Jaundice is a common health problem especially during the monsoons/summers. There are several reasons for jaundice, most common causes include liver infection due to viruses (Hepatitis A, B, C, D, E), blockage of the biliary system due to stone or cancer, liver abscess and increased breakdown of red blood cells.
- Hepatitis B affects more number of people than the HIV virus.
- Despite there being a vaccine, Hepatitis B virus kills one person every 30-45 seconds.
- Most people who are infected (almost three-fourths) are unaware of their infection.
- The infection can kill 25% of the infected people due to liver cancer or liver failure from cirrhosis.
Liver infection due to liver virus can be due to five virus which are named alphabetically – Hepatitis A,B,C,D and E.
Hepatitis A and E are transmitted by contaminated food and water, bad sanitary practices etc. and causes short term disease lasting less than 6 months. The infection usually resolves on its own with medicines.
Hepatitis B and Hepatitis C are transmitted by contaminated blood and syringes, sexual route, needle stick injuries, intravenous drug abuse etc. Hepatitis D only occurs in presence of Hepatitis B. Infection by hepatitis C can be potentially long term and may require treatment. However, hepatitis B usually resolves in >90%cases and does not require treatment. Hepatitis B is 1000 times more infectious than HIV, but is preventable by vaccination.
Diagnosis is done by special blood tests like Liver function test and others. In some cases, the disease may become severe and cause bleeding, altered behaviour, abdominal swelling and even coma called as fulminant hepatitis. This condition requires ICU care and even liver transplantation.
There is no specific treatment for Hepatitis A and E. Treatment for Hepatitis B and C is done only in certain special circumstances.
Blockage of bile duct due to stone or cancer is another common cause of jaundice. Presence of stones is diagnosed by Ultrasound and is removed by an endoscopic procedure called ERCP (Endoscopic retrograde cholangio-pancreatography). Cancer of gall bladder or bile duct usually presents with itching, weight loss and can be diagnosed using ultrasound and CT scan. If the cancer is in early stage, surgery may be done. However, if the cancer is advanced and surgically non-removable, then palliative management with stenting can be done to relieve symptoms and improve quality of life.
Liver abscess which means pus in the liver, presents with fever, pain abdomen, jaundice and nausea/vomiting. It may occur due infection by parasite of amoeba or due to blockage of bile duct. This is treated with intravenous antibiotics, and in some severe cases aspiration of pus from the liver. The most dangerous complication is rupture of the abscess cavity, in which case emergency surgery may be required.