Ms. Liu has recently felt poor appetite. Usually, she can eat some meat with each meal, but now she doesn’t even think about it. She still feels nauseous when she sees meat, and her body often feels tired. She was worried that there would be problems if she continued like this, so she went to the clinic for medical treatment. The doctor saw that her face was yellow and suspected jaundice. Sure enough, the blood test results showed that there were problems with bilirubin and liver function, and the values ​​were high, so she was rushed to hospital According to the examination results, he is considered to be at high risk of developing acute hepatitis in this situation.

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

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 manifested as an increase in the level of bilirubin in the blood, causing the sclera of the eyes and skin to appear yellow, and the urine may appear dark brown. .

This problem may be taken for granted by many people, but in fact the skin looks yellow, not necessarily jaundice, some people’s skin may have pigmentation, if these pigments themselves are yellow, it may cause skin hyperpigmentation. Yellowing, such as carotene deposition, but generally this type of deposition occurs in the hands and feet, and the eyes will not turn yellow (the white part of the eyes). This can be a way to distinguish jaundice. But what everyone needs to understand is that jaundice does not necessarily cause the whites of the eyes to turn yellow. An important diagnosis still requires a blood test at the hospital.

In addition, we belong to the yellow race. Although modern people work less outside and have fairer skin, if they have bad habits such as staying up late, it may still lead to darker skin and a yellowish-brown state. Sometimes it cannot be considered as jaundice.

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

At this time, some people may ask, the color of urine is yellow when you have jaundice, and taking vitamin B will also change the color of urine. 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 tea-colored; 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 be tea-colored, but the color is relatively translucent.

What is the cause of jaundice?

When it comes to jaundice, most people will first think of whether they have a liver disease. This possibility is possible, but there are many causes of jaundice, and it is necessary to carry out targeted examinations to understand the cause of the disease. We cannot simply think that it is the liver. The problem.

First, we need to confirm the level of bilirubin in the blood. Bilirubin is a product of red blood cell metabolism in the blood. It is indirect bilirubin before it enters the liver. The bilirubin will enter the liver with the blood flow and pass through the liver. After metabolism, it becomes direct bilirubin, then enters the biliary tract, and finally is discharged into the intestinal tract through the common bile duct, and then excreted with the feces. If there is a problem in this process and the bilirubin cannot be excreted smoothly, it will cause jaundice, that is to say, if there is a problem in any link in this process, jaundice will form.

Then, we can judge which link is the problem by knowing whether the direct bilirubin is high or the indirect bilirubin is too high. Generally speaking, the normal value of total bilirubin is required to 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 is a problem with these values, the cause of the jaundice is different:

1. Higher indirect bilirubin: The main reason is that too much bilirubin is produced, mainly because of infection or certain drugs that cause hemolysis in the human body, or hemolytic diseases, etc. The most common is hemolytic anemia. The patient’s red blood cells undergo massive apoptosis, and a large amount of indirect bilirubin appears. Although the patient’s liver function is normal at this time, due to too much bilirubin, it cannot be metabolized normally at all, 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 missing, it will also lead to an increase. 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 often has little to do with the liver, but has more to do with blood problems.

2. High direct bilirubin: The most common reason for high direct bilirubin is that liver cells are damaged due to hepatitis. When liver cells are damaged, bilirubin cannot be discharged smoothly and will flow back into the blood. Bilirubin will rise.

In addition, if the biliary tract is blocked by stones or tumors, the excretion of bilirubin will also be affected, which will also cause jaundice.

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 alcohol that damages your liver, whether you have taken any medicines that damage your liver, and to understand according to your diet, whether you are tired of being greasy, whether you have a fever and an inflammatory reaction, etc., especially People with a history of hepatitis and high liver function transaminases should consider the serious damage to liver function caused by hepatitis.

From here, we know that jaundice caused by direct bilirubin is mostly related to liver disease, which requires further examination, such as B-ultrasound, CT, etc., to find out whether there is liver disease, tumors in the liver and gallbladder, etc., and 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 have general fatigue, nausea, loss of appetite, and then jaundice; biliary stones may have infection, fever, and right upper quadrant pain; Cancer and other cancers, jaundice and obvious weight loss will occur, but usually the patient will not have acute severe abdominal pain and so on.

Knowing the cause is the right way to deal with it

Knowing the etiology of jaundice can solve the problem to a certain extent by carrying out relevant treatment according to the etiology. More importantly, understanding the etiology can also prevent the disease from getting worse.

For example, chronic hepatitis is often caused by viruses, and the treatment method is antiviral treatment. At present, there are many related drugs. Hepatitis C can even be cured.

For biliary tract problems, if it is a polyp or stone, it can be treated endoscopically, and even the gallbladder can be removed for radical treatment.

For liver and gallbladder tumors, you should choose surgery or conservative treatment depending on the condition of the disease, or you can choose newer treatment methods such as targeted therapy.

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