A simple health check with the help of a stool color chart could save infants suffering from congenital biliary atresia from deadly liver damage, health officials said, adding that the Taiwan-developed chart has been adopted by many countries.
Since 2004, the Ministry of Health and Welfare has included the “Stool Check Chart” in its Children’s Health Manual to help parents and nurses determine, based on stool color, whether babies are affected with congenital biliary atresia, a disease of the bile ducts that only affects infants.
Bile is a digestive liquid that is made in the liver. It travels through the bile ducts to the small intestine, where it helps digest fats. In biliary atresia, the bile ducts become inflamed and blocked soon after birth. This causes bile to remain in the liver, where it starts to destroy liver cells, causing cirrhosis, or scarring of the liver.
In 2006, Taiwan established the world’s first reporting system for nationwide screening of biliary atresia, encouraging healthcare personnel at hospitals and clinics to perform the examination on 30-day-old infants by asking their parents or caregivers about the color of their babies’ stools.
Over the past decade, 300 infants have been found to have to have bile duct abnormalities and liver dysfunction through use of the stool color check, officials from the ministry’s Health Promotion Administration said.
The infants were treated and had bile drained, the officials said, adding that without such treatment, infant biliary atresia can easily develop into liver cirrhosis, which can lead to death within two years.
According to the HPA, about 200,000 babies are born in Taiwan every year, 30 to 40 of whom have biliary atresia.
National Taiwan University Hospital professor of pediatrics Chang Mei-hwei (張美惠), who in 2002 developed the chart with the administration, said that from 1976 to 2000 — before the chart had been distributed — the percentage of infants with biliary atresia who received the Kasai procedure — surgery to drain bile from the liver — within the first 60 days of birth was 35.6 percent.
The percentage increased to 65.8 percent in the period from 2004 until last year, Chang said.
Moreover, after tracking biliary atresia cases, the five-year survival rate of patients who have not received a liver transplant climbed from 37.5 percent in 1999-2000, before the circulation of the nine-color chart, to 64.3 percent in 2002-2005, Chang said.
The total five-year survival rate has surged from 55.7 percent to 89.3 percent, Chang added.
The results were published in the Journal of Hepatology in 2008, since when countries, including the US, the UK, Canada, New Zealand, Switzerland, the Netherlands, Oman, Thailand, Philippines, Malaysia, Israel and Mexico have asked to use the chart or conduct research on it, the ministry said.
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