Jaundice

jaundice its cause,types,symptoms,diet,treatment,pharmacology

1. JAMIA HAMDARD NAME:-FARAZUL HODA M.PHARMA(P.P) 1 st SEM

2. CONTENTS:- DEFINITION CLASSIFICATION SYMPTOMS CAUSES DIET TREATMENT MANAGEMENT

3. Jaundice is a term used to describe a yellowish tinge to the skin and the whites of the eye. Body fluids may also be yellow.

4. The color of the skin and whites of the eyes will vary depending on levels of bilirubin . Moderate levels lead to a yellow color , while very high levels will appear brown. About  60 percent  of all infants born in the United States have jaundice. However, jaundice can happen to people of all ages and is normally the result of an underlying condition. Jaundice normally indicates a problem with the liver or bile duct.

5. Risk factors:- Acute inflammation of the liver:  This may impair the ability of the liver to conjugate and secrete bilirubin , resulting in a buildup . Inflammation of the bile duct:  This can prevent the secretion of bile and removal of bilirubin , causing jaundice. Obstruction of the bile duct:  This prevents the liver from disposing of bilirubin .

6. Hemolytic anemia :  The production of bilirubin increases when large quantities of red blood cells are broken down. Gilbert's syndrome:  This is an inherited condition that impairs the ability of enzymes to process the excretion of bile. Cholestasis :  This interrupts the flow of bile from the liver. The bile containing conjugated bilirubin remains in the liver instead of being excreted.

7. Common symptoms of jaundice  include : a yellow tinge to the skin and the whites of the eyes, normally starting at the head and spreading down the body pale stools dark urine itchiness

8. Fatigue abdominal pain weight loss Vomiting Fever pale stools dark urine Accompanying symptoms of jaundice resulting from low bilirubin levels include:

9. Test:- The level of bilirubin is defined in a blood test called a bilirubin test. This measures unconjugated , or indirect, bilirubin levels. These are responsible for the onset of jaundice . Bilirubin levels are measured in milligrams per decilitre (mg/ dL ). Adults and older children should have a level of between  0.3 and 0.6 mg/ dL .Around 97 percent of infants born after 9 months of pregnancy have levels lower than  13 mg/ dL . If they show higher levels than this, they are usually referred for further investigation .

10. Diet for prevention of jaundice

11. Differential diagnosis

12. The  most common causes  of pre-hepatic jaundice are: malaria , a blood infection caused by a parasite sickle cell anemia , a genetic condition in which red blood cells become crescent-shaped rather than the typical disc shape spherocytosis , a genetic condition of the red blood cell membrane that causes them to be sphere-shaped rather than disc-shaped thalassemia , a genetic condition that causes your body to make an irregular type of hemoglobin that limits the number of healthy red blood cells in your bloodstream

13. Common symptoms of pre-hepatic jaundice include:

14. Hepatic jaundice happens when the liver tissue is scarred (known as  cirrhosis ), damaged, or dysfunctional. This makes it less effective at filtering out bilirubin from your blood. Since it can’t be filtered into the digestive system for removal, bilirubin builds up to high levels in your blood. Hepatic jaundice

15. The  most common causes  of hepatic jaundice are:

16. Common symptoms of hepatic jaundice include:

17. Post-hepatic, or obstructive jaundice, happens when bilirubin can’t be drained properly into the bile ducts or digestive tract because of a blockage. Post-hepatic jaundice

18. The  most common causes  of post-hepatic jaundice are:

19. biliary atresia , a genetic condition in which patient having narrow or missing bile ducts pancreatitis , an inflammation or infection of the pancreas

20. Common symptoms of post-hepatic jaundice include:

21. being overweight eating a high-fat, low- fiber diet having  diabetes mellitus having a family history of gallstones being female Some risk factors for this type of jaundice include: Aging smoking tobacco products drinking a lot of alcohol having a previous pancreas inflammation or infection being exposed to industrial chemicals

22. Neonatal jaundice Neonatal jaundice  is a common type of jaundice that happens to newborn babies. Most babies are born with a lot of red blood cells, and because the liver isn’t fully developed yet, bilirubin can’t be processed quickly. As a result, child may have jaundice symptoms a few days after they’re born.

23. Physiological.  This happens because the liver isn’t fully formed yet. Prematurity.  This results from a baby being born too early and being unable to poop out bilirubin properly. Types of neonatal jaundice include:

24. Breastfeeding.  Breast milk jaundice  occurs from a baby having trouble breastfeeding or not getting enough breast milk. Incompatible blood type.  This results from a baby and mother having different blood types, which can cause the mother to make antibodies that break down her baby’s red blood cells.

25. long periods of high-pitched crying arching of their neck and back Fever throwing up having trouble feeding Seek emergency medical attention if you notice that your child has any of the following symptoms:

26. Therapeutic approaches and managements Infusion of immunoglobulins is used as primary treatment for pre-hepatic jaundice. Phototherapy is considered as an effective treatment of high levels of bilirubin in pre-hepatic jaundice. Bilirubin rapidly decreases within two hours of onset of phototherapy. Pre-hepatic jaundice

27. However the duration of therapy and the strength of light treatment depend upon the severity of hyperbilirubinemia . Metaloporphyrins are also considered as a treatment possibility of pre-hepatic jaundice, because these metaloporphyrins target the hemeoxygenase enzyme to limit the production of bilirubin .

28. • Phototherapy - for neonatal jaundice. • Phenobarbital can be used for treatment of neonatal physiological jaundice however it is not frequently used due to certain drawbacks involving somnolence and febrile seizures. • Supportive therapy - fluids, rest, pain relief - for Hepatitis A. • Abstinence from alcohol and cessation of medications contributing to liver dysfunction. Hepatic jaundice

29. • Steroids - for autoimmune hepatitis. • Immunosuppressant - for autoimmune hepatitis. • Interferon - for chronic hepatitis B and C. • Liver transplantation for fulminant hepatitis and end stage liver failure.

30. Low fat diet should be given to patient suffering from post-hepatic jaundice to minimize the discomfort due to fat ingestion and diarrhea . The treatment of the post hepatic obstructive jaundice is mechanical decompression however the complications and other symptoms are also necessarily treated. Post hepatic jaundice

31. Decompression can be done by surgical bypass, percutaneous insertion of stents, removal of lesions and endoscopic insertion of stents. Dexchlorophenramine , Hydroxyzine , Cholestyramine , Ursodeoxycholic acid and Naltrexone are used as a therapeutic approach in treatment and management of post hepatic jaundice.

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