Causes, symptoms and treatment of jaundice in adults
Content:
- What is jaundice?
- Jaundice symptoms
- Causes of jaundice
- Types of jaundice
- Diagnosis of jaundice
- Jaundice treatment
Most people use the term "jaundice" to understand hepatitis, or Botkin's disease. In fact, this word is customary 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 impaired bilirubin metabolism, which can occur for various reasons.
What is jaundice?
Jaundice is a range of symptoms that appear as yellow discoloration of the skin, sclera and mucous membranes, which is associated with an excess accumulation of bilirubin in the body. Normally, this substance is released during the breakdown of red blood cells that 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 yellow staining of the sclera and mucous membranes. Why is this happening? During the breakdown of hemoglobin, the body produces a yellow pigment. Normally, it leaves the body during bowel movements. With the development of jaundice, which is accompanied by liver failure and impaired patency of the biliary tract, a lot of bilirubin remains in the blood. In this case, a small amount of this substance is excreted through the skin or kidneys.
This disease is one of the most common. Jaundice is especially common in countries with warm climates and unfavorable sanitary conditions. For example, in Central Asia, almost every child has time to recover from this disease. In Eastern Europe, the prevalence of the viral form of the disease is 250 people per 100,000 population per year.
What is jaundice hepatitis?
Most often, jaundice is popularly called hepatitis A, or Botkin's disease. This is a viral pathology, which is accompanied by general intoxication of the body and impaired liver function. In addition, there are viral hepatitis B and C, as well as autoimmune, mononucleosis, toxic, bacterial, medicinal forms of the disease.
The incubation period with the development of jaundice can last for several months. Depending on the duration, the disease can be acute, protracted or chronic.
Jaundice symptoms
Common signs of illness 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;
- the emergence of a venous network in the abdomen.
In adulthood, jaundice can manifest itself as severe itching of the skin, changes in the shade of urine and feces. Due to the high concentration of bilirubin in the body, the feces acquire a grayish tint, and the urine darkens strongly. A person loses appetite and often experiences severe pain in the right hypochondrium, which can be spasmodic or pulling in nature.
Causes of jaundice
There are many factors that can trigger the onset of jaundice in an adult:
- education in the liver of a benign or malignant nature;
- congenital pathologies of the structure of the biliary tract;
- infection with parasitic microorganisms;
- pathology of the liver and gallbladder;
- postoperative complications;
- the use of some groups of medications.
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 sex 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
The symptoms and treatments for jaundice are directly related to the type and stage of the disease. There are many forms of this pathology, which differ depending on the cause of the occurrence.
Conjugative jaundice
This form of jaundice does not act as an independent disease - it is associated with a violation of the conversion of indirect bilirubin, which leads to a sharp increase in its content in the body. This phenomenon is more typical for newborn children, since their metabolic processes are still imperfect. However, sometimes this form of jaundice is diagnosed in adults. It usually develops as a result of negative factors affecting the liver, for example, the use of drugs. Also, conjugational jaundice can be a consequence of congenital pathologies, among which it is worth highlighting the Gilbert-Meilengracht syndrome.
Hemolytic jaundice
Pathological destruction of erythrocytes, accumulation of excessive amounts of bilirubin and difficulties with its elimination from the body lead to the development of this form of disorder. This condition can be provoked by various disorders and pathologies - anemia, lymphocytic leukemia, tropical malaria, lymphosarcoma. Hemolytic jaundice can also result from the toxic effects of drugs on the body.
Physiological jaundice
This type of jaundice is characteristic of 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 can be associated with disorders of 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 of high amounts of bilirubin in the blood. This disorder is very common and may be a consequence of the enzymatic immaturity of hepatocytes, increased production of bilirubin and insufficient serum binding capacity of 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 cirrhosis of the liver. As a result, the patient's liver increases in size, the skin first turns yellow, and then becomes reddish. In this case, 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, drug lesions of the liver, cirrhosis, alcoholic hepatitis, and malignant formations in the liver can lead to the development of hepatic jaundice. Most often, this form of the disease is accompanied by icteric discoloration of the skin, loss of appetite, nausea, pain in the right hypochondrium, discoloration of urine and feces. The choice of therapy tactics is carried out depending on the cause that provoked the development of hepatic jaundice.
Diagnosis of 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 make an accurate diagnosis, a specialist will prescribe the following studies:
- General and biochemical blood test.
- Tests to determine the content of bilirubin in the blood.
- Studies of the liver.
- Liver biopsy - allows you to determine the nature of the disease and assess the severity of organ damage.
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Jaundice treatment
Treatment methods for pathology directly depend on its form and stage of development. For the therapy to be as effective as possible, it is necessary to establish the cause of the development of the disease. In any case, conservative treatment can be used to eliminate the symptoms of jaundice, which will help to cope with the underlying disease, and surgical intervention - it is usually required in advanced cases and consists in liver transplantation.
Conservative therapy includes the following components:
- The use of drugs - antihistamines, steroids.
- Plasmapheresis.
- Phototherapy.
- Compliance with a diet.
The goal of treatment is to get rid of the virus, prevent cirrhosis of the liver and reduce the risk of infection in others. If a person develops a chronic form of autoimmune hepatitis, treatment with corticosteroids is indicated.
If therapy is not started on time, the pathological process can develop so strongly that doctors cannot achieve a period of remission. In this case, dangerous complications appear, 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 results from the formation of stones in the bile duct, endoscopic papillosphincterotomy is used - this procedure helps to remove about 90% of stones in the bile duct. If obstructive jaundice is associated with malignant tumors, the patient is shown radical treatment. Usually, such patients undergo palliative operations, which are aimed at reducing the level of cholestasis.
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With the development of viral hepatitis A, patients recover without treatment. In this case, antiviral drugs are not prescribed, and the drugs used in modern medicine are not aimed at fighting the virus, but at reducing the concentration and cleansing the body of harmful substances that have arisen as a result of liver dysfunction.
In this case, detoxification solutions, glucose, vitamins can be administered to patients. Also shown is the use of hepatoprotectors - drugs that are designed to protect liver cells. These include drugs such as sirepar, silibor, silibinin. In addition to these drugs, antispasmodics can be prescribed - papaverine, no-shpa, remidone.
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In difficult cases, the principles of treatment remain the same, but much more attention is paid to symptomatic therapy. As a rule, liver function is fully restored over time.
To speed up the healing process and restore the normal exchange of red blood cells, you must adhere to a special diet. A person must definitely eat foods containing proteins, iron, B vitamins. This category includes fish and poultry meat, eggs, dairy products. You should also include dried apricots and grain bread in the diet.
To restore the processes of hematopoiesis, you need folic acid. Its sources are green vegetables, liver, yeast, cabbage, legumes. Fiber is no less important during this period, and therefore oatmeal should be present in the diet. In addition, you should eat raw and boiled vegetables - cucumbers, tomatoes, carrots, cabbage, zucchini. It is equally important to consume enough fruits and juices.
Regardless of the type of jaundice, a person needs to give up alcohol, fatty and spicy foods - all of them put an additional burden on a weakened liver. With the development of this disease, it is recommended to eat small meals.
Jaundice in adults is a fairly common group of disorders that can be associated with various diseases. In any case, the appearance of yellowness of the skin and pain in the right hypochondrium should be the reason for immediate medical attention. Only timely treatment will help to cope with the disease in a short time and avoid negative health consequences.
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
