatal jaundice is a fairly common neonatal pathology. According to statistical data, it occupies the 4th place in the structure of the incidence of babies in the first week of life. It occurs in 0.7 percent of newborns. Obstructive jaundice is also an equally rare pathology. It occurs in 40 percent of patients suffering from cholelithiasis. In people with tumors of the liver and biliary tract, jaundice occurs in 99 percent of cases. Parenchymal jaundice is characteristic of viral infection liver. However, it does not occur immediately, but only at decompensated stages, when the body is no longer able to fight the disease on its own.

Causes of jaundice

The main cause of jaundice is the accumulation of excess bilirubin in the tissues. Bilirubin is a liver pigment, the main source of which is hemoglobin.

The pathogenesis of jaundice

For the synthesis of bilirubin, hemoglobin comes from destroyed red blood cells. The average lifespan of red blood cells ( erythrocytes) equals 120 days. After the end of this period, red blood cells are destroyed, and the hemoglobin previously contained in them enters the liver and spleen. Initially, bilirubin iron undergoes oxidation, then it transforms into ferritin. The synthesized porphyrin ring is converted into bilirubin by several reactions.

The resulting bilirubin enters the bloodstream. Bilirubin is insoluble in water and therefore uses the protein albumin for its transport. Bilirubin is delivered to the liver cells - hepatocytes - with the blood flow. Initially, it is captured by these cells, and then transported to the liver, where it binds to glucuronic acid, after which it is released into the bile capillaries. There are two types of bilirubin - free ( indirect) and related ( straight). Before binding to glucuronic acid, bilirubin is called free. After conjugation ( connections) with acid, bilirubin becomes bound or direct.

Bile secretion follows a gradient ( differences) pressure - the liver secretes bile at a pressure of 300 - 350 millimeters of water column. Further, it accumulates in the gallbladder, which already secretes bile, depending on the need. Bilirubin enters the intestine and, under the action of enzymes, is converted into mesobilinogen and urobilinogen. Urobilinogen is excreted from the intestine as stercobilinogen ( 60 - 80 mg per day). The latter stains feces brown. A small part of urobilinogen is reabsorbed through the intestines and enters the liver with the blood stream. At healthy person The liver completely metabolizes urobilin, so it is not normally detected in the urine. Part of the stercobilinogen enters the general circulation and is excreted by the kidneys ( about 4 mg per day), giving the urine a straw-yellow color.

Thus, the exchange of bilirubin in the body is quite complex and includes several stages. Violation of one of them can cause jaundice.

The causes of jaundice are:

obstruction of the biliary tract and gallbladder;
pathology of the liver hepatitis, cirrhosis);
premature destruction of red blood cells.

Obstruction of the biliary tract
Total or partial obstruction of the biliary tract is one of the most common causes jaundice. At the same time, jaundice develops, which is called mechanical or subhepatic. The name of jaundice in this case reflects the cause of the disease. With obstructive jaundice, an increase in the concentration of bilirubin in the blood occurs due to blockage of the ducts. Blockage of the biliary tract can be triggered by various pathologies.

The causes of blockage of the bile ducts are:

stones of the gallbladder or biliary tract;
cyst localized in the head of the pancreas;
tumors bile ducts;
stenoses ( narrowing) biliary tract.

These and many other pathologies can cause complete or partial blockage of the biliary tract. This, in turn, leads to a violation of the outflow of bile and its accumulation in biliary tract. Over time, the pressure in the ducts increases, and bile, trying to find an outflow path, begins to saturate the walls of the gallbladder. As a result, bilirubin and bile acids are released into the blood. The content of bilirubin in the blood plasma begins to exceed the norm. The skin and mucous membranes quickly become icteric.

Since bile due to obstruction ( patency disorders) does not enter the intestines, then the feces of a patient suffering from obstructive jaundice become discolored. At the same time, freely circulating bilirubin in the blood gives it a dark brown color.

pathology of the liver hepatitis, cirrhosis)
Various liver diseases provoke the development of true or so-called "parenchymal" jaundice. Most often, parenchymal jaundice is based on an infectious or toxic lesion of liver cells ( hepatocytes).

Pathologies that can provoke parenchymal jaundice include:

acute hepatitis;
exacerbation of chronic hepatitis;
cirrhosis of the liver, including primary biliary cirrhosis;
systematic use of alcohol;
exposure to certain viruses, poisons.

The basis of these diseases is a violation of the metabolism, capture and transport of bilirubin in hepatocytes, which leads to the development of cytolytic and cholestatic syndrome. The first syndrome reflects the process of cell destruction ( cyto-cell, lysis - destruction), which occurs with the release of bilirubin. Cholestatic syndrome is characterized by stagnation of bile and a decrease in its flow into the intestine. These two syndromes determine the clinical picture of parenchymal jaundice. The color of the skin in this type of jaundice is reddish ( "red jaundice"). As with other types of jaundice, the sclera, the soft palate, and then the skin are stained first. As a result of the destruction of hepatocytes ( which already contain pigments) bilirubin enters the lymphatic and blood vessels. Once in the bloodstream, bilirubin stains the skin and sclera yellow.

Drugs leading to the development of parenchymal jaundice

Premature destruction of red blood cells
Premature destruction of red blood cells underlies hemolytic or suprahepatic jaundice. In this case, an increase in the concentration of hemoglobin in the blood occurs due to the intensive breakdown of erythrocytes and, as a result, excessive production indirect bilirubin (since erythrocytes contain indirect bilirubin). The phenomenon of massive breakdown of erythrocytes can be observed in the pathology of the spleen, namely in primary and secondary hypersplenism. Also, anemia can be the cause of the intensive breakdown of red blood cells.

Due to the breakdown of red blood cells, a large amount of indirect bilirubin is formed, which the liver does not have time to metabolize. Thus, part of the bilirubin, which is nevertheless captured by hepatocytes, binds to glucuronic acid, and part remains unbound. Unbound bilirubin, which should not normally be, stains the mucous membranes and skin in a bright lemon color.

Hemolytic jaundice can also be autoimmune. The basis of this disease is the massive destruction of red blood cells by the body's own cells. Causes of autoimmune hemolytic jaundice, like others autoimmune diseases, are unknown. Jaundice can also be caused by various genetic diseases.

The genetic pathologies that are accompanied by jaundice include Gilbert's syndrome. This is a genetic disease in which the process of bilirubin metabolism is disturbed in hepatocytes ( its capture and absorption). The ratio of men and women in this pathology is 3 to 4, and the average age of the onset of the disease is 12-25 years. Contents total bilirubin in the blood ranges from 5.1 to 21.5 micromoles per liter. To the share of the indirect ( free) bilirubin accounts for 4 - 16 micromoles per liter ( 75 - 85 percent of the total), while the direct concentration ( related) is 1 – 5 micromoles per liter ( 15 - 25 percent of the total).

An increase in the concentration of bilirubin in the blood over 27 - 34 micromoles per liter is called hyperbilirubinemia. Bilirubin binds to the elastic fibers of the skin and conjunctiva and gives the skin and mucous membranes an icteric coloration.
Depending on how high the level of bilirubin is, there are several degrees of severity of jaundice.

The severity of jaundice

The rate of increase in the concentration of bilirubin depends on the severity of the pathology that underlies jaundice. So, with complete obturation ( blockage) of the biliary tract, the level of bilirubin increases daily by 30-40 micromoles per liter. With partial blockage, the level of bilirubin rises more slowly.

The severity of jaundice is:

a mild form of jaundice with a bilirubin concentration of up to 85 micromoles per liter;
moderate form of jaundice with a concentration of bilirubin from 86 to 169 micromoles per liter;
a severe form of jaundice with an increase in the level of bilirubin over 170 micromoles per liter.

How bright is the staining of the skin and mucous membranes ( intensity of jaundice), depends on skin color, bilirubin concentration and tissue blood supply. Initially, the visible mucous membranes, that is, the sclera, are stained. That is why, if a liver pathology is suspected, the doctor initially examines the patient's sclera.

Somewhat later, icteric staining of the skin is added. If health care is not provided on time, the skin acquires a greenish tint. This is due to the gradual oxidation of bilirubin to biliverdin, which has in green. Even if at this stage the patient is not helped, the skin and mucous membranes acquire a blackish-bronze color. Thus, the evolution of the skin in jaundice is as follows. First yellow, then greenish, and then bronze.

Types of jaundice

Depending on the cause of origin and pathogenesis, there are three main types of jaundice. Each type has its own causes, as well as its own clinical picture. In addition, true jaundice and pseudo-jaundice are distinguished. Pseudojaundice is the result of the accumulation of carotenes in the skin. This can occur with prolonged consumption of carrots, pumpkins, oranges, and other foods.

The difference between pseudo-jaundice and true jaundice is that in the first case, only the skin turns yellow, in the second, both the skin and mucous membranes.

Types of jaundice include:

obstructive jaundice (subhepatic);
hemolytic jaundice (suprahepatic);
hepatic jaundice (parenchymal).

Mechanical jaundice

The name of jaundice reflects the essence of its pathogenesis, namely the presence of an obstruction factor. The reason in this case is a mechanical factor, namely partial or complete obstruction of the biliary tract. Stones, abscesses, tumors, cysts can act as a mechanical factor. All these structures create obstacles for the flow of bile. As a result, bile begins to accumulate in the bile ducts.

The intensity of accumulation depends on the degree of obstruction. If stones or a cyst completely close the lumen of the duct, then further flow of bile into the intestine stops. Bile accumulates in the bile ducts, creating in them high blood pressure. Finding no further exit, it begins to seep into the bloodstream. As a result, bile components, namely bilirubin and bile acids, enter the bloodstream. Bilirubin stains the skin and mucous membranes in an icteric color.

Symptoms of obstructive jaundice are:

severe itching;
icteric coloration of the skin and mucous membranes;
weight loss.

Severe itching
Since with obstructive jaundice a large amount of bile acids (bile components), there is a pronounced pruritus. It significantly impairs the patient's quality of life, often causing sleepless nights. Skin itching with obstructive jaundice is due to irritation of nerve endings by bile acids.

Icteric coloration of the skin and mucous membranes
The intensity of jaundice depends on the concentration of bilirubin in the blood. As a rule, with obstructive jaundice, the increase in the concentration of bilirubin occurs very quickly. Therefore, the coloring of the skin is always expressed very brightly. A feature of obstructive jaundice is a greenish tint of the skin.

Weight loss, vitamin deficiency
Due to the fact that bile does not enter the intestinal lumen, there is no absorption of fatty acids and fat-soluble vitamins. Recall that bile plays an important role in the process of assimilation of food consumed. It breaks down fats into small molecules, facilitating their absorption. Also, thanks to the components of bile, vitamins A, D, E and K are absorbed. Therefore, often with obstruction of the gallbladder ( or with another mechanical reason ) patients quickly begin to lose weight.

A deficiency of all fat-soluble vitamins - A, D, E and K - gradually develops. Vitamin A deficiency leads to the development of such a disease as night blindness. Vitamin D deficiency underlies the development of osteoporosis and pain in the spine. In chronic cholestasis ( bile stasis) osteomalacia develops, which manifests itself in a decrease in the density bone tissue. Symptoms of vitamin E deficiency are very diverse. It includes symptoms such as polyneuropathy, retinal degeneration, cerebellar ataxia. The most dangerous consequence of cholestasis is vitamin K deficiency, which is manifested by hemorrhagic syndrome.

Obstructive jaundice differs not only clinical symptoms but also laboratory tests. She is also characterized by acholic ( colorless) feces, beer-colored urine, increased levels of all components of bile.

Diagnosis of obstructive jaundice
As a rule, the diagnosis of obstructive jaundice is not difficult. Very often the cause is gallstones or cholangitis ( inflammation in the bile ducts). In this case, Charcot's triad is observed - pain in the right hypochondrium, fever and jaundice. The pain that the patient complains about is very severe, almost unbearable. The patient rushes about, cannot sit down. Ultrasound is the most commonly used diagnostic tool ( ultrasound). characteristic feature blockade of the biliary tract on ultrasound is the expansion of the bile ducts ( biliary hypertension).

In addition to ultrasound, endoscopic cholangiopancreatography is often used. This diagnostic method is performed using an endoscope ( hollow tube), which is entered into duodenum. Further, a probe with a video camera attached at the end is pulled out of the endoscope, which reaches the bile ducts. The image from the ducts is transmitted to the monitor screen. Thus, a more complete and clear picture of the state of the bile ducts is achieved.

Supports the diagnosis of obstructive jaundice increased concentration bilirubin, bile acids, liver enzymes. During a medical examination, a dense and tuberous liver is palpated, and local pain is observed in the projection zone of the gallbladder.

Hemolytic jaundice

The name of this type of jaundice reflects the mechanism of its formation. Jaundice is caused by hemolysis ( destruction) red blood cells, hence the name - hemolytic jaundice.

Hemolytic jaundice is characterized by intense breakdown of red blood cells and the release of a large amount of bilirubin from them. Hemolytic jaundice is also called suprahepatic jaundice. This means that the reason this disease lies not in the liver itself ( as in hepatic form), nor under it ( as in mechanical), and higher, that is, still in circulatory system. The main laboratory sign in hemolytic jaundice is an increase in the concentration of indirect bilirubin.
The reasons for the massive breakdown of red blood cells can be anemia, the ingestion of various poisons and toxins that lead to the destruction of red blood cells.

Symptoms hemolytic anemia are:

jaundice bright lemon color;
splenomegaly;
blood changes.

Jaundice
With hemolytic jaundice, the skin is distinguished by its bright lemon color. The degree of yellowness is moderate. The reason for staining the skin yellow is the circulation in the blood increased amount indirect bilirubin. As with other types of jaundice, the mucous membranes stain first ( sclera and soft palate), and then the skin itself. Hemolytic jaundice is always accompanied by anemia, as there is a breakdown of red blood cells. If anemia is very severe ( hemoglobin concentration decreases by less than 70 grams per liter), then jaundice may be inferior to pale skin. Itching is moderate or absent.

Splenomegaly
Splenomegaly is a syndrome characterized by an enlarged spleen. The increase in the size of the spleen depends on the intensity of hemolysis ( destruction of erythrocytes). Often splenomegaly is accompanied by hepatomegaly ( liver enlargement). Urine and feces with hemolytic jaundice becomes intensely dark color.

Changes in the blood picture
In the blood with hemolytic jaundice, the concentration of indirect bilirubin sharply increases, while the level of direct ( related) remains within the normal range. Also, a large number of young and immature erythrocytes appear in the blood, which replace the destroyed ones. This phenomenon is called reticulocytosis ( young forms of red blood cells are called reticulocytes) and is characteristic of all hemolytic jaundices. Another indicator of hemolytic jaundice is elevated level serum iron. Liver tests and cholesterol were within normal limits.

Hepatic jaundice

hepatic jaundice ( or parenchymal) occurs in various liver diseases. Its development is based on damage to the parenchyma ( the fabric itself), so hepatic jaundice is also called parenchymal. Damage to liver cells can be caused by the most various reasons. Most often, hepatic jaundice is infectious or toxic in origin.

Causes of hepatic ( parenchymal) jaundice are:

infectious and toxic hepatitis;
viral hepatitis B, C, D;
biliary cirrhosis of the liver;
drug intoxication.

As a result of the destructive action of a virus or drug ( depending on the cause of jaundice) liver cells are destroyed. From the destroyed hepatocytes, bile pigments, including bilirubin, enter the lymphatic and blood vessels. Most of the bilirubin enters the urine and stains it dark. Less bilirubin enters the intestine, so the stool with parenchymal jaundice is always light.

Symptoms and signs of hepatic jaundice
The clinical picture of parenchymal jaundice is determined by its causes. If jaundice is based on intoxication, then symptoms such as nausea, vomiting, abdominal pain will be present. Jaundice in this case is characterized by a saffron hue, as a result of which the patient's skin becomes red. If the course of jaundice is delayed, and there is no adequate treatment, the skin may acquire a greenish tint. Parenchymal jaundice is also accompanied by pruritus, but it is less pronounced than with obstructive jaundice. In the blood, the level of all liver enzymes increases - aminotransferase, aldolase, phosphatase. Urine turns dark shade of beer). On palpation, the liver is enlarged, dense and painful. Often hepatic jaundice can be complicated by hemorrhagic syndrome.

Diagnosis is based on the patient's complaints, laboratory and objective data. Patients with hepatic jaundice complain of pain in the right hypochondrium, moderate itching and dyspeptic symptoms ( nausea, vomiting). Laboratory data include an increase in the level of bilirubin in the blood, liver enzymes, the appearance of urobilin in the urine and stercobilin in the feces. Objective data include signs identified by the doctor himself during the examination. This is the color of the skin saffron color), an enlarged and painful liver.

Jaundice in newborns

Neonatal jaundice is a specific medical term used to refer to the icteric hue of tissues in children. Bilirubin provokes this phenomenon ( bile pigment), which accumulates in the child's body. Based on the reasons accompanying symptoms and other factors distinguish between physiological and pathological jaundice.

Physiological jaundice of newborns

This type of jaundice is the most common and accounts for about 90 percent of all diagnosed cases of yellow skin in newborns. According to statistics, about 60 percent of babies are born with physiological jaundice. In most cases, this phenomenon is diagnosed in premature babies. Tissue staining appears in the period from the 3rd to the 5th birthday and lasts no more than 2-3 weeks.

Causes
The cause of icteric staining of tissues in newborns is the immaturity of the systems that are responsible for the exchange and excretion of bilirubin ( substance resulting from the breakdown of red blood cells). In the human body, bilirubin is processed by the liver and excreted naturally. At the time of intrauterine development, the mother's body "helps" to process the fetal bilirubin. After birth, the child's body cannot cope on its own with the "neutralization" of the entire volume of the bile pigment. In addition, after birth, the level of bilirubin in the blood increases significantly. This is because during intrauterine development, the fetus needs more erythrocytes, and after birth the need for them decreases. Red blood cells begin to break down, forming bilirubin. The increased amount of bilirubin, combined with the immaturity of the child's liver, leads to the fact that the pigment begins to accumulate in the body of the newborn. There are a number of factors that increase the likelihood of a newborn developing physiological type jaundice.

The circumstances that contribute to the development of physiological jaundice are:

not balanced diet future mother;
use of tobacco products and other bad habits of a woman;
the presence of diabetes in a pregnant woman;
iodine deficiency during gestation;
the use of certain drugs;
general unsatisfactory physical condition of the woman.

All these moments negatively affect the development of the fetus, as a result of which the child is born with an unformed enzymatic system, and his body cannot cope with the removal of bilirubin.

Symptoms
The only symptom of physiological jaundice is a yellowish tint to the skin. At the same time, the child's behavior corresponds to the norm - he is active, does not act up, eats well. Sometimes, with a pronounced staining of the skin, the baby may be too sleepy, lethargic to eat. The level of hemoglobin during testing is normal, feces and urine have a natural color.

Treatment
Physiological jaundice does not require medical care. In some cases, the newborn is given intravenous administration glucose. Most effective method The treatment for such a condition is breastfeeding. Breast milk is especially effective in the first days after birth, as it has a mild laxative effect, as a result of which the bile pigment is more quickly excreted along with feces.

The maximum period of physiological jaundice is 3 weeks. During this period, you should observe whether the yellowness becomes more pronounced. If the shade becomes more intense, you should consult a doctor. It is also necessary to resort to medical assistance if, after 21 days after birth, the baby's skin has not acquired a natural shade.

Consequences
Physiological jaundice does not pose any threat to the further growth and development of the newborn.

Pathological neonatal jaundice

Pathological jaundice is not as common as the previous type, but is more prolonged and severe course. Unlike physiological, this form of jaundice appears on the first day after birth and can continue indefinitely.

Symptoms
Regardless of the cause that provoked pathological jaundice, there are a number of common symptoms this state.

Common signs of pathological jaundice are:

in the pathological form of jaundice, skin staining is more intense;
icteric shade can be observed on visible mucous membranes ( e.g. in the mouth) and eye sclera;
in addition to yellowness, petechial hemorrhages and bruises may be present on the skin;
The hallmark of pathological jaundice is its undulating course ( skin color may begin to recover and then become icteric again);
the child's behavior is inhibited and lethargic, he refuses food or eats reluctantly;
may be present increased tone muscles, monotonous crying;
often urine becomes darker, and feces, on the contrary, become discolored;
with the progression of pathological jaundice, symptoms such as convulsions, slowing down heart rate, strong piercing cry;
in aggravated cases, the newborn may fall into a stupor or coma.

In addition to the general symptoms, there are some specific signs pathological jaundice, the nature of which is determined by the cause that provoked this condition.

Causes
To date, there are more than 50 factors that can result in pathological jaundice.

The most common causes of pathological jaundice are:

Abnormal structure of erythrocytes. It is a congenital disease in which yellowness of the skin is accompanied by an increase in the liver and spleen. Subsequently, the child develops anemia.
Incompatibility of the Rh factor, blood group or other blood parameters of the mother and fetus. It provokes an increased breakdown of red blood cells, as a result of which pathological jaundice develops, in which the skin acquires a pronounced yellow tint.
cephalohematoma (accumulation of blood under the periosteum of the cranial bones). A hematoma is formed due to trauma that the child can receive when passing through birth canal or because of wrong position in the womb. When the hematoma resolves, hemoglobin decay products enter the bloodstream, as a result of which the skin acquires a characteristic shade.
Gilbert's syndrome. In this disease, the process of removing bilirubin from the body is disrupted due to the abnormal structure of hepatocytes ( liver cells). Often such pathological jaundice is diagnosed as physiological.
Crigler-Najjar syndrome. Serious disease inherited, in which the nervous system of the child is affected. Jaundice manifests itself in the first hours after birth.
Dubin-Johnson Syndrome. congenital pathology, which is characterized by a violation of the process of removing bilirubin from the liver. Staining of the skin is weak or moderate, the liver may be slightly enlarged.
Features of the composition of breast milk. In some cases, in breast milk there is an increased concentration fatty acids and other substances that disrupt the process of removing bilirubin in a newborn. Unlike other forms of pathological jaundice, in this case, skin staining occurs on day 3 and persists for 1 to 2 months. When transferred to artificial feeding, the manifestations of jaundice are significantly reduced.
Hormone deficiency in a newborn. With insufficient thyroid function in a child, the maturation of enzymes that are responsible for the proper metabolism of bilirubin is blocked. Yellow skin tone persists long time, in some cases up to 20 weeks. Pathological jaundice is accompanied by dry skin, swelling, lethargy. Also, this pathology is characterized by an increase in the abdomen, digestive disorders ( constipation or diarrhea), low body temperature, low rough voice.
Liver damage of a viral or bacterial nature. Yellowness can appear both immediately after birth, and after a few weeks. In addition to the main symptoms, there are signs such as bloating, vomiting, enlargement and hardening of the liver.
Abnormal structure of the biliary tract. With this pathology, the lumen of the biliary tract is narrowed or completely clogged. Because of this, the outflow of bile is disturbed, and bilirubin enters the bloodstream. Initially yellow skin gradually acquires a greenish tint. At the same time, the liver significantly increases in size, dilated veins appear on the abdomen.

Consequences

In the absence of timely and correctly prescribed treatment, pathological jaundice can lead to various serious complications. The consequences of such a condition can manifest themselves both within a short time and at an older age.

Possible consequences of pathological jaundice are:

Toxic poisoning. With an excess of bilirubin, this substance begins to accumulate in adipose tissue and other body structures, which can lead to intoxication.
Albuminemia. High level bilirubin leads to a decrease in the amount of albumin protein in the blood. This condition is accompanied by severe swelling, diarrhea.
Bilirubin encephalopathy. Brain damage, which develops due to exposure to bilirubin. Accompanied by convulsions, hearing impairment, paralysis and can lead to mental and physical development child.

Prevention of jaundice in newborns

Prevention of jaundice in a newborn, regardless of its type, should begin even during pregnancy planning. It is especially important to observe precautionary measures for women in the group increased risk the birth of a child with this pathology.

Factors that increase the risk of having a baby with jaundice include:

the woman's age is less than 18 or older than 40;
the presence of abortions and / or miscarriages in history;
previously transferred premature birth;
smoking and other bad habits during pregnancy;
diabetes in a pregnant woman;
intrauterine infections;
negative Rh factor of blood;
jaundice in previously born children.

Women who are at high risk should be observed by a doctor from the moment of planning and throughout the entire period of pregnancy. At negative Rh factor appointed special preparations to bind Rh antibodies. During pregnancy, a woman should follow a balanced diet, limit the influence of stress and other factors that may adversely affect the development of the fetus.

Symptoms of jaundice

The main symptom of jaundice is the coloring of the skin and mucous membranes in various shades of yellow. The shade depends on the initial color of the patient's skin and on the type of jaundice. In hepatic jaundice, the patient's skin turns yellow-red ( saffron) color, with mechanical - in greenish, and with hemolytic - in lemon.
In addition to the main symptoms for jaundice, the symptoms of the disease that causes jaundice are also characteristic.

The symptoms of jaundice are:

discoloration of urine and feces;
change in skin color;
skin itching;
changes in the blood picture.

Urine and feces for jaundice

A change in the color of urine with jaundice is one of the first symptoms of the disease. At the same time, the color of the feces also changes.

The color of urine and feces in various types of jaundice

Itching with jaundice

Itching with jaundice is at least important indicator. However, its intensity depends on the type of jaundice. So, the most intense and unbearable itching is observed with obstructive jaundice. It is so pronounced that sometimes it causes insomnia and exhaustion of the patient's nervous system. With hepatic and hemolytic jaundice, skin itching is moderately expressed. The cause of itching is the circulation of a large amount of bile acids in the blood, which, in turn, irritate the nerve endings localized in the skin.

Skin with jaundice

Skin color change is the very first and most clear symptom with jaundice. Its development is based on the release of a large amount of bilirubin into the bloodstream. Further, bilirubin binds to the fibers of the skin, giving it an icteric color.
However, even before the staining of the skin, the visible mucous membranes, namely the sclera, initially turn yellow. Often the patient, being very attentive to his appearance, may himself notice that the sclera of the eyes have changed their color. After the mucous membranes, the skin is already stained.

The skin of a patient with jaundice may take on various shades. So, with obstructive jaundice, the skin acquires a greenish tint, with hemolytic jaundice - lemon, with hepatic jaundice - saffron. Often, traces of scratching may remain on the skin, which are the result of excruciating itching. With long-term jaundice, the skin begins to become covered with age spots. Pigmentation of the skin is the result of the deposition of bilirubin in the dermis of the skin.

In addition to the above symptoms, jaundice is accompanied by signs of the underlying disease. For example, if the cause of jaundice is viral hepatitis, then in clinical picture disease present nausea, vomiting, ascites ( accumulation of fluid in the abdomen). If the cause of jaundice is gallstones, then the patient begins to lose weight quickly. Also, stones are accompanied by hepatic colic, which manifests itself in acute and sharp pains in the right side.

Differential diagnosis of jaundice

Diagnosis of jaundice is based on objective data that the doctor receives, on the patient's complaints, as well as on laboratory data.

Complaints of a patient with jaundice are:

skin itching;
digestive difficulties;
a sharp decrease in body weight;
yellowing of the skin;
pain in the right hypochondrium.

The doctor carefully asks the patient how these symptoms evolved, when they appeared, how quickly they developed, what preceded them, whether the patient ate food rich in carotene.

Patient examination
Examination of the patient begins with a more detailed study of his mucous membranes ( soft palate and sclera) and skin. Next, the doctor proceeds to palpation of the abdomen, liver and spleen. The abdomen of a patient with jaundice may be slightly swollen and tender. Next, the liver and spleen are palpated. With hemolytic anemia, the spleen is always enlarged due to the breakdown of red blood cells, and with hepatic jaundice, the liver is enlarged. With obstruction of the gallbladder, local tenderness may be detected.

Bilirubin and other tests for jaundice

With jaundice, changes are noted on the part of the blood test, general urinalysis and fecal analysis. However, these changes vary depending on the type of jaundice.

Laboratory indicators for jaundice

Parameter	Hepatic jaundice	Mechanical jaundice	Hemolytic jaundice
*Bilirubin*		Increased concentration of direct bilirubin.	Increased concentration of indirect bilirubin.
*Liver enzymes*	The concentration of ALAT and ASAT was significantly increased.	Significantly increased all enzymes - alkaline phosphatase (AP), ALAT, ASAT.	Enzymes are moderately elevated.
*bilirubin in urine*	Significantly increased.	Significantly increased.	Missing.
*Urobilinogen in urine*	Missing.	Missing.
*blood picture*		An increase in the number of leukocytes ( leukocytosis), an increase in ESR.	Anemia, reticulocytosis, increased ESR.
*Viral markers*	Positive.	None.	None.
*Plasma prothrombin*	Decreased in severe hepatitis.

Ultrasonography ( ultrasound) with jaundice

This method is most informative for obstructive jaundice. A characteristic sign of obstruction of the biliary tract on ultrasound is the expansion of the bile ducts. With parenchymal jaundice, ultrasound is also informative. It reveals various dystrophic processes, the presence of nodes, changes in the architectonics of the liver. These changes are characteristic of chronic hepatitis, cirrhosis. In addition to ultrasound, endoscopic cholangiopancreatography is often used. This diagnostic method is carried out using an endoscope and a probe with a video camera attached to the end. The probe reaches the bile ducts, and the image from the ducts is transmitted to the monitor screen. Thus, a more complete and clear picture of the state of the bile ducts is achieved.

Treatment of jaundice

The treatment of jaundice depends entirely on its type, that is, on the causes of the disease. At the first stage, treatment is carried out exclusively in a hospital, that is, in a hospital. The patient must be under medical supervision. It is important to remember that in the case of parenchymal jaundice there is a high risk of bleeding.

The principles of treatment for jaundice are as follows:

The cause is treated, that is, the underlying disease, not the symptom. If the pathology is based on viral hepatitis, then antiviral agents are prescribed. In the case of obstructive jaundice, only surgical intervention will help the patient. The operations used for obstructive jaundice are varied and depend on the cause and level of bile outflow obstruction. If the cause of jaundice is toxic medications, then they are urgently canceled.

Mandatory point of treatment is diet. The intake of fats and triglycerides is limited to 40 grams per day.
Enzymes are also mandatory. The standard for enzyme therapy is Creon. In parallel with enzymes are prescribed fat soluble vitamins- A, D, E, K. The dose of prescribed vitamins depends on the degree of their deficiency in the body.
With non-obstructive cholestasis ( that is, with stagnation of bile without the presence of stones) Ursodeoxycholic acid is prescribed. It is produced under the name ursosan, ursofalk.
All patients are required to be hospitalized.

The treatment of jaundice can also be attributed to the treatment of this disease with the help of special biologically active additives the world-famous Tianshi Corporation. To date, this system of treatment is divided into three stages. The first stage involves the use of such bioadditives as Cordyceps, Holican, Chitosan. The second stage is based on the application of San-gao, Weikang and Ant Powder. And, finally, during the third stage of jaundice treatment, you will need to purchase such dietary supplements as Biocalcium, Zinc Plus and Digest natural. Correct use all of the above supplements will help to detoxify the body, overcome the virus, restore the membranes of liver cells, and also restore disturbed metabolic processes to normal. There are a lot of treatments for jaundice. Which of them will be offered to a particular patient will be decided directly by the specialist doctor.

Treatment of obstructive jaundice

Treatment of obstructive jaundice takes place in two stages. The first stage is the elimination of cholestasis, the second is the prevention of liver failure.

The first stage includes various minimally invasive ( less traumatic) methods that are aimed at eliminating stagnation of bile ( cholestasis). This stage is carried out in combination with conservative therapy. If within 2-3 days minimally invasive methods do not give the desired effect, and jaundice continues to grow, it is necessary to perform direct surgical interventions.

Kinds surgical interventions with obstructive jaundice

*Minimally invasive methods*	endoscopic methods with lithotripsy ( destruction of stones), lithoextraction ( extraction of stones) and drainage of ducts; percutaneous cholangiostomy with external or internal drainage;
*Direct surgical interventions*	laparoscopic drainage, can be performed through a cholecystostomy hole; reconstructive operations on the biliary tract with the imposition of bilio-intestinal anastomoses ( connections between the bile ducts and intestines).
*Radical surgery*
*Nucleoside analogs*	lamivudine; tenofovir; entecavir.	Viral hepatitis B, C.
*Interferons*	pegasis; pegintron.	Viral hepatitis B, C, D.

Treatment of jaundice in newborns

Treatment of pathological jaundice in newborns, first of all, is aimed at correcting the underlying cause of this condition. Therapy is also carried out, the purpose of which is the speedy removal of bilirubin from the body of the newborn.

Methods that are used to "neutralize" bilirubin are:

phototherapy;
infusion therapy;
taking medication.

Phototherapy
For phototherapy sessions, an ultraviolet lamp is used, under the influence of which the process of breakdown and excretion of bilirubin is accelerated. Fluorescent lamps may also be used. To achieve maximum effect, it is advisable to use both types of lamps.

The rules for phototherapy are as follows:

The light source is placed above the bed or couveuse ( special camera) child. The eyes and genitals of the child are covered with a special bandage.
The session time depends on the amount of bilirubin in the blood. At low and medium rates, phototherapy is carried out intermittently. With high values of bilirubin, the child is constantly under the lamp until his condition improves.
During the session, the child should not remain in one position. Therefore, every hour the health worker turns the newborn over.
The child's body temperature is checked every two hours. This will prevent overheating of the newborn.
The amount of fluid a child consumes during phototherapy should be increased by 20 percent. This is necessary in order to prevent dehydration. It is also recommended to continue during treatment breast-feeding.

In some cases, during phototherapy, phenomena such as increased dryness of the skin, peeling, rash are observed. Feces can change color due to the withdrawal of a large amount of bilirubin. Often the child becomes more drowsy, lethargic.

Infusion therapy
Infusion therapy is the introduction into the body, most often intravenously, of various medicinal solutions. Such treatment is prescribed during phototherapy to restore fluid volume, if it is not possible to water the child naturally. Also, infusion therapy is indicated for vomiting and frequent regurgitation, and for other conditions in which the newborn loses a lot of fluid.
In some cases, the introduction of a solution of glucose and sodium chloride is prescribed in order to eliminate the consequences of intoxication and speed up the process of removing the bile pigment. With a decrease in the level of protein in the blood, the introduction of an albumin solution is indicated.

Taking medication
The goal of drug therapy is to accelerate the process of removing bilirubin from the body of a newborn. For this, various adsorbents, drugs that improve the functionality of the liver, and drugs to stimulate metabolism are used.

Drugs that are used to treat jaundice in newborns are:

Activated carbon. One of the most affordable sorbents. Long-term use of the drug is not recommended, as activated charcoal particles can injure the intestinal mucosa.
Enterosgel. Sorbent based on organic silicon, which has a pronounced detoxification effect.
Polysorb. Effective drug with sorbent ( absorbent) action, made on the basis of silicon dioxide.
Magnesia. It is prescribed both inside and in the form of electrophoresis

The established opinion calls to consider jaundice as a disease, however, this is not entirely true. Jaundice (jaundice) is a set of symptoms that indicate a disease.

Treatment of jaundice is carried out necessarily, including at home, a set of measures is provided for this. But first you need to establish the reasons for its occurrence.

in adults, it occurs when bilirubin accumulates in the blood and tissues. Bilirubin is the main component of bile, which is formed as a result of the natural destruction of red blood cells that have served their time. The latter help move oxygen and carbon dioxide around the body.

By itself, bilirubin poisonous substance, and the liver is responsible for the processing of poisons in the body. When the process of processing bilirubin by the liver is disturbed, jaundice occurs. It is called true and in this case treatment is prescribed.

But there is also false jaundice - for example, it occurs when eating bright yellow or orange foods in excessive quantities. Carotenes (pigments) accumulate in the body, which give the icteric color to the skin. Treatment of jaundice in adults should be timely, including the treatment of concomitant diseases.

Principles of treatment of jaundice

Features and principles of treatment of jaundice in adults is that home therapy depends on several factors, primarily on the type of jaundice:

- occurs in adults due to the development of any pathologies (among them - a decrease in hemoglobin in the blood, lymphocytic leukemia, tropical malaria, etc.);
- associated with liver damage and often develops against the background of and;
- occurs due to a violation of the passage of bile against the background of the formation of stones or tumors.

The decision on how to treat jaundice in adults, the doctor takes and depending on the degree of intensity and duration of the disease. Important for the treatment of adults at home are the results of tests - blood (for the presence of hepatitis, including), urine and feces.

An ultrasound of the internal organs is prescribed, and in difficult cases and additional studies - endoscopy, computed tomography, sometimes a liver biopsy for proper treatment jaundice in adults.

Therapy carried out at home should be aimed at preserving the liver, preventing cirrhosis, as well as protecting others from infection with viral hepatitis. General Methods jaundice treatment:

diet therapy;
taking drugs to increase immunity, relieve itching, and in some cases, painkillers;
taking vitamins and hepatoprotectors;
plasmapheresis - blood purification, its filtration;
phototherapy - exposure of the pigment to ultraviolet light.

Nutrition

A comprehensive treatment of jaundice at home in adults prescribed by a gastroenterologist includes, first of all, a diet.

The diet should be high-calorie, balanced, consisting of dishes that will not harm the liver. Meals should be eaten only fresh and warm. In the patient's diet, proteins, vitamin D (found in meat and animal products) and iron must be present in sufficient quantities.

You need to eat at home often in small portions, at least 5 times a day. A diet for the treatment of jaundice in adults is prescribed, which consists of three stages.

The first stage (about two days) involves the consumption of a glucose solution, fruits, sweet compotes and tea. Due to the intake of glucose, there is a normalization of processes in the liver cells. Solid food during this period is not welcome, liquids contribute to the removal of toxins from the body.

The second stage (about a week) involves the inclusion of vegetable broths and cereals in the diet, as well as a small amount of solid food.

The third stage (until recovery) allows you to eat dietary foods that are allowed for liver diseases.

What can be done during the treatment of jaundice in adults:

dry bread, crackers, biscuits;
vegetable and cereal soups, vegetable stew and porridge;
lean meat, poultry and fish only in boiled or baked form, steamed cutlets from them;
low-fat milk, kefir and cottage cheese, casseroles and puddings from them, hard cheeses;
sweet compotes, jelly, marmalade, jam, caramel.

In the treatment of jaundice at home in adults, the consumption of fresh berries- raspberries and strawberries, herbs - dill and parsley.

What is not allowed during the treatment of jaundice in adults:

canned food, smoking, pickles and marinades, fried foods;
fatty meat, poultry and fish, broths from them;
spices, chocolate, spices, coffee, alcohol (under a particularly strict ban);
legumes, radishes and radishes, mushrooms;
fresh bread, cream cakes, pastries.

Medical support

When answering the question of how to treat jaundice at home in adults, one should not forget about medications in addition to diet.

Etiotropic (eliminating the cause) therapy - a cure for jaundice with viral hepatitis(lamivudine) and ( antiviral drugs based on sofosbuvir, daclatasvir; ribavirin, interferon), with inflammatory process in the gallbladder - antibacterial drugs.
Improving digestion - taking enzyme preparations (Creon, Pancreatin, etc.).
Vitamins A, K and D.
Immunity boost.
An increase in the concentration of active acids, a decrease in the synthesis of cholesterol in the liver - (ursodeoxycholic acid - UDCA).
Removal of skin itching (antihistamines).
Strengthening the exchange (Essentiale, Heptral, etc.).
Antispasmodics in case of obstructive jaundice (No-shpa, Dibazol, etc.).

Treatment of adults for the disease includes the installation of droppers and injections of drugs. These manipulations belong to classical drug therapy.

Phototherapy

Medication support for adult home treatment will be effective in conjunction with phototherapy sessions for jaundice. At such sessions, under the influence ultraviolet rays the pigment is destroyed and the patient feels better.

In phototherapy for the treatment of adults are used ultraviolet lamps. Bright Sun rays also have a positive effect.

A treatment procedure is applied. However, in the treatment of jaundice in adults, phototherapy enjoys well-deserved popularity.

The lamp for the treatment of jaundice in adults has an optimal radiation spectrum, as a result of its exposure, bilirubin acquires a water-soluble form and becomes non-toxic.

Non-traditional methods of treatment

Folk, non-traditional methods for treating adults at home can alleviate the patient's condition during the period of attenuation of the disease or during the course of chronic jaundice. However, you need to know how to treat jaundice at home with non-traditional methods.

juice therapy

Usually used beetroot juice with the addition of a few drops of lemon. Squeeze juice from bright burgundy fruits, without streaks, let the drink stand in the refrigerator for about 3 hours. Every morning take about 100 g of juice. Useful pumpkin juice, it is recommended to take up to 200 g per day.

Healing herbs

Well helps to cleanse the liver of toxins collection of herbs - mint, yarrow and chamomile. Mint is a medicinal, essential oil plant, is a choleretic and analgesic. The phylloquinones contained in yarrow actively dissolve fats. Pharmacy chamomile relieves internal swelling, spasms and inflammation.

Sauerkraut brine

horseradish root

The plant itself and its root are extremely rich in vitamins B and C. It contains a lot of potassium, calcium, contains essential oils. The crushed root is poured with a liter of well-boiled water. Insist day, during the day you need to drink a glass of tincture, dividing its contents into 4 parts.

Lice

Lice treatment for jaundice has been known for a long time. Lice are rolled into a bread crumb and eaten, recovery, according to reviews, comes rapidly. Evidence-based medicine does not this way treatments are effective. Moreover, lice are carriers of various infectious diseases: Eating them may not be safe.

Prevention of jaundice

Preventive measures against are simple and accessible to everyone at home. They help avoid conservative therapy with jaundice.

Maintaining personal hygiene and leading a meaningful, healthy lifestyle. An image that does not allow the use of suspicious, harmful substances, close contacts with little-known people.
Foods that are eaten on a daily basis require attention. Vegetables and fruits should be washed well. Use exclusively for drinking boiled water, tap water is prohibited.
Modern disinfectants work well for large cluster people. They wipe hands, work surfaces, stationery items.
Vaccination - famous modern way the fight against hepatitis, causing various. Vaccination against jaundice (from,) guarantees that there is no danger of getting hepatitis for 5-10 years.
Demonstration of accuracy when visiting tattoo and piercing parlors. Listen to feedback regarding the operation of these establishments and observe the manipulation and hygiene of employees.
Caution during sexual intercourse, the use of protective equipment, with people whose past is little known.

Useful video

For more information about jaundice, see the following video:

Conclusion

Jaundice is not considered a disease in the full sense of the word. Jaundice is a syndrome or set of some disease that causes it.
To understand how to treat jaundice in adults, you need to determine the reasons that caused it. For this you need to go comprehensive examination v medical institution. When the results are obtained, proceed to the treatment of jaundice.
The main component of treatment is a diet, it is required to take medication, phototherapy and, if desired, folk methods of getting rid of jaundice. All these measures, applied at home, in combination will lead to a complete recovery (except for chronic hepatitis B).
Prevention of disease in adults is much more important: for this, special preventive measures have been developed that are available to everyone.