Jaundice and Liver Failure
Jaundice is a sign that something is wrong in the body, especially with the liver, bile ducts, or blood. Many people have misunderstandings about jaundice, so it is important to know the causes, tests, treatment, and prevention.
What causes jaundice?
Jaundice is broadly classified into infective jaundice and obstructive jaundice.
A common cause of infective jaundice is Hepatitis A, which spreads through contaminated food and water. Children are often affected.
Other important viruses are Hepatitis B and Hepatitis C. These spread mainly through blood, blood products, contaminated needles, tattooing, and body fluids such as saliva, sweat, semen, and vaginal fluids. Close contact and sexual transmission can also spread these infections.
Hepatitis B and Hepatitis C can lead to chronic liver disease, cirrhosis, liver cancer, and eventually liver failure.
Other viruses linked to jaundice include Hepatitis D and Hepatitis E. Hepatitis E is commonly spread through contaminated water.
Infections such as leptospirosis can also cause jaundice. In some cases, stones or growths block the flow of bile, causing obstructive jaundice. Certain drugs may also trigger jaundice.
How is leptospirosis transmitted and treated?
Leptospirosis is usually spread through food or water contaminated with rat urine. The patient may develop fever, followed by jaundice and sometimes kidney failure. If it is not treated early, it can be fatal.
Treatment usually includes antibiotics such as penicillin or doxycycline.
Which type of infective jaundice is most dangerous?
Hepatitis C is one of the most serious forms of jaundice because it can lead to chronic liver disease and long-term liver damage.
Which form of jaundice may require surgery?
When stones or growths block the pathway of bile from the liver to the small intestine, surgery may be needed.
Bile stones often come from the gallbladder, and treatment may include removal of the gallbladder and the stones in the bile duct. If the blockage is caused by a tumor, major surgery may be required. In advanced cases, a bypass operation may be done to relieve the jaundice.
What tests are done for jaundice?
The main investigations are blood tests, scans, and endoscopy.
Blood tests help check the overall function of the liver. These are known as Liver Function Tests (LFTs). They can show whether liver damage is ongoing and help identify the type of jaundice. Clotting tests may also be done to see whether the liver is producing enough proteins for blood clotting.
An ultrasound scan is usually done first to look for structural problems in the liver. If needed, a CT scan or MRI may be done. MRI is now often the best test for detecting abnormalities in the liver and nearby organs, especially in obstructive jaundice.
Endoscopy may be used to examine the food pipe, stomach, and the first part of the small intestine. A special procedure called ERCP can also be done to study the bile ducts and pancreatic ducts.
What diet is recommended for jaundice?
A diet rich in glucose is usually recommended because it supports liver cell recovery and provides energy. Fat intake should be reduced.
Deep-fried foods and alcohol should be avoided.
What is the treatment for jaundice?
Treatment depends on the cause.
For viral hepatitis, there is usually no specific cure. The main treatment is supportive care, while the body’s immune system clears the virus naturally.
If jaundice is caused by blockage of bile flow, surgery or another procedure may be needed.
What is the role of immunisation?
Hepatitis B vaccination is very important because it can prevent a major cause of jaundice and its serious complications. The vaccine is usually given in three doses, and vaccination now begins in infancy. A booster dose may be needed later to maintain protection.
Do herbs help in jaundice?
A commonly used herb is Keezhanelli, but its effectiveness has not been fully proven.
Liver Disease
What are the functions of the liver?
The liver has many important functions. Its two main jobs are synthesising and detoxifying.
Synthesising
The liver helps break down and store nutrients such as carbohydrates, proteins, and fats.
If there is excess glucose in the blood, the liver stores it as fat.
If blood glucose is low, the liver can help produce glucose from fat and protein.
It stores vitamins A, D, K, B12, and folate.
It also makes important proteins such as albumin and clotting factors.
Detoxifying
The liver breaks down drugs, alcohol, and poisons absorbed from the intestine.
That is why liver failure is often described as power failure.
What is the relation between alcohol and liver disease?
The liver processes alcohol from the blood and bears the full burden of its toxic effects. Long-term alcohol use can damage the liver.
Regular intake of 3 units or more daily in men and 2 units or more daily in women for more than five years can lead to liver disease.
What is cirrhosis of the liver?
Cirrhosis is the final stage of liver damage caused by repeated injury from viruses, alcohol, toxins, or other causes. In cirrhosis, normal liver tissue is replaced by fibrous tissue, which does not work properly.
This disrupts blood flow in the liver and causes serious complications.
What are the complications of cirrhosis?
Complications of cirrhosis include:
- Fluid retention in the abdomen, causing swelling.
- Leg swelling due to low protein production.
- Anaemia and increased risk of infections.
- Varicose veins in the food pipe, which may burst and cause life-threatening bleeding.
- Liver failure, where the liver cannot remove toxins properly, leading to confusion, coma, and death.
What are the signs of liver failure?
Common signs of liver failure include:
- Jaundice
- Bleeding tendency
- Swollen abdomen
- Swollen feet
- Reduced urine output
- Confusion or altered consciousness
- Hand tremors
- Muscle wasting