Ms. Liu recently felt that her appetite was not good. She usually eats some meat at every meal, but now she doesn’t even think about it. She feels nauseated and nauseous when she sees meat, and her body often feels tired. She was worried that there would be problems if it continued like this, so she went to the clinic to see a doctor. The doctor saw that her face was yellow and suspected jaundice. Sure enough, the blood test showed that there were problems with bilirubin and liver function. Treatment, based on the test results, considered him at high risk of acute hepatitis in this case.

Ms. Liu has a question, is jaundice all caused by the liver?

What is jaundice? Is yellowing of the skin jaundice?

In fact, jaundice is just a symptom. It is a symptom of certain problems in the human body. It is often reflected in the increase of bilirubin levels in the blood, causing the sclera and skin of the eyes to appear yellow, and the urine may appear dark brown. .

Many people may take this problem for granted, but in fact the skin looks yellow, not necessarily jaundice. Some people may have pigmentation on their skin. If these pigments themselves are yellow, it may cause the skin Yellowing, such as carotene deposition, but generally this kind of deposition occurs in the hands and feet, and the eyes do not turn yellow (the white part of the eye), which can be a way to distinguish jaundice. But what everyone needs to understand is that jaundice does not necessarily mean yellowing of the whites of the eyes. The important diagnosis still needs to go to the hospital for a blood test.

In addition, we belong to the yellow race. Although modern people work less abroad and their skin is whiter, if they have bad habits such as staying up late, it may still lead to darker skin and a yellowish-brown state. It should not be considered jaundice.

Generally speaking, jaundice is caused by the high level of bilirubin in the blood, then the blood metabolism and urine will change first, such as brown color, etc., and then the eyes. When a person’s skin has jaundice, it often means that the condition is more serious. Therefore, frequent discoloration of urine should be paid attention to.

At this time, some people will ask, the color of urine when jaundice is more yellow, and eating vitamin B will also make urine color, how is this different?

It depends on whether it is frequent or transient. If it is jaundice, as long as you go to the toilet, you can observe that the urine continues to turn yellow, and it will also appear brown; and the yellow urine caused by taking vitamin B is often after taking the medicine. Once you stop taking the medicine, it will be normal, and the yellow urine will not appear brown, and the color will be more translucent.

What is the cause of jaundice?

When it comes to jaundice, most people will first think about whether they have liver disease. This possibility is possible, but there are many reasons for jaundice. It is necessary to carry out targeted examinations to understand the cause of the disease. It is not simply the liver. The problem.

First of all, we need to confirm the level of bilirubin in the blood. Bilirubin is the product of the metabolism of red blood cells in the blood. It is indirect bilirubin before it enters the liver. These bilirubin will enter the liver with the blood flow and pass through the liver. After metabolism, it becomes direct bilirubin, then enters the bile duct, and finally is excreted into the intestine through the common bile duct, and then excreted with the feces. If there is a problem in this process, bilirubin cannot be smoothly excreted from the body, then it will lead to jaundice, that is to say, if there is any problem in this process, jaundice will be formed.

Then, we can judge which link is the problem by knowing whether the direct bilirubin is too high or the indirect bilirubin is too high. Generally speaking, the normal value of total bilirubin should be controlled between 1.71-17.1umol/L, the normal value of direct bilirubin should not exceed 5umol/L, and the range of indirect bilirubin should be between 1.71-16.0umol/L , if there are problems with these values, the causes of jaundice are different:

1. High indirect bilirubin: The main reason is that bilirubin is produced too much, mainly because the human body has infection or some drugs cause hemolysis, or hemolytic disease, etc. The most common is hemolytic anemia, The patient’s red blood cells are apoptotic, and indirect bilirubin appears in large quantities. Although the patient’s liver function is normal at this time, because there is too much bilirubin, it cannot be metabolized normally, resulting in jaundice.

In addition, in the process of forming direct bilirubin, indirect bilirubin needs to be assisted by some enzymes. If these enzymes are lacking, it will also lead to elevation. The lack of these enzymes is often a congenital problem, and patients often develop the disease when they are young. .

From the above situation, we can understand that high indirect bilirubin is often not related to the liver, but has more to do with blood problems.

2. Higher direct bilirubin: The most common cause of excessive direct bilirubin is liver cell damage caused by hepatitis. When liver cells are damaged, bilirubin cannot be discharged smoothly and will flow back into the blood. Bilirubin increases.

In addition, if the biliary tract is blocked due to stones or tumors, the excretion of bilirubin will also be affected, and jaundice may also be caused.

So, how do you know if it is hepatitis? You need to ask if you have a history of hepatitis B or C, whether you drink too much to harm the liver, whether you take some drugs that damage the liver, and whether you have a diet, whether you are tired of being greasy, and whether you have a fever or inflammation, etc., especially People with a history of hepatitis and high liver function transaminases are considered to be caused by severe liver damage caused by hepatitis.

From here, we understand that jaundice caused by direct bilirubin is mostly related to liver disease, which requires further examination, such as B-ultrasound, CT, etc., to know whether there is liver disease, tumors of the liver and gallbladder, etc. There are also some targeted indicators to understand the biliary tract. The problem.

In addition, the clinical manifestations of different liver diseases are also different. For example, viral hepatitis may cause general fatigue, nausea, loss of appetite, and then jaundice; bile duct stones may cause infection, fever, and right upper quadrant pain; bile duct cancer or pancreas Cancer and other cancers, there will be jaundice and significant weight loss, but usually patients do not have acute severe abdominal pain and so on.

Knowing the cause can lead to the correct treatment

Knowing the cause of jaundice, then the relevant treatment and treatment according to the cause can solve the problem to a certain extent, and more importantly, understanding the cause can also prevent the disease from further worsening.

For example, chronic hepatitis is often caused by a virus, and the treatment method is antiviral therapy. Currently, there are many related drugs. Hepatitis C can even be radically cured, while hepatitis B requires a combination of treatment and follow-up examinations to avoid further serious illness.

For problems of the bile duct, if it is a polyp or a stone, it can be treated with an endoscope, or even the gallbladder can be removed for radical cure.

For tumors of the liver and gallbladder, depending on the condition of the patient, surgery or conservative treatment can be selected, and newer treatment methods such as targeted therapy can also be selected.

For blood diseases, you should consider going to a blood specialist for targeted treatment.