A Simple Guide to Liver Diseases
By Kenneth Kee
()
About this ebook
Jaundice is the symptom of yellowish discoloration of the skin, mucous membrane and sclera due to accumulation of bile pigments in tissues associated with the increase in serum bilirubin level.
Bilirubin is the breakdown product of hemoglobin during the end of life span of a red blood cells.
The types of bilirubin are:
1. unconjugated bilirubin which is toxic, fat soluble and cannot be excreted by the kidneys
2. conjugated bilirubin which the hepatocytes in the liver has conjugated the unconjugated bilirubin and excretes in the bile.
Conjugated bilirubin is water soluble and in high levels is also excreted in the urine as dark tea colored urine.
What are the causes of Jaundice?
The causes of jaundice are:
1. Hemolytic anemia is due to the break up of red blood cells
Here the major form of bile pigment is unconjugated
2. Hepatocellular or liver causes:
a. Acute:
1. viral hepatitis A to F,
2. alcoholism,
3. toxic chemical hepatitis including drugs and
4. bacterial infections such as leptospirosis.
More of conjugated bilirubin at early stages followed by unconjugated bilirubin.
b. Chronic liver cirrhosis - mostly unconjugated bilirubin
3. Obstructive jaundice: mainly conjugated bilirubin accumulates
a.Intrahepatic cholestasis due to drug sensitivity
b. Extra hepatic gallstones, carcinoma of biliary systems or adjacent organs.
What are the effects of Jaundice?
The effects of jaundice:
1. yellowing of the skin and white of eye and mucous membranes like inside of the lips
2. liver enlargement and palpable gallbladder in blockage
3. enlarged spleen especially in hemolytic anemia
4. dark colored urine due to presence of bilirubin in the urine
5. pale stools
6. prolonged tiredness from anemia, loss of blood,
7. encephalopathy from bilirubin affecting the brain
8. nausea and vomiting.
9. poor appetite
Diagnosis of causes:
1. Hemolytic anemia
a. bilirubin raised
b. liver function tests normal
c. urine and stools may be normal except for excess urobilinogen
d. blood hemorrhage tests for hemolytic anemia
2. Hepatocellular
a. liver function test normal except for increased liver enzymes, proteins normal but alkaline phosphates may be raised
b. tests for infections such as hepatitis, mononucleosis, and cytomegalovirus
c. antinuclear antibody
3. Obstructive:
a. liver function tests-conjugated bilirubin raised, liver enzymes raised, alkaline phosphatase raised
b. previous attacks of jaundice
c. biliary colic
Other tests include:
1. Utrasound of liver and gallbladder
2. cholecytograms
3. cholangiography
4. MRI of liver and abdomen
5. liver biopsy
What is the treatment for Jaundice?
Treatment usually includes:
1. supportive treatment like
a. rest
b. adequate fluids
2. adequate nutrition and vitamin B
3. treatment depends on the cause:
a. blood transfusion or platelet transfusion for hemolytic anemia
b. treatment of infections
c. surgery for obstructive lesions
Prognosis:
depends on the underlying cause.
Prevention:
1. Avoid seafood especially cockleshells which may cause hepatitis A
2. Avoid casual sex which can spread hepatitis B and C
3. Avoid reusage of syringes in drug addicts to prevent Hepatitis C and AIDS
4. Avoid medicine which can cause obstructive jaundice.
TABLE OF CONTENT
Chapter 1 Jaundice
Chapter 2 Hepatitis
Chapter 3 Hepatitis A
Chapter 4 Hepatitis B
Chapter 5 Hepatitis C
Chapter 6 Liver Cirrhosis
Chapter 7 Liver Cancer
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Book preview
A Simple Guide to Liver Diseases - Kenneth Kee
A
Simple Guide
To
Liver
Diseases
by
Dr Kenneth Kee
M.B.,B.S. (SINGAPORE
PH.D (HEATHCARE ADMINISTRATION)
COPYRIGHT KENNETH KEE 2012 Smashwords Edition
Published By Kenneth Kee At Smashwords.com
DEDICATION
This book is dedicated
to my wife Dorothy
and my children
Carolyn, Grace
and Kelvin
Many people have asked me what Jaundice is.
Jaundice is a symptom of Liver Diseases.
The Liver is an important organ in the body.
This book explains why Liver Diseases are so dangerous to your health
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Chapter 1
JAUNDICE
What is Jaundice?
Jaundice is the symptom of yellowish discoloration of the skin, mucous membrane and sclera due to accumulation of bile pigments in tissues associated with the increase in serum bilirubin level.
Bilirubin is the breakdown product of hemoglobin during the end of life span of a red blood cells.
The types of bilirubin are:
1. unconjugated bilirubin which is toxic, fat soluble and cannot be excreted by the kidneys
2. conjugated bilirubin which the hepatocytes in the liver has conjugated the unconjugated bilirubin and excretes in the bile.
Conjugated bilirubin is water soluble and in high levels is also excreted in the urine as dark tea colored