Jaundice, Abdominal Pain Require Quick Action
As hospitalists, we are always looking for diseases that could be potentially life threatening if not treated right away. For example, any patient that comes in with chest pain, we always want to make sure it is not a major heart attack.
Similarly, there are several life threatening conditions that can present with abdominal pain. Today, I will be talking about one specific type of abdominal pain that is easy to recognize but needs very specialized treatment.
There is one very specific symptom that is associated with this type of abdominal pain. These patients normally have a rapidly developing jaundice. Jaundice is a yellowish discoloration of the body. It is most prominent in the eyes. The white part of the eyes turn yellow. There are many different causes of jaundice but when it starts rapidly and comes together with the specific type of abdominal pain, there is a very high probability of this particular disease. The pain is mostly located on the right side of the stomach just below the rib case. One other feature of this disease is high fevers and chills.
If anyone develops pain in the right side of the stomach that is associated with rapid onset jaundice and high fevers, you need to think about this life threatening disease and need to seek medical attention right away.
The name of the disease is cholangitis. Literally, it means inflammation of bile ducts. Bile is a colorful liquid that is produced by the liver. In addition to several other functions, the main role of bile is to help with the digestion of fatty food. After being produced in the liver, it is stored in a small sac that is located on the right side of the liver just below the rib cage. When our body detects the presence of fat particles in the food, it causes this sac called "gall bladder" to contract and release the bile through a system of small pipes called bile ducts. These small bile ducts eventually form a bigger duct called the common bile duct which empties the bile into the top part of the intestine where it is needed.
This disease is triggered by obstruction of the path of bile flow. There can be several causes for it but the most common one is a small stone formed in the gall bladder that passes along with the bile only to obstruct the pipe down the line. Now the bile does not have anywhere to go and starts to flow back into the liver and into the veins. This is what causes the yellow discoloration. When its path is obstructed, it becomes stagnant and leads to infection.
If left untreated, it can rapidly cause the body to go into shock, and the blood circulation can collapse resulting in death.
Unfortunately, the treatment for this condition is not yet available in our community. We do not have a highly specialized doctor trained to use a piece of equipment specially designed for this purpose. When we suspect this disease, we start treatment with medications and provide temporary stability and then rush the patient to Omaha or Lincoln for this procedure called ERCP.
Like any other medical emergency, time is critical and late diagnosis decreases the chances of survival.
If you happen to see any of your friends or loved ones develop fever, yellow discoloration and belly pain, you can help save his/her life by rushing the patient to the emergency department to evaluate for possible cholangitis.
Nabin Sapkota, MD, is board certified in internal medicine and is a physician with the hospitalist program at Columbus Community Hospital. His book, "The Secrets of Modern Medicine Revealed" can be purchased online at www.medicinerevealed.com.
Learn more at: www.medicinerevealed.com
Story by: Dr. Nabin Sapkota of the Columbus Telegram
