Diagnosis and differential diagnosis of jaundice

The incidence of jaundice is very high for babies, and almost all babies will experience jaundice to a greater or lesser extent. Jaundice can be divided into two main types: physiological jaundice and pathological jaundice. Physiological jaundice will usually disappear automatically after some time, but pathological jaundice requires timely medical treatment, otherwise it will affect the baby's normal growth. So how do we diagnose and identify baby 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.

2. Differential Diagnosis

1. 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. Yellow and fat are mostly related to worm syndrome. Various worms, especially hookworms, live in the intestines, which consume Qi and blood for a long time, causing spleen deficiency and dampness, which leads to malnutrition of the skin. The moisture gradually stops, causing swelling and yellow face, yellow body with white, but not yellow eyes. The book "Xizhu on the Origin of Various Diseases and Its Causes, including Jaundice and Carbuncle" discusses this in detail: "Jelly and carbuncle are a chronic disease, which is different from jaundice which is an acute disease. In jaundice, the eyes are all yellow without swelling; in jaundice, the eyes are mostly swollen, yellow with white, and the eyes are normal, or the patient is listless. Although the root of the disease lies in the spleen, jaundice is caused by the accumulation of dampness and heat in the spleen meridians; in jaundice, the dampness and heat are not severe, but are caused by worms and food accumulation, and the patient will vomit yellow water, have straight hair, or like to eat raw rice, tea leaves, charcoal, etc." The key to distinguishing the two is the presence or absence of yellow eyes.