aside from manifestation of jaundice for those who have liver disease... i had a hepatitis profile and the results shows that i am negative the same as the ultrasound in my liver and gallbladder shows that it is normal and negative in inflammation and obstruction. but still i have an icteric sclera and yellowish skin (i have this manifestaion since 1st yr. highschool and cant remember that i have this one during childhood days). what do you think is my illness? and what kind of field in the medicine should i have a consultation? i really really need a help and im desperate!!.. thanks! Let me first explain what causes jaundice:
The red blood cells die in the body. When this
happens, the iron on the red blood cells is
released. This iron is what carries the oxygen
throughout the body on the red blood cell.
The liver and spleen are known to clean the
blood of these dead red blood cells and
release this iron, which is then processed
into a substance known as bilirubin. The liver
receives this bilirubin in the blood and
converts it and adds it to a substance known
as bile which flows from the liver through tube
like structures to the intestine and is used
to help digest fats that we eat.
Bilirubin is what causes the appearance of jaundice which is the yellowing of the white
of the eyes and the skin. Knowing this...you may be able to realize what can go wrong:
If this tubing, that goes from the liver to the
intestines is blocked, becomes mal formed,
or has inflammation, cancer,or stones...it can cause the bile to back up into the liver which will causes the bilirubin to go out into the blood
causing jaundice.
If the liver has a disease where the cells die,
then it also cannot process this bilirubin and
it stays in the blood.
If there is a problem with the enzymes not
being there, or too low, in the liver...it also
will not be processed properly.
If the body "produces" too many red blood cells,
it can cause an overabundance of bilirubin
being made when they die off and cause this.
OR if the body red blood cells die off faster than normal without overabundance of them..
which may be anemia.
There may also be a defect in the making of
the red blood cells causing them to have too
much iron.
This may be a problem with the liver, the
enzymes of the liver, a blood condition...
or even eatting too much carotene which comes
from carrots.
There are a number of considerations. Just
having an ultrasound may not be enough.
Usually, to check for liver disease, the doctor
performs blood tests and look for elevations
in the liver enzymes and liver functions. They
also see the amount, size, and conditions of
the Red Blood cells this way. They
then may do an ultrasound or CT scan. One
thing a patient has to realize, is that these tests
are not 100% accurate. How accurate they
are depends on the person doing the tests and
the knowledge of the person giving the results
of the tests...there is alot of room for error.
Therefore, doctors don't rule anything out until
they do a certain number of tests.
The best test to be sure of a liver problem is
the liver biopsy since they look directly at
a specimen and not just pictures of it.
The next thing is, that there is many different
causes of liver disease: alcohol abuse, drug
abuse, being exposed to chemicals, biliary
problems, viral diseases, etc. So unless
a patient is upfront in telling the doctor their
life style and what they do...it makes it
more difficult to diagnosed. People taking
tylenol, which is an over the counter drug,
may be taking too much of it cause it is a
drug that is combined with a number of
other drugs they are taking and it is becoming
toxic in their body and can cause liver damage. So this means the patient needs to
let the doctor know what herbs, over the
counter items, foods, and medications they
are taking and how much.
If you think that it is a liver problem...the
best doctor is a Hepatologist.
If you think that it may be a blood problem...
then a Hemotologist is the best doctor.
Please remember that Jaundice is just a
symptom and not a disease.
Jaundice does show up in babies and also
pregnancy...but the cause of the jaundice
in babies is because the baby is born when
the liver isn't completely functioning as yet...
this usually clears up over time.
Try to consider other symptoms you may
have because of this: like the urine being
darker in color, or the stool being lighter or
darker in color. Bilirubin causes,many times
the urine to appear a darker yellow, orange,
or deep brown color and it causes a pale
color stool if the bile isn't flowing through
the bile tubes to the intestines appropriately.
It can also cause very itchy skin. Be sure
to let the doctor know if you experience this.
I hope this is of some help to you. I also
hope you find out the cause. Skin discolorations come under the heading of dermatology. You might consult a board certified dermatologist to get information about your skin changes if you are currently, certain that it is not caused by liver jaundice, or other internal medical conditions. The only processes I am familiar with for jaundice is from the liver. Hepatitis isn't the only liver disease out there. One measure of liver function is an ALT, AST, and alkaline phosphatase. Be sure to get regular checkups with your physician to monitor these levels.
If you take a lot of tylenol, try to avoid it for a while to see if the scleral icterus and yellowed skin goes away. Also alcohol can be a cause. Do you eat a lot of carrots? I have actually heard of cases in children where that was pretty much all they would eat...and for some reason, their skin discolored.
You can try a Dermatology consultation since they specialize in the skin; an Ophthalmology consultation for your eyes; and work closely with your doctor to monitor your liver function and discuss with him/her the possibility of seeing a Hepatologist for further evaluation and other testing that is available out there.
I wish you the best of luck...a lot of times these evaluations do take time, but do work closely with your doctor...he/she knows your medical history the best...and it can get frustrating while waiting and continuing to get negative results. Monitoring is the key. Anything abnormal can more easily be investigated than normal results. Most are due to a fault in the liver or gallbladder, but a few are not and may be more serious. I went to wrong diagnosis.com here is a list of what all the things that can cause jaundice. I hope its not any of these, and its just a clogged bile duct dr's are not finding.
type in newly born babies.
Liver diseases
Hepatitis
Viral hepatitis
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Hepatitis G (type of Viral Hepatitis)
Hepatitis X
Autoimmune hepatitis
See also underlying causes of hepatitis
Hemochromatosis
Liver failure
Cirrhosis of the liver
Causes of hemolytic jaundice:
Hemolytic anemia
Rh incompatibility
Malaria
Causes of obstruction jaundice:
Bile duct obstruction
Gallstones
Biliary system tumor
Biliary infection
Gallbladder cancer
Bile duct cancer
Pernicious anemia
Stomach cancer
Secondary liver cancer (type of Liver cancer)
Pancreatic cancer
Typhoid fever
Yellow fever
Leptospirosis
Snake venom I would see a General Surgeon, if you have not had an ERCP yet that may be your next test. It might be a gallstone that temporally gets stuck in your bile duct. Also a consult with a hematologist might help. It might be a blood related issue that no one has picked up yet. |
