In this video, I will attempt to explain the functions of the liver and what causes jaundice, a condition that makes our eyes and our skin yellow.
Come join me today in this video to unravel the function of the liver and what causes jaundice.
I will also touch upon viral hepatitis as a major cause of liver inflammation and dysfunction.

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Think of the liver as a factory that is functioning 24/7.
It’s a factory that has a production line, waste disposal system and a very well run storage system.

The manufacturing component of the liver produces
A) Bile juice, which is critical in the digestion and absorption of fat in the small intestines. Bile also helps in the disposal of waste via our stool
B) Albumin and blood plasma proteins are essential in preventing leakage of fluid out of our blood vessels and in ensuring that our blood can clot to prevent excessive bleeding.
C) immune components and cells such as complement components and acute phase proteins which helps us get rid of external invading agents.

It also has excellent storage capabilities.
It stores the excess glucose floating in our bloodstream and pack them into glycogen within the liver, allowing our human body to utilise this energy when we need it.
It stores essential minerals and vitamins like vitamins A, D, E, K and B12 as well as iron and copper.
All of these minerals and vitamins are vital to our bodily functions, including the formation of blood haemoglobin.

And perhaps the most important function of the liver is in its filtration and waste disposal capability.
All the blood leaving the stomach and intestines passes through the liver, which removes toxins, byproducts, bacteria and other harmful substances, which include drugs that we consume.
Ammonia, which is produced from all organs in our body, is removed almost entirely by the liver.
And If allowed to accumulate, high levels of ammonia can be toxic to our brain, causing confusion, hallucinations and even coma.
Our red blood cells renew themselves every 3 months. Old and dying red blood cells are broken down and the yellowish bilirubin is removed via our liver as well.

So, if you can imagine, what will happen to us if our liver fails?
We will no longer be able to remove wastes and toxins. When this waste builds up, it poisons our organs from within and our body will shut down and stop functioning.
Our blood vessels become leaky with fluid accumulating in our skin and subcutaneous tissues, resulting in a swollen face, swollen abdomen and swollen legs.
In severe cases, water accumulates in our lungs, causing the sensation of drowning.
Our immune system will become severely weakened and we will be prone to all sorts of infection and we may start to bleed easily as our clotting function becomes impaired.
And we will start turning yellow because of the accumulation of bilirubin in our system.
This is known as jaundice

Now let us discuss more jaundice.
Jaundice occurs when high levels of yellowish bilirubin accumulate in our bloodstream, turning the white of our eyes and our skin yellow.
There are many causes of jaundice, which is a lecture by itself.
Jaundice can occur due to the overproduction of bilirubin in our bloodstream – such as when there is overwhelming destruction of our red blood cells.
Or it can occur due to the blockage of the bile duct by stones or cancers, resulting in bilirubin failing to be discharged in our stool. The bilirubin will then overflow back into our bloodstream.
In the majority of cases, it is often due to the inflammation and infection of the liver, of which viral hepatitis is the top culprit.
Hepatitis A, B, C and E are endemic in Singapore. Meaning they are around us all year round.
Inflammation of the liver by viral hepatitis can severely impair the liver’s ability to remove bilirubin.
And therefore jaundice is one of the prominent signs of advanced viral hepatitis.

00:00 Intro
00:45 Functions of liver
00:54 Liver manufacturing capabilities
01:25 Liver storage functions
01:55 Liver Filtration and Waste disposal capabilities
03:19 What is jaundice & causes of jaundice

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Jaundice: Clinical essentials – Dr. Kiran Peddi MRCP(UK), FRCP(London), CCT(Gastro)

What is jaundice?
Jaundice is a condition in which the skin, sclera (whites of the eyes) and mucous membranes turn yellow. This yellow color is caused by a high level of bilirubin, a yellow-orange bile pigment. Bile is fluid secreted by the liver. Bilirubin is formed from the breakdown of red blood cells.

SYMPTOMS AND CAUSES
What causes jaundice?
Jaundice can be caused by a problem in any of the three phases in bilirubin production.

Before the production of bilirubin, you may have what’s called unconjugated jaundice due to increased levels of bilirubin caused by:

Reabsorption of a large hematoma (a collection of clotted or partially clotted blood under the skin).
Hemolytic anemias (blood cells are destroyed and removed from the bloodstream before their normal lifespan is over).
During production of bilirubin, jaundice can be caused by:

Viruses, including Hepatitis A, chronic Hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis).
Alcohol.
Autoimmune disorders.
Rare genetic metabolic defects.
Medicines, including acetaminophen toxicity, penicillins, oral contraceptives, chlorpromazine (Thorazine®) and estrogenic or anabolic steroids.
After bilirubin is produced, jaundice may be caused by obstruction (blockage) of the bile ducts from:

Gallstones.
Inflammation (swelling) of the gallbladder.
Gallbladder cancer.
Pancreatic tumor.
What are the symptoms of jaundice?
Sometimes, the person may not have symptoms of jaundice, and the condition may be found accidentally. The severity of symptoms depends on the underlying causes and how quickly or slowly the disease develops.

If you have a short-term case of jaundice (usually caused by infection), you may have the following symptoms and signs:

Fever.
Chills.
Abdominal pain.
Flu-like symptoms.
Change in skin color.
Dark-colored urine and/or clay-colored stool.
If jaundice isn’t caused by an infection, you may have symptoms such as weight loss or itchy skin (pruritus). If the jaundice is caused by pancreatic or biliary tract cancers, the most common symptom is abdominal pain. Sometimes, you may have jaundice occurring with liver disease if you have:

Chronic hepatitis or inflammation of the liver.
Pyoderma gangrenosum (a type of skin disease).
Acute hepatitis A, B or C.
Polyarthralgias (inflammation of the joints).

DIAGNOSIS AND TESTS
—————————————-
How is jaundice diagnosed?
Doctors diagnose jaundice by checking for signs of liver disease such as:

Bruising of the skin.
Spider angiomas (abnormal collection of blood vessels near the surface of the skin).
Palmar erythema (red coloration of the palms and fingertips).
Urinalysis (urine testing) that’s positive for bilirubin shows that the patient has conjugated jaundice. The findings of urinalysis should be confirmed by serum testing. The serum testing will include a complete blood count (CBC) and bilirubin levels.

Your doctor will also do an exam to determine the size and tenderness of your liver. He or she may use imaging (ultrasonography and computer tomographic (CT) scanning) and liver biopsy (taking a sample of the liver) to further confirm diagnosis.

MANAGEMENT AND TREATMENT
——————————————————
How is jaundice treated?
Jaundice usually doesn’t require treatment in adults (it’s a more severe problem in infants). The causes and complications of jaundice can be treated. For instance, if itching is bothersome, it may be eased by cholestyramine (Questran®).

What are some of the complications/side effects of the treatments of jaundice?
Constipation.
Bloating.
Stomach pain.
Gas.
Upset stomach.
Vomiting.
Diarrhea.

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Jaundice Causes,Sign, Symptoms,Treatment and Risk Factor
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