Jaundice

Your skin looked a little pale lately. At first you did not pay attention, because you know that the color of the skin depends on how much time a person spends on the air, and is not necessarily related to health. In addition, you are reassured by the fact that you go to work early in the morning and come back already at dusk. In any case, soon leave, and a week in the sun will fix everything. But today you noticed that you are not just pale and puffy - you have turned yellow!

Okay, the skin turned yellow. But does this mean that you have jaundice? Look at the whites of the eyes. If they are yellow - you actually have jaundice. But if they are white, while everything else is yellow-orange, especially the palms and soles, then you have caroteneemia , not jaundice. This color disruption is typical for healthy people with an addiction to oranges, carrots and green vegetables. Pigment carotene, contained in this food, dyes the skin in a color very similar to the color of jaundice. Although carotemia is also found in people with a decreased thyroid function , it is not a disease in itself, and one can not worry.

Jaundice is the result of the staining of the tissues with bilirubin, a yellow pigment contained in red blood cells, red blood cells, whose job is to deliver oxygen to any part of the body. Oxygen in these cells is carried by hemoglobin, which includes bilirubin and iron. Red blood cells live approximately 120 days, after which they are destroyed by the spleen (located in the upper left part of the abdomen). This body mysteriously removes those red blood cells that have lived 120 days. When he does this, the hemoglobin molecule breaks up into two components - bile pigment and iron, which then re-enter the bloodstream. The bile pigment goes to the liver where it is processed in a way that can be used again, and again combines with iron in the bone marrow, where new red blood cells are formed. Nothing is thrown away. Everything is used again.

This perfect mechanism can be disrupted in two ways, and in both cases there will be too much bilirubin in the blood. At the first, the blood cells will collapse more quickly than after 120 days. So now there will be more excess bilirubin and iron in the bloodstream. At the second, something happens to the liver, so that it can not cope with the processing of the normal amount of bilirubin entering it.

When red blood cells are destroyed prematurely, this pathology is called hemolytic anemia . It can arise because of drugs, a strong infection, allergies, autoimmune diseases (the immune system mistakenly starts to consider its own red blood cells as alien and then attacks and destroys them) and malaria (the parasite causing this disease gets into the red blood cells and Destroys them). A person with hemolytic anemia has too much bilirubin in the blood so that even a healthy liver can cope with it. Excess leaves the blood and enters the tissues, including the skin and eyes, coloring them in yellow.

When the liver is damaged - drugs, a tumor, viruses, other infections or a chemical substance - it is not capable of treating even the normal amount of bilirubin in the blood. Pigment, which has nowhere to go, accumulates in the blood, seeps into the tissue and causes jaundice.

However, the liver can be able to perfectly treat all the bilirubin that enters it, but the ducts through which it leaves the liver are blocked by gallstones or a tumor in the appropriate place (usually in the pancreas).

Thus, the main causes of jaundice :

• Abnormally fast decomposition of hemoglobin,
• Liver disease,
• Blocked hepatic ducts.

The correct diagnosis, in any case, is based on an external examination, a blood test, an X-ray and what you tell the doctor. You will understand a lot about the cause of your jaundice if you make the following observations.

Check your first aid kit. Medicines can cause jaundice in several ways:

• They can disrupt the ability of the liver to process bilirubin;
• Can cause edema of the bile ducts and their blockage;
• Can make red blood cells more sensitive, so the spleen will destroy them sooner.

The list of potential criminals is long and includes such antibiotics as erythromycin and sulfa derivatives, some antidepressants, antitumor drugs, aldomet (used in the treatment of hypertension), antituberculous drug rifampin, steroids, antidiabetic drugs (chlorpropamide, tolbutamide), birth control pills, testosterone (male sex hormone ) And propylthiouracil (used for increased thyroid function).

Have you recently washed floors? Carbon tetrachloride detergent can damage the liver if you inhaled its vapors in a poorly ventilated room or if, God forbid, they were swallowed.

The combination of a sudden onset of jaundice and anemia suggests hemolytic anemia, viral hepatitis, bile duct stones , blocking ducts, or some kind of chemical damage to the liver . If, on the other hand, the yellowish skin color develops gradually and becomes stronger with time, there may be a tumor in this area (usually in the pancreas), cirrhosis (the formation of scar tissue in the liver in alcoholics and those who have suffered severe hepatitis) and various Other liver diseases.

Do you have fever, chills and colic in the right upper abdomen? Then jaundice is a consequence of a stone located in the bile duct or passing through it.

Have you eaten recently raw shellfish, oysters or other crustaceans? Maybe they traveled around the country, whose sanitary conditions leave much to be desired? You have probably contracted hepatitis A - a benign inflammation of the liver, which almost always goes away without serious liver damage, but can give you jaundice for several days.

Do not you introduce yourself intravenously anything, did not you do tattoos or any injections using needles, the purity of which can be doubted? If yes, and especially if your joints also hurt, then you, most likely, have hepatitis B - a serious form of viral liver damage.

Have you had your blood transfused in the last weeks or months? You could get hepatitis "non-A non-B", almost the only type of hepatitis, which in our time can be obtained with blood transfusion.

In addition to these questions, there are some simple observations that you can make by determining the cause of your jaundice.

If the intensity of jaundice varies from day to day, then you have periodic blockage of gallstones.

If your urine is of normal color, there is a chance that you have hemolytic anemia , but if it is the color of tea or mahogany, think about liver disease or jaundice due to blockage of the ducts.

Discolored or almost white stools indicate jaundice due to blockage (because the normal brown color of the stool is due to bilirubin , which now can not leave the liver and enter the intestine ).

Do you feel sick and you have lost the taste for cigarettes? Be aware that aversion to tobacco, along with jaundice, indicates viral hepatitis.

Have you lost a few pounds in recent weeks? This is a bad symptom in combination with jaundice, as it can reflect a malignant tumor - in the liver, pancreas or neighboring organs.

Did your stomach swell? The presence of fluid in the abdominal cavity suggests the suggestion of cirrhosis of the liver, especially if you are an alcoholic or have been transferred before hepatitis B.

The cause of jaundice is not always easy to establish. Nevertheless, most cases fall into one of the categories that we just described, and the questions and observations that are discussed here will help you narrow your search to one category or another.

Symptom: jaundice