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Diseases » Jaundice » Treatments

Treatments for Jaundice



Contents

Jaundice: Is the Diagnosis Correct?

The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Jaundice may include:

Hidden causes of Jaundice may be incorrectly diagnosed:

Jaundice: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Jaundice:

Jaundice: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Latest treatments for Jaundice:

The following are some of the latest treatments for Jaundice:

Hospital statistics for Jaundice:

These medical statistics relate to hospitals, hospitalization and Jaundice:

  • 0.049% (6,261) of hospital consultant episodes were for unspecified jaundice in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 76% of hospital consultant episodes for unspecified jaundice required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 56% of hospital consultant episodes for unspecified jaundice were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 44% of hospital consultant episodes for unspecified jaundice were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • more hospital information...»

Book Excerpts: Treatment of Jaundice

Treatments of Jaundice: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Jaundice.

Jaundice: Treatment
(In a Page: Signs and Symptoms)

  • Discontinue and avoid potentially hepatotoxic medications
  • Supportive care for viral hepatitis
  • Rehydrate/refeed for Gilbert's syndrome
  • Consider steroids in fulminant alcoholic hepatitis
  • Cholecystectomy or ERCP with stone removal for obstructing gallstones
  • Treat underlying causes of hemolysis or other disorders
  • Antibiotics for cholangitis, sepsis
  • Hydroxyurea and folate for sickle cell disease, prevent crises by adequate hydration, vaccinating against diseases, and try to prevent other infections

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Jaundice in Infants – Direct: Treatment
(In A Page: Pediatric Signs and Symptoms)

  • Varies by specific disorder
  • General medication principles of cholestasis include
    –Promoting bile flow with ursodeoxycholic acid
    –Consider phenobarbital (increases bile excretion)
    –Fat-soluble vitamins including K, D, E
    –Vitamin A is a relative contraindication given hepatotoxicity at high levels
  • Consider formula with medium chain triglycerides as fat source (does not require bile acids to be absorbed)
  • Treat underlying disorder
    –Kasai portoenterostomy for biliary atresia
    –Surgical repair of choledochal cyst
    –Special formulas for tyrosinemia
    –Lactose free formula for galactosemia (e.g., soy based)
    –Remove toxic exposures
    –Treat infections
    –Treat hypothyroidism

    • » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Jaundice in Infants – Indirect: Treatment
    (In A Page: Pediatric Signs and Symptoms)

      • Treatment options vary based on level of bilirubin, age of presentation, and cause
        –Goal is prevent levels high enough to cause kernicterus
      • Phototherapy involves the use of photon energy to change the structure of bilirubin and permit excretion without glucuronidation
        –Decisions for use are age-based
        –Considered when serum level above 14 mg/dL
    • Exchange transfusion should be considered with serum levels above 25 mg/dL
    • IVF or breast-feed more frequently to increase volume
    • Correct endocrine abnormality
    • Improve perfusion if cardiac problem
    • Correct anatomic abnormality
    • Consider enteral binding agents
      –Cholestyramine, charcoal, calcium phosphate
    • Crigler-Najjar: Phenobarbital, may need liver transplantation

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Jaundice [Icterus]: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Jaundice: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals. Teach the patient ways to reduce pruritus.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Jaundice [Icterus]: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ To decrease pruritus, frequently bathe the patient; apply an antipruritic lotion, such as calamine; and administer diphenhydramine or hydroxyzine.

    ▪ Prepare the patient for diagnostic tests to evaluate biliary and hepatic function, including laboratory studies (such as urine and fecal urobilinogen, serum bilirubin, liver enzyme, and cholesterol levels; prothrombin time; and a complete blood count), computed tomography, ultrasonography, cholangiography, liver biopsy, and exploratory laparotomy.

    Patient teaching

    ▪ Teach the patient appropriate dietary changes.

    ▪ Discuss ways to reduce pruritis.

    ▪ Review with the patient prescribed medications and their possible adverse effects.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Jaundice - Case 15-3: 2-Month-Old Boy: VI. Treatment
    (Pediatric Complaints and Diagnostic Dilemmas)

    Replacement of the hormones produced by the pituitary's target organs is the cornerstone of hypopituitarism therapy. Thyroid hormone replacement should begin as soon as confirmatory testing is completed; delays in therapy can result in increased risk of cognitive impairment. Jaundice improves as the underlying endocrine disorder is treated.

    » READ BOOK EXCERPT ONLINE »

    Source: Pediatric Complaints and Diagnostic Dilemmas, 2003

    Jaundice - Case 15-4: 6-Week-Old Girl: VI. Treatment
    (Pediatric Complaints and Diagnostic Dilemmas)

    The hepatic portoenterostomy (Kasai procedure) for biliary atresia involves the anastomosis of a limb of small intestine to hepatic ducts in the region of the porta hepatis (where the portal vein and hepatic artery enter the liver and the hepatic ducts exit). It relies on the patency of tiny duct remnants to allow for bile drainage from the liver. Cholangitis is among the most worrisome of the postoperative complications of hepatic portoenterostomy; its signs and symptoms include fever, diminished bile flow, and the return of hyperbilirubinemia. Over time, survivors of hepatic portoenterostomy are also at risk for liver dysfunction, portal hypertension, esophageal varices, hypersplenism, and hepatopulmonary syndrome, in which arteriovenous shunts form within the lung. Liver transplantation is often required for patients who have undergone portoenterostomy for EHBA, and it is sometimes necessary as a primary operation if liver disease is far advanced at the time of diagnosis. Estimates of 10-year survival for patients with EHBA range from 40% to 70%. Approximately 25% to 40% of patients survive 10 years without requiring transplantation.

    » READ BOOK EXCERPT ONLINE »

    Source: Pediatric Complaints and Diagnostic Dilemmas, 2003

    Jaundice - Case 15-6: 5-Week-Old Girl: VI. Treatment
    (Pediatric Complaints and Diagnostic Dilemmas)

    Treatment of Alagille syndrome focuses on the medical management of cholestasis, promotion of growth and development, and treatment of any comorbidities (e.g., congenital heart disease). Children with Alagille syndrome suffer from malabsorption and require supplementation of fat-soluble vitamins and provision of sufficient calories for growth, which may necessitate tube feeding. Infants should receive formulas containing medium-chain triglycerides, which are absorbable without bile salts. Medications that may benefit Alagille patients (for example, by promoting bile flow or reducing pruritus) include phenobarbital, cholestyramine, ursodeoxycholic acid, and antihistamines.
    Long-term follow-up of patients with Alagille syndrome includes monitoring for the development of cirrhosis, portal hypertension, ascites, and liver failure. The 20-year life expectancy for patients with Alagille syndrome is about 75% overall, although rates are lower for those patients who require liver transplantation and for those with severe associated abnormalities (e.g., congenital heart disease).

    » READ BOOK EXCERPT ONLINE »

    Source: Pediatric Complaints and Diagnostic Dilemmas, 2003

    Jaundice: Jaundice - TREATMENT
    (The 5-Minute Pediatric Consult)

    Clinical pearls:

    • Treat Crigler-Najjar syndrome promptly with phototherapy and phenobarbital to prevent kernicterus.
    • Older children with Wilson disease may present with profound hemolysis and may have predominantly unconjugated hyperbilirubinemia with severe parenchymal liver disease and fulminant liver failure.

    » READ BOOK EXCERPT ONLINE »

    Source: The 5-Minute Pediatric Consult, 2008


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