Differential diagnosis and treatment of jaundice

On average, nine out of every nine newborns will develop jaundice, so jaundice is now attracting more and more attention. Many people don’t understand jaundice. In fact, there are two main types of jaundice: physiological jaundice and pathological jaundice. Among them, physiological jaundice is the most common and has no effect on children, but pathological jaundice is serious and you must go to the hospital for examination. So how do we differentiate, diagnose and treat jaundice?

1. Diagnosis

1. The main symptoms are yellow eyes, yellow body and yellow urine, among which yellow eyes are the essential symptom.

2. Often accompanied by abdominal distension, poor appetite, nausea, flank pain, heaviness in limbs, etc.

3. There is often a history of improper diet, contact with hepatitis patients, or taking drugs that damage the liver, as well as excessive fatigue and other inducements.

4. Serum total bilirubin, direct bilirubin, urine bilirubin, urobilinogen, serum alanine aminotransferase, aspartate aminotransferase, as well as B-ultrasound, CT, cholecystography and other examinations are helpful for diagnosis and differential diagnosis.

5. Both chlorosis, jaundice and chlorosis have yellow body color, so they need to be distinguished. The causes of jaundice are invasion of seasonal pathogens, damage due to diet, weak spleen and stomach, sand and gravel, stasis, etc.; the causes of chlorosis are heavy blood loss, long-term illness and spleen deficiency, etc. The pathogenesis of jaundice is the obstruction of dampness and turbidity, dysfunction of the spleen, stomach, liver and gallbladder, bile not flowing through the normal channels, and overflowing with the blood; the pathogenesis of chlorosis is spleen deficiency that cannot transform qi and blood, or excessive blood loss, leading to qi and blood deficiency and malnutrition of the skin. Jaundice is characterized by yellow eyes, body and urine; chlorosis is characterized by yellowing of the body and face, which becomes dry and dull, but the eyes and urine are not yellow, and it is accompanied by obvious symptoms of qi and blood deficiency, such as dizziness, tinnitus, palpitations and insomnia. The key to distinguishing the two is the presence or absence of yellow in the eyes.

2. How to care for baby jaundice

1. Feed more to allow the baby to expel meconium as soon as possible

In the early stages, we need to feed the newborn as soon as possible so that the meconium can be excreted as soon as possible, because the meconium contains a lot of bilirubin. If the meconium is not excreted cleanly, the bilirubin will be reabsorbed into the blood through the special enterohepatic circulation of the newborn, causing increased jaundice. How to tell whether the meconium is discharged cleanly? The main thing is to see if the meconium changes from black to yellow, which means it is completely excreted.

2. Feed more milk to give the newborn enough water

The way to determine whether a newborn's fluid intake is sufficient is to look at the newborn's urine. Generally, a normal newborn urinates 6-8 times a day. If the number is less than that, it is possible that his fluid intake is insufficient. Too little urination is not conducive to the excretion of bilirubin. We should ensure the fluid intake of newborns. Generally, the meconium of newborns should be discharged within 2-3 days, which can reduce the degree of jaundice.