Elevated bilirubin levels

       Common causes of increased total bilirubin levels include:

　　(1) Liver diseases: acute jaundice type hepatitis, acute yellow necrosis of the liver, chronic active hepatitis, liver cirrhosis, etc.

　　(2) Extrahepatic diseases: hemolytic jaundice, blood type incompatibility in transfusion reactions, cholecystitis, cholelithiasis, etc;

　　(3) Seen in toxic or viral hepatitis, hemolytic jaundice, aplastic anemia, paroxysmal hemoglobinuria. Polycythemia, neonatal jaundice, internal hemorrhage, post-transfusion hemolytic jaundice, acute yellow atrophy of the liver.

　　Indirect increase

　　1. Hemolytic jaundice. Due to some hemolytic diseases, red blood cell destruction can be excessive, leading to an increase in indirect bilirubin levels in the blood;

　　2. Hepatocellular jaundice. When liver cells are damaged, bilirubin cannot be converted into bile normally, due to liver cell swelling, compressing the bile ducts within the liver, obstructing bile excretion, and causing an increase in bilirubin levels in the blood.

　　3. Blood transfusion errors. Incompatible blood type transfusions can cause hemolysis, leading to excessive destruction of red blood cells and the release of a large amount of indirect bilirubin into the blood.

　　4. Neonatal jaundice. It is mainly caused by blood type incompatibility between mother and child or congenital bile duct malformations in neonates, leading to elevated indirect bilirubin levels in the blood.

　　Direct increase

　　1. Obstructive jaundice. It is mainly caused by bile duct blockage (such as cholelithiasis, liver cancer, pancreatic head cancer).

　　2. Diseases that can cause excessive liver cell damage, such as acute and chronic hepatitis, hepatocellular jaundice, liver cirrhosis, etc.

　　1) Excessive destruction of red blood cells.

　　2) Indirect bilirubin can penetrate cell membranes, causing toxic effects on cells and cannot be excreted out of the body through the kidneys.

　　3) Elevated indirect bilirubin levels indicate low compensatory capacity of the liver or problems with the liver.

　　Elevated bilirubin in the blood causes the sclera, skin, mucosa, and other tissues and body fluids to turn yellow. When the total serum bilirubin is significantly elevated, the skin, sclera of the eyes, urine, and serum appear yellow, hence the term 'jaundice'. Jaundice can be caused by inflammatory, necrotic, and toxic damage to the liver, as well as by biliary tract diseases and hemolytic diseases.

　　If elevated bilirubin is caused by liver disease, in addition to the symptoms of jaundice, clinical symptoms such as decreased appetite, fatigue, low fever, nausea, vomiting, and abdominal pain may also occur; if elevated bilirubin is caused by anemia, in addition to the symptoms of jaundice, symptoms such as dizziness, fatigue, muscle or joint pain may also occur.

　　To prevent elevated bilirubin, it is necessary to pay attention to a regulated diet, avoid excessive alcohol consumption, avoid eating unclean food, and avoid overeating spicy, hot, and fatty foods. Jaundice patients should rest well, maintain a pleasant mood, and eat a light diet.

      Once the disease is discovered, it should be isolated and treated immediately, and its utensils should be disinfected. The excreta should be buried deep or disinfected with bleaching powder. After the jaundice subsides after treatment, it is not advisable to stop taking medication immediately. Treatment should continue according to the condition to prevent recurrence.

　　Laboratory and other examinations

　　(One) Alkaline phosphatase (ALP): ALP is significantly increased in extrahepatic, intrahepatic obstructive jaundice, and intrahepatic cholestasis.

　　(Two)The determination of total cholesterol, cholesterol esters, and lipoprotein-X (LP-X) in serum. In cholestatic jaundice, the total cholesterol content increases; in hepatocellular jaundice, especially in cases with extensive necrosis, cholesterol esters decrease.

　　(Three)(Prothrombin time: in hepatocellular and cholestatic jaundice, the production of prothrombin decreases, resulting in prolonged prothrombin time. After 24 hours of re-examination of the prothrombin time after injection of vitamin K2-4mg, if there is a significant shortening compared to before injection, it indicates normal liver function, and jaundice may be cholestatic. If there is no change, it indicates that the liver's function to produce prothrombin is impaired, and jaundice may be hepatocellular.)

　　(Four)(Ultrasonic imaging: if intrahepatic bile duct dilation is found, it is definitely due to extrahepatic bile duct obstruction causing jaundice.)

　　(Five)(X-ray examination)

　　1. Barium swallow and gastrointestinal barium meal examination. If esophageal or gastric fundus varices are found, liver cirrhosis can be diagnosed.

　　2. Endoscopic retrograde cholangiopancreatography (ERCP) is very helpful in diagnosing chronic pancreatitis, pancreatic cancer, and understanding the condition of the biliary tract system.

　　3. CT has great diagnostic value for the diagnosis of liver, gallbladder, and pancreatic diseases, as well as for the location, extent, and nature of extrahepatic obstructions.

　　(Six)Liver biopsy and laparoscopy can assist in diagnosing hepatocellular jaundice, intrahepatic cholestasis, and Dubin-Johnson syndrome, etc.

　　In summary, jaundice is an important symptom and sign of many diseases. The cause of jaundice originates from abnormal bilirubin metabolism. By analyzing bilirubin, urobilinogen, and stercobilinogen, the nature of jaundice can be initially classified. However, accurate diagnosis of the cause still depends on the comprehensive analysis of medical history, signs, and various laboratory and auxiliary examinations by clinical physicians.

　　Patients with high bilirubin levels should have a light and nutritious dietSuch as soy products, fish, vegetables, fruits, etc., which contain a large amount of vitamins A, B, C, E, have good antioxidant functions and are easy to digest and absorb. It is advisable to eat more mushrooms, sesame seeds, walnuts, jujubes, lean meat, and animal livers, but patients with high bilirubin levels should not eat animal liver foods. Hepatitis B patients should pay attention to high bilirubin levels and seek treatment at a regular liver disease hospital in a timely manner.

　　Patients with high bilirubin levels should avoid drinking alcoholAlcohol contains ethanol, which is the most direct and greatest harm to the liver. Studies have shown that more than 80% of heavy drinkers have some degree of fatty liver, 10% to 30% can develop alcoholic hepatitis, and 10% to 20% will develop liver cirrhosis. It is advisable to drink more water in daily life, as drinking water can replenish body fluids, enhance blood circulation, promote metabolism, and also promote the secretion of digestive glands, especially digestive juices and pancreatic juice, bile. This is conducive to digestion, absorption, and the excretion of waste, and can reduce the damage caused by metabolic products and toxins to the liver.

　　Appropriate exercise for patients with high bilirubin levels can allow the body's metabolismCirculation is enhanced, which helps the liver and kidneys metabolize waste and excrete it quickly--sweating, which is beneficial to the physical health of patients with high bilirubin levels and can also improve the body's ability to resist diseases. Therefore, patients with high bilirubin levels should engage in more outdoor activities such as walking, hiking, playing ball, Tai Chi, etc., but those with poor liver health should avoid strenuous exercise.

　　Firstly, observe and if the indicators continue to rise, medical treatment can be carried out. Light therapy can be used, which is a simple and effective method to reduce unconjugated bilirubin in serum. Medication: 1, inject albumin or plasma 2, hepatotoxic agents, phenobarbital 5mg/kg per day, 2-3 times a day, for 4-5 days. 3, intravenous immunoglobulin, early application is effective.