Jaundice: symptoms, causes and treatment. Indications and contraindications for prescribing the medication. Manifestations of physiological jaundice

Jaundice is a common symptom that varies in severity, mechanism of development and accompanying symptoms. There are many processes that cause icteric syndrome and they all require certain treatment. For each type of jaundice, medications are selected that eliminate the cause of its appearance, so it is important to consult a doctor at the first symptoms in order to avoid serious consequences.

The term jaundice covers many diseases in which the skin and whites of the eyes become discolored. yellow. But they all depend on the level of bilirubin in the blood, which gives the skin a yellow color, which is why it is called the yellow pigment of the body. Diseases that accompany jaundice are divided into several types depending on the process occurring in the body.

Types of jaundice:

Since jaundice is a fairly common symptom accompanying various diseases, there are various methods treatment. In each specific case, a specific drug regimen is selected, and some patients may require surgical assistance.

The doctor can prescribe the correct treatment only after full examination and identifying the causes of icteric syndrome. It is important that the diagnosis is made by an experienced specialist, as there is high probability errors and prescription of incorrect treatment.

The selection of treatment methods is carried out based on the causes of the disease, the presence of concomitant pathologies, the condition and age of the patient. In many cases, you can get rid of jaundice by taking medications that eliminate the cause of the disease.

Most often these are drugs that suppress the activity of pathogenic microorganisms, choleretic, hepatoprotectors and anti-inflammatory drugs. In some cases, drugs are added to traditional treatment traditional medicine, but this is only possible with the permission of the attending physician and not in acute conditions.

In most cases, surgery is required to remove stones that have blocked the ducts, tumors, strictures, or to restore the patency of the ducts using stenting. Some require long-term treatment, for example, with viral hepatitis B. In this case, constant monitoring and treatment during periods of exacerbations are required.

It should be remembered that even slight yellowing of the skin or sclera is a reason emergency treatment to the doctor. Delay can lead to serious complications and death of the patient, even if no other symptoms of the disease are observed.

Treatment methods for various jaundices

Not only is a specific treatment selected for each type of jaundice - even if the diseases are included in the same group, the regimen and duration of treatment may be completely different in each case.

Suprahepatic

Drugs for treatment are selected based on the cause of the disease:

Other medications are also prescribed for a speedy recovery:

1. Diuretics (Furosemide, Mannitol).
2. Hepatoprotectors (Phosphogliv, Heptral).
3. Ringer's solution.
4. Antibiotics (Gentamicin).
5. Immunostimulants (Polyoxidonium).

The treatment regimen may include several drugs with different actions, so treatment begins at inpatient conditions to monitor not only the patient’s condition, but also the body’s reaction to the prescribed drugs.

Nikolai writes: “My teenage daughter has a congenital autoimmune anemia, and she is constantly being treated with Prednisolone, as well as potassium and calcium supplements. Treatment is long and exacerbations occur frequently. Doctors do not give further prognosis yet.”

Treatment of jaundice also requires strict adherence to a diet to support the functioning of the liver and the body as a whole. General rules of therapeutic nutrition:

1. It is necessary to include cereals, low-fat dairy products, vegetables, non-acidic fruits, lean meat and fish in the diet.
2. Foods with a lot of fat and salt, mayonnaise, hot sauces and seasonings, everything fried, smoked and too sweet are excluded.
3. The consumption of alcoholic and carbonated drinks, coffee and strong tea is strictly prohibited. As for drinks, it is best to prefer natural jelly, compotes and still mineral water.

Maintaining a diet is not difficult, given that treatment begins in a hospital setting, where patients are allowed to eat only certain products. But even when continuing therapy at home, it is necessary to follow the rules of the diet.

Hepatic

It also depends on the cause of the disease. In many cases, the patient is initially sent to a hospital, and after recovery or improvement of the condition, maintenance therapy is prescribed, which can be carried out at home.

How to treat hepatic jaundice:

As with any type of jaundice, it is necessary to maintain a diet and maintain a drinking regime in order to reduce the load on the diseased liver.

Thus, Alexander writes:“I was diagnosed with cholestasis while I was in the hospital and undergoing treatment, everything was fine, but at home I stopped maintaining my diet and almost ended up in the hospital again. I realized that the most important thing is to exclude harmful foods, otherwise no pills will help.”

Subhepatic

With obstructive jaundice, it is necessary to maintain long-term, and in some cases lifelong, diet No. 5. The diet for this diet consists of cereals, light soups, vegetables, lean meat and dairy products.

For cholangitis, cholelithiasis and cholecystitis, treatment with drugs of various groups is prescribed:

1. Hepatoprotectors: Heptral, Essentiale, Ursosan, Hepel, Liv-52.
2. Antispasmodics: Papaverine, No-shpa, Drotaverine.
3. B vitamins.
4. Cholesterol-lowering drugs (statins, fibrates, nicotinic acid derivatives).
5. To normalize blood circulation in the liver: Methionine, Lipocaine.
6. Angioprotectors: Trental, Pentoxifylline.
7. Introduction.

For malignant lesions, surgery to remove the tumor and chemotherapy are performed. Also surgical intervention may be necessary if the bile ducts are blocked by a stone, stenosis has developed, or adhesions have formed on the bile ducts. Before the operation, preparation is carried out based on the removal inflammatory process and normalization of blood clotting.

Sometimes physiotherapeutic procedures are included in treatment: plasmapheresis, phototherapy, ultrasound or iontophoresis. Such methods can be used for any type of jaundice if there are no contraindications.

Nadezhda answers:“And they wanted to do an operation on me too, only for gallbladder, but I went to another doctor, and he advised me to try taking Ursosan and maintain strict diet. As a result, I’ve been going without surgery for 5 years.”

Home remedies

Traditional methods of treating jaundice are used only at the recovery stage or for chronic diseases during remission. The possibility of treatment with folk remedies should be discussed with your doctor.

Effective recipes for inflammation of the bile ducts and bladder:

1. Mix 4 tbsp. spoons of cilantro fruits, mint leaves, three-leaf watch and 8 tbsp. spoons of immortelle flowers. Take a spoonful of the mixture and bring to a boil in 200 ml of water. The decoction should steep for at least an hour, after which it can be strained and taken 3 times a day, half a glass.
2. Infuse a teaspoon of dry wormwood in 2 cups of boiling water for half an hour. Add a little honey to the strained infusion to reduce the bitterness. Drink 1/3 glass 3 times a day before meals.
3. Take 10 g of a mixture of birch leaves and buds, pour a glass of boiling water and leave for 20-10 minutes. Drink 3-4 times a day.

Recipes for removing bile:

1. Before each meal, drink a teaspoon of freshly squeezed juice from aloe leaves. Recommended course is 15-20 days.
2. Dried and crushed hydrangea is infused for 40 minutes. For one glass of boiling water, take 1 tablespoon of herb. Take the infusion in the morning and evening, up to 2 tablespoons.
3. Take St. John's wort and immortelle in equal parts, mix, pour 4 tablespoons of the mixture into 4 cups of boiling water and keep in a water bath for 10 minutes. Drink half a glass of the strained broth 4 hours a day.

Recipes for treating the liver and removing bilirubin from the blood:

1. Every day before each meal, drink a tablespoon of mixed vegetable juice. To prepare, take 200 ml carrot juice, 150 ml celery juice and 60 ml parsley juice. You need to prepare fresh juice every day and store it in the refrigerator during the day.
2. Take 3 tbsp. spoons of nettle leaves and horsetail, as well as 4 tbsp. spoons of knotweed and any kidney tea. Pour two tablespoons of the mixture into 3 cups of boiling water and leave for at least 6 hours. Drink half a glass of the strained broth 3 times a day.
3. Pour two tablespoons of celandine into 2 cups of boiling water, let it brew and strain. Drink the resulting decoction in the morning and evening, one glass at a time.

Also, for jaundice, it is useful to drink decoctions of juniper fruits, rhubarb root, burdock and St. John's wort. It should be remembered that you need to be careful with folk remedies so as not to provoke a worsening of the condition.

Maria writes: “The skin constantly turns yellow due to problems with the liver and gall bladder. I'm tired of constantly taking pills, so when it's not too bad, I drink a decoction of wormwood or horsetail with knotweed. They help very quickly, but sometimes you still have to take the medications prescribed by the doctor.”

Treatment of jaundice primarily depends on correct setting diagnosis. It is not always possible to identify the disease that led to the occurrence of icteric syndrome the first time, which leads to incorrect prescription of medications and a deterioration in the patient’s well-being. But if you seek help from an experienced specialist at the first signs of the disease, you can quickly and without consequences get rid of jaundice.

Jaundice – painful condition, characterized by the accumulation of bilirubin in the blood and its deposition in tissues with a yellow coloration of the skin, mucous membranes, and sclera of the eyes. This is not an independent disease, but a consequence of a number of diseases of the liver and biliary tract.

Causes of the disease

Blockage of the bile ducts, through which bile salts and pigments are drained into the intestines. Bile mixes with the blood, causing the skin to turn yellow.

Clogging of the bile ducts occurs due to the appearance of stones or inflammation of the liver due to viral hepatitis, less commonly due to typhus, malaria, and tuberculosis.

Symptoms of jaundice

Main symptoms of jaundice:

• prostration,
• irritability,
• headache,
• elevated temperature,
• loss of appetite,
• constipation,
• nausea,
• characteristic yellow tint of skin and eyes,
• darkening of urine
• dull pain in the liver area.

Treatment of jaundice

The first stage of treatment for jaundice– use of drugs from the group of hepatoprotectors. The drugs of choice may be:

• Products based on milk thistle - Karsil, Silymarin, Silymar.
• Thioctic acid – Berliotin.
• Phospholipids – Essentiale, Livenciale.
• Ursodeoxycholic acid – Ursolite, Ursosan, Ursofalk.
• Heptral.

Despite belonging to one pharmacological group, active ingredients drugs have different effects. The selection of medication must be carried out by the attending physician, taking into account the manifestations of the disease. Self-prescription in this case is contraindicated, since it may be ineffective and lead to the development of serious complications.

In addition to hepatoprotectors, the patient is prescribed:

• Antispasmodics: Drotaverine (No-Shpa).
• Enterosorbents to reduce itching – Enterosgel.
• Rifampicin and Metronidazole to influence metabolism bile acids, reducing their synthesis, and, accordingly, itching.
• Antihistamines - Tavegil, Suprastin.
• In case of severe intoxication of the body, it is necessary intravenous infusion Ringer's solution.
• External treatment of itching is carried out using drugs that include novocaine and anesthesin.

Against the background of jaundice, the absorption of calcium and vitamin D3 may be disrupted. In order to prevent the development of osteoporosis, vitamin and mineral complexes are prescribed: Vitrum Calcium, Kalcemin.

With the development of obstructive jaundice (excessive, persistent increase in bile acid, bilirubin and cholesterol in the blood plasma), drug treatment does not have the desired effect and surgical intervention is required.

Treatment with folk remedies

• Birch (buds). 50 g of birch buds are infused in 0.5 liters of vodka for 10 days. Take 1 teaspoon with water 3 times a day 20 minutes before meals.
• Immortelle. Pour 25 g of immortelle herb into 1 liter of water and boil over low heat until the volume is reduced by half, strain. Take 50 ml 3 times a day 30 minutes before meals for jaundice until complete recovery.
• Cornflower blue. Pour a teaspoon of blue cornflower flowers with a glass of boiling water, leave for 30-40 minutes, strain. Drink 1/4 cup 3 times a day 20-30 minutes before meals as a choleretic agent for jaundice.
• Zhoster laxative. For 1-1.5 cups of boiling water, take 1 tablespoon of laxative joster berries (prickly buckthorn), brew them and leave, wrapped, for 2 hours. Take the infusion 1 tablespoon 3-4 times a day 30 minutes before meals.
• Calendula. Calendula infusion has a choleretic effect. Pour 2 teaspoons of inflorescences with 2 cups of boiling water, leave for 1 hour, strain. Take 0.5 cups 4 times a day.
• Corn (columns). Pour a tablespoon of corn stalks with stigmas into 1 cup of boiling water, leave for 1 hour, strain. Drink 1 tablespoon of infusion every 3 hours as a choleretic agent for hepatitis, cholecystitis, cholangitis.
• Cinquefoil anseri. Brew a tablespoon of cinquefoil herb with a glass of boiling water as tea and strain. Take 1-2 glasses a day for cholangitis, cholecystitis.
• Peppermint. As a choleretic agent, take peppermint infusion at the rate of 5 g of dry crushed leaves per 1 glass of water. Drink 1 tablespoon every 3 hours.
• Large plantain. For inflammation of the gallbladder, take an infusion of plantain leaves. Pour 200 ml of boiling water over a tablespoon of leaves, leave for 10 minutes, strain. Drink the resulting infusion in small sips over an hour (daily dose).
• Wheatgrass. Take a decoction of wheatgrass, 1 tablespoon 4-5 times a day.
• Horsetail. Take a decoction of 50 g of horsetail herb, 3 tablespoons 3-4 times a day, or 0.5 teaspoon of pharmaceutical horsetail extract. Tincture: 30 g of herb per 100 ml of alcohol.
• Horseradish. 0.5 kg of peeled horseradish root is grated, the pulp is poured with 1 liter of boiling water, tightly closed with a lid and left for 24 hours. Then squeeze out the infusion, filter and drink 1/4 cup 3 times a day before meals. The course of treatment is 6-7 days. Horseradish root is contraindicated for gastritis, nephritis and enterocolitis.
• Salvia officinalis. Pour 2 teaspoons of crushed sage leaves into 2 cups of boiling water, leave for 30 minutes, strain. Drink 1 tablespoon of infusion every 2 hours for inflammation of the liver and gall bladder.
• Barley. Boil a cup of barley in 3 liters of water and leave for 3 hours. Drink several times a day.

Fees for the treatment of jaundice

• On initial stage Infusions of barberry, birch leaves, yarrow, rose hips, juniper or wormwood can help. A teaspoon of any of the herbs is poured into 200 ml of boiling water, left for 30 minutes and drunk 1 glass in the morning and evening.
• After jaundice, to maintain liver function, mix mint, chamomile inflorescences, yarrow herb and buckthorn bark in equal proportions. Pour a tablespoon of the prepared mixture into a glass of boiling water. Leave for 30 minutes. Take 1/2 cup at night and in the morning on an empty stomach.
• Prepare a mixture of peppermint leaves, dill seeds, wormwood and yarrow, taking 2 parts of each herb, and 3 parts of sandy immortelle. Prepare an infusion of 2 teaspoons of the mixture in 2 glasses of water. Leave for 8 hours. Take throughout the day.
• Mix three-leaf watch leaf (15 g), chamomile flowers (15 g), centaury herb (15 g), knotweed herb (15 g), dandelion root (40 g), St. John's wort herb (40 g). Pour three teaspoons of the mixture into a glass of water, boil for 7-10 minutes, strain. Take a glass in the morning and evening.
• Collect the ingredients in the indicated proportions: chicory root, great celandine herb, walnut leaf - equally. Pour a tablespoon of the mixture into a glass of water, boil for 30 minutes, cool and strain. Take a glass 3 times a day.
• Collect the ingredients in the indicated proportions: lemon balm leaf - 30 g, centaury herb - 30 g, bitter Poland herb - 25 g. Pour a tablespoon of the mixture into a glass of water, boil for 20 minutes, leave for 10 minutes and strain. Take a glass 3 times a day.
• Collect the ingredients in the indicated proportions: dandelion (roots) - 2 parts, common chicory (roots) - 2 parts, buckthorn (bark) - 1 part. Pour a tablespoon of the mixture into a glass of water, boil for 30 minutes, strain. Take a glass of decoction in the evening for cholecystitis, cholangitis.
• Collect the ingredients in the indicated proportions: sandy immortelle flowers - 40 g, three-leaf leaves - 30 g, peppermint leaves - 20 g, coriander fruits - 10 g. To prepare a decoction, pour 10 g of the collection with a glass of boiled water, heat in a water bath 30 minutes, cool at room temperature for 10 minutes, strain, adjust the volume of the decoction boiled water up to 200 ml. Take 1/2-1/3 cup 3 times a day 30 minutes before meals as a choleretic agent for jaundice.
• Mix centaury grass, calamus rhizome, and sandy immortelle flowers equally. Pour a teaspoon of the mixture into 2 glasses of water, leave for 10-12 hours in a warm place, boil for 5-7 minutes and strain. Drink one glass on an empty stomach, the rest throughout the day in 4 doses, an hour after meals.

Folk remedies for the treatment of jaundice in newborns

• Dodder. Bath your child in a decoction of dodder (Cuscuta europaea).
• Castor oil. You just need to give a laxative: anoint the nipple with castor oil and give it to the child. At artificial feeding You can lubricate the rubber nipple with castor oil.
• Goldenflower. In summer you can use a simple remedy: boil 2-3 handfuls of yellow flowers garden plant merigold (golden flower) and bathe the child in this decoction. It is better to take flowers from a high variety of plant, rather than a low one, known as “marigold”.
• Compresses. A remedy tested by Vanga is also cold bandages on the liver with various squeezed juices, camphor and sandalwood. This remedy can eliminate jaundice the same day and make urine normal in color.
• Eye wash. If you have jaundice, wash your eyes with rose water, coriander juice and salt water. You can also use water in which Venus hair was boiled, marjoram, Dubrovnik polyum (Dubrovnik white-tomentose), chamomile, and dill is especially useful.

Diet for jaundice

1. First of all, you need to take a laxative to cleanse your intestines.
2. Then you should maintain a juice fast for several days. Cup tomato juice in the morning with a pinch of salt and pepper - good remedy from jaundice.
3. For the next few days, you should eat only fruits 3 times a day with an interval of 5 hours.
4. Then you can go to simple easy carbohydrate foods that do not contain fat, and also eat fruits and vegetables.
5. Digestive disorders and intestinal blockages should be avoided (exclude legumes).
6. Drink more fluids, such as mineral water, and eat lemons, onions and pomegranates.

Jaundice is considered the main symptom pathological lesion liver and bile ducts, and is characterized by icteric staining of the skin, sclera of the eye and the mucous membrane of the patient’s soft palate. There are several types of jaundice, differing from each other in the way they manifest and the causes of their occurrence. Today we will understand what cholestatic jaundice is, what are the symptoms and causes of its occurrence, and what treatment is required for the pathology.

Cholestatic jaundice, or so-called intrahepatic cholestasis, is a pathological process in the patient’s body in which bile does not flow through the liver into duodenum, but accumulates in the blood, which causes icteric discoloration of the skin and mucous membranes.

This type of jaundice is a subtype of hepatic jaundice, which occurs due to damage to the liver hepatocyte cells that bind indirect bilirubin and remove it through the bile ducts into the duodenum. Indirect bilirubin is formed in the reticuloendothelial system from hemoglobin, released after the breakdown of red blood cells - erythrocytes. The formation of bilirubin occurs every second, and due to dysfunction of the liver in its secretion and processing, stagnation of bilirubin occurs in the blood serum and the liver itself. The skin with drug jaundice can take on shades from pale yellow to reddish. Prolonged stay in the tissues causes the oxidation of bilirubin into biliverdin, causing the skin to take on a green tint.

Cholestatic jaundice can be a sign of either a mild disorder of cellular metabolism or the most dangerous disease liver and gallbladder with ducts, so timely treatment medical institution very important for the patient.

Clinical picture

Cholestatic jaundice is accompanied by a whole complex of symptoms characteristic of functional damage to the liver and gallbladder.

• severe itching of the skin, especially intense on the legs and forearms;
• fast fatiguability;
• weakness in the body;
• bad breath;
• nausea and vomiting, worse after eating;
• an increase in the size of the liver, and rarely an enlargement of the spleen;
• poor blood clotting, which often causes internal (gastrointestinal, uterine - in women) or external (nasal) bleeding and hemorrhages under the skin;
• the formation of xanthomas and xanthelasmas - fatty accumulations under the skin, most often in the corners of the eyelids;
• loss of appetite, and as a result, severe weight loss of the patient;
• ascites and spider veins;
• bone remineralization;
• dark color urine and discoloration of stool;
• periodic increase in body temperature;
• discomfort in the area of ​​the right hypochondrium, which with the development of the disease turns into severe pain;

This entire symptom complex in combination with jaundice is called cholestatic hepatitis.

Etiology

Since the main reason for the progression of the pathology is liver damage medicines, it is called drug jaundice.

Drugs that provide toxic effects on liver cells and causing disruption metabolism in the liver are considered:

1. Aminazine is an antipsychotic, has a sedative effect on the central nervous system person.
2. Androgenic steroids are drugs containing testosterone or its synthetic substitutes.
3. Anabolic steroids are drugs that accelerate the renewal of cells and tissues of the body, as well as muscle structures.
4. Sulfonamides are antimicrobial drugs.

Also, the cause of intrahepatic cholestasis can be an exacerbation of an existing chronic illness liver.

Cholestatic jaundice can be a sign of such dangerous diseases:

• primary biliary cirrhosis of the liver;
• acute viral hepatitis;
• exacerbation of chronic hepatitis;
• cholestasis of pregnancy;
• alcoholic and fatty hepatosis;
• infections: malaria; toxoplasmosis, syphilis;
• cholecystoatonia;
• intoxication of the body after poisoning with alcohol, poisons, toxins;
• Wilson's disease, most often inherited;

How the disease develops

Indirect bilirubin is a bile pigment that does not dissolve in water, which is formed in the human reticuloendothelial system after the breakdown of hemoglobin, and enters the liver along with the blood. Hepatocytes capture it and bind it with glucuronic acid, after which conjugated water-soluble bilirubin is formed, which is secreted into the duodenum along with bile. Most of the bilirubin in the form of stercobilinogen enters the large intestine, where, under the action of enzymes, it is converted into stercobilin and excreted in the feces. The rest of the bilirubin is oxidized into urobilinogen and excreted in the urine through the kidneys.

In cholestatic hepatitis, the liver parenchyma cannot cope with the binding and transformation of indirect bilirubin, which is why it accumulates in the blood. Bile acids in the blood cause jaundice and intense itchy skin, which does not pass from antihistamines or applying moisturizers. The flow of bile into the duodenum is disrupted, causing digestion to worsen, and feces contain undigested fat. Stercobilinogen gives a dark color to stool, which is why it is observed light color stool when the flow of bilirubin into the colon. On the contrary, the level of urobilin in the urine increases, which explains the darkening of its color.

Drug jaundice develops slowly, but against the background of exacerbation or acute form of liver and biliary system disease it can progress rapidly. This is very dangerous for the patient, since complete dysfunction of hepatocytes to transform indirect bilirubin can occur, and it accumulates in the blood serum. Indirect bilirubin is very toxic to human cells and tissues, so the prognosis for the patient can be dismal, even fatal.

Diagnosis of pathology

For precise definition pathologies can be prescribed both laboratory and instrumental studies. In addition to visually noticeable symptoms, the doctor determines an increase in the size of the liver when palpating the patient’s abdomen.

Laboratory tests for drug jaundice:

• biochemical analysis blood – determines an increase in bilirubin levels, alkaline phosphatase and cholesterol in the blood;
• enzyme immunoassay blood test to detect antibodies to various infections - allows you to detect a current or past infection;
• general analysis of stool and urine.

Instrumental studies are carried out only when individually necessary, when other methods do not provide sufficient information about the disease.

It can be:

1. Ultrasound of the liver and gallbladder.
2. Radiography.
3. MRI of the hepatobiliary zone and CT scan of the liver.
4. Cholecystography.

In case of emergency, the patient undergoes a puncture biopsy of the liver, which makes it possible to study the morphological changes in liver cells.

The doctor makes the final diagnosis after comparison clinical symptoms, the patient’s well-being and the results of the studies.

Treatment of the disease

Treatment for cholestatic jaundice should be aimed primarily at eliminating the cause of its occurrence, and is prescribed after an accurate diagnosis has been established. If jaundice is caused by taking medicines or toxins enter the body, it is necessary to immediately stop their intake.

However, if the disease occurs in an acute inflammatory form, the patient is prescribed small doses of prednisolone, which helps slow the progression of the pathology. For unbearable itching, medications may be prescribed to neutralize the effect of bile acids. The patient can also be given glucose or ascorbic acid, as they have positive influence on the liver tissue and lower the level of bilirubin in the blood for several hours.

Important! No matter how strong the treatment, it will not give a positive effect if you do not follow a diet. For any liver disease, dietary table No. 5 is indicated, which involves the exclusion of fatty, fried and salty foods, and the most gentle diet possible.

Prevention and lifestyle

First of all, liver dysfunction is caused by poor lifestyle and nutrition, so you need to take care of your body in advance and try to eat less fast food and other harmful foods. digestive tract dishes. Try to eliminate or minimize alcohol, because its consumption inevitably leads to destructive processes in the liver. You should consult a doctor at the first appearance of symptoms of the pathology, since with timely detection and treatment, cholestatic jaundice is completely treatable, and the outcome for the patient is quite favorable.

Jaundice in an adult is manifested by a specific icteric appearance of the skin and mucous membrane. Often the outer layer of the eye (sclera) is also involved in the process. This symptom can be a companion to various diseases.

The main cause and types of jaundice in adults

The change from normal skin color to jaundice is a consequence of a violation of pigment metabolism, in particular bilirubin, a substance formed during the breakdown of red blood cells. accumulates in the blood, poisons the body and colors the skin in characteristic color tones.

Doctors use pathogenetic (according to the mechanism of occurrence) and clinical classification jaundice.

This stands out:

• prehepatic(suprahepatic) jaundice – hemolytic, resulting from blood diseases);
• hepatic(parenchymal) – develops as a result of liver disease;
• subhepatic(mechanical) – in which there are obstacles to the removal of bilirubin from the liver.

Each type of jaundice is characterized by the most typical shades of color on the skin:

• yellow with the addition of reddish - appears with hepatic variants of jaundice;
• yellow with lemon tones - characteristic of blood diseases against the background of hemolysis (breakdown of blood cells);
• dark green – characterizes the presence of mechanical obstacles to the outflow of bile.

What conditions and diseases cause jaundice in adults

For correct understanding the mechanism of development of jaundice, it is necessary to establish the causal relationship of the main forms of this condition.

Suprahepatic Jaundice is the result of the process of decomposition and breakdown of red blood cells. It leads to an increase in the content of bilirubin in the blood, the “utilization” of which the liver is not able to fully cope with.

note: Bilirubin consists of two main types. First - free(indirect, insoluble, unconjugated) toxic complex that is associated with blood proteins and circulates freely in the bloodstream. Second - unfree(direct, soluble, conjugated), formed by binding in the liver cells of the first type with glucuronic acid. It is not poisonous and is released into the intestines as part of bile.

With the suprahepatic variant of jaundice, growth total bilirubin is caused by an increase in free bilirubin, since liver cells cannot cope with its binding. This toxic substance leads to poisoning of the body.

The main type of disease causing suprahepatic jaundice is hemolytic anemia(they cause destruction of blood cells): familial hemolytic jaundice, thalassemia, sickle cell anemia etc.

Some autoimmune processes lead to hemolysis.

Hepatic jaundice is caused by damage (alteration) of liver cells (hepatocytes) and intrahepatic bile capillaries. The process of destruction of hepatocytes is accompanied by an increase in the content of total bilirubin in the blood, against the background of an increase in free bilirubin.

The development of hepatic jaundice is caused by:

• infectious (acute and chronic forms);
• of various etiologies;
• in the liver against the background of chronic alcohol poisoning, other toxic and medicinal lesions;
• (hepatocellular) liver;
• autoimmune diseases that damage liver tissue.

Subhepatic jaundice develops when there is a violation of the outflow of bile from intra- and extrahepatic bile ducts. This disorder provokes a mechanical obstruction in the path of bile secretion (blockage, obstruction).

Obstructive jaundice gives characteristic changes in... The level of bilirubin increases mainly due to the direct fraction. The indirect form may be within normal limits, or slightly increased. Bilirubin is also detected in urine.

Diagnosis of diseases leading to jaundice

When determining the cause of jaundice, patients undergo an examination, which begins with an examination and interview with a doctor.

Additionally assigned:

Symptoms of jaundice in adults

The picture of the disease depends on the underlying disease and complications leading to the development of jaundice. But at the same time, a number of similar symptoms characteristic of jaundice can be identified. These include:

• an increase in body temperature that is not relieved by antipyretics;
• frequent, loose stools;
• dark urine, discoloration of stool infectious hepatitis;
• itchy skin sensation;
• general weakness due to intoxication, which is accompanied by and;
• (constant, or paroxysmal) in the right hypochondrium, weight loss;
• decreased appetite, bitterness in the mouth;

note: the clinical picture may complement specific symptoms, characteristic of specific diseases that caused jaundice in the patient.

Directions for treating diseases with jaundice in adults

The choice of treatment plan depends on the underlying disease that caused the jaundice and the severity of the patient’s condition. This determines the need inpatient treatment(in therapeutic or surgical departments) or the possibility of outpatient therapy.

Patients undergo:

• Detoxification treatment– prescribed for acute forms of pathology accompanied by severe intoxication. Duration and volume infusion therapy is decided individually, based on the patient’s condition and laboratory diagnostics (especially for infectious hepatitis, acute and chronic alcohol poisoning, drug-induced liver damage, drug complications).
• Treatment– indicated in cases of infectious bacterial causal factors leading to jaundice. It is necessary to carry out a previous determination of the sensitivity of microbial flora to antimicrobials. Compliance with treatment regimens is very important high doses and concomitant antifungal therapy.
• For diseases that lead to jaundice against the background of damage to hepatocytes, a positive effect is given hepatoprotectors, protecting and restoring liver tissue.
• Anemia in most cases requires hematotherapy(natural blood and its preparations, as well as plasma transfusions and blood substitutes).
• The oncologist chooses the treatment tactics for the neoplastic process (surgical treatment, chemotherapy, radiotherapy).
• Surgery– shown when available large quantity large stones in the gallbladder, ducts. Plastic surgeries are performed for anomalies of the biliary tract and after complications due to a previous intervention. Sometimes a liver transplant is used.
• Immunotherapy.
• In severe cases - therapy hormonal drugs.

Traditional medicine and jaundice in adults

Treatment with traditional medicine in acute icteric period ineffective, it should be used in the attenuation phase of the disease and in chronically ongoing processes between exacerbations.

Complications of diseases that cause jaundice in patients

The manifestation of jaundice can essentially also be attributed to complications of diseases. And the consequences that may occur against the background of existing jaundice may be different.

Most often, pathologies occurring with jaundice often lead to:

• anemia;
• chronicization of the main process;
• development of benign and malignant processes;
• acute and chronic liver failure;
• shock, against the background of pain;
• hepatic encephalopathy;
• death in severe cases.

Diet for jaundice and prevention of its occurrence

In hospitals, patients suffering from diseases with icteric manifestations receive dietary food No. 5 according to Pevzner.

The diet includes:

During illness you should avoid:

• all types of conservation;
• fatty foods (meat and dairy, fish);
• fried foods, which are strictly contraindicated for jaundice;
• chocolate, cocoa, coffee, pastries, seasonings, spices;
• any types of alcohol.

Forecast and prevention of jaundice in adults

The outcome of the disease accompanied by jaundice depends on the cause, form and severity of the process. With properly organized treatment, in most cases it is possible to cure the patient or significantly improve his condition.

For preventive purposes, in order to avoid the development of jaundice, it is necessary to promptly seek advice from a specialist. For chronic diseases, follow the regime and dietary guidelines.

Lotin Alexander, medical columnist