Health A to Z
Jaundice is a term used to describe the yellowing of the skin and the whites of the eyes.
It's caused by a build-up of a substance called bilirubin in the blood and body's tissues.
The most common signs of jaundice are:
Always seek immediate medical advice if you develop the above signs of jaundice. They're a warning sign that something is wrong with the normal processes of your body.
There are three types of jaundice depending on what's disrupting the normal removal of bilirubin from the body. They are:
Read more about the causes of jaundice.
Intra-hepatic and post-hepatic jaundice are more common in middle-aged and elderly people than in the young. Pre-hepatic jaundice can affect people of all ages, including children.
If you have jaundice, you'll have a number of tests to find out how severe it is and determine the underlying cause.
You'll probably have a urine test and liver function and blood tests. If intra-hepatic jaundice or post-hepatic jaundice is suspected, it's often possible to confirm the diagnosis using imaging tests to check for abnormalities inside the liver or bile duct systems.
Read more about diagnosing jaundice.
Treatment for jaundice in adults and older children depends on what's causing it. This may involve treating the underlying condition, a blood transfusion or surgery.
Read more about treating jaundice.
It's not possible to prevent all cases of jaundice because it can be caused by a wide range of conditions or circumstances.
However, you can take precautions to minimise your risk of developing jaundice. These include:
Jaundice is caused by a build-up of a substance called bilirubin in the blood and tissues of the body.
Any condition that disrupts the movement of bilirubin from the blood to the liver and out of the body can cause jaundice.
Bilirubin is a waste product created when red blood cells break down. It's transported in the bloodstream to the liver, where it's combined with a digestive fluid called bile.
This eventually passes out of the body in urine or stools. It's bilirubin that gives urine its light yellow colour and stools their dark brown colour.
There are three types of jaundice, depending on what's affecting the movement of bilirubin out of the body.
Pre-hepatic jaundice occurs when a condition or infection speeds up the breakdown of red blood cells. This causes bilirubin levels in the blood to increase, triggering jaundice.
Causes of pre-hepatic jaundice include:
Intra-hepatic jaundice happens when a problem in the liver – for example, damage due to infection or alcohol, disrupts the liver’s ability to process bilirubin.
Causes of intra-hepatic jaundice include:
Post-hepatic jaundice is triggered when the bile duct system is damaged, inflamed or obstructed, which results in the gallbladder being unable to move bile into the digestive system.
Causes of post-hepatic jaundice include:
Some causes of jaundice are common, such as hepatitis and gallstones, whereas other causes, such as Crigler-Najjar syndrome and Dubin-Johnson syndrome, are much rarer.
If you have jaundice, you'll have a number of initial tests to find out how severe it is and determine the underlying cause.
It's likely your GP or hospital doctor will take a detailed medical history to try to determine why you have jaundice.
You may be asked whether:
It's likely you'll also have a physical examination to check for signs of an underlying condition, such as swelling of the legs, ankles and feet (a possible sign of cirrhosis), or a noticeable swelling of your liver (a possible sign of hepatitis)
A urine test can be used to measure levels of a substance called urobilinogen. It's produced when bacteria break down bilirubin inside the digestive system.
Higher-than-expected levels of urobilinogen in your urine may suggest pre-hepatic jaundice or intra-hepatic jaundice. Lower levels could suggest post-hepatic jaundice.
A liver function test is a type of blood test used to help diagnose certain liver conditions including:
When the liver is damaged it releases enzymes into the blood. At the same time, levels of proteins that the liver produces to keep the body healthy begin to fall.
By measuring the levels of these enzymes and proteins, it's possible to build up a picture of how well the liver is functioning. In addition, your blood can be tested for infections known to trigger jaundice, such as malaria and hepatitis C.
If intra-hepatic jaundice or post-hepatic jaundice is suspected, imaging tests can be used to check for abnormalities inside the liver or bile duct systems. These include:
A biopsy may be recommended to assess the condition of the liver tissue if it may have been damaged by a condition such as cirrhosis or liver cancer.
During a liver biopsy, your tummy is numbed with a local anaesthetic, and a fine needle is inserted so that a small sample of liver cells can be taken and sent to a laboratory for examination under a microscope.
There are many possible treatments for jaundice, depending on the underlying cause.
A general overview of the recommended treatment plans for the main types of jaundice is outlined below, including links to more detailed information.
In treating pre-hepatic jaundice, the objective is to prevent the rapid breakdown of red blood cells that's causing bilirubin levels to build up in the blood.
In cases where pre-hepatic jaundice has been caused by an infection, such as malaria, medication to treat the underlying infection is usually recommended. For genetic blood disorders, such as sickle cell anaemia or thalassaemia, blood transfusions may be required to replace the red blood cells.
Gilbert's syndrome doesn't usually require treatment because the jaundice associated with it isn't particularly serious and doesn't pose a serious threat to health.
In cases of intra-hepatic jaundice, little can be done to repair any liver damage, although the liver can often repair itself over time. The aim of treatment is to prevent further liver damage.
For liver damage caused by infection, such as viral hepatitis or glandular fever, anti-viral medications may be used to help prevent further damage.
If the damage is caused by alcohol or exposure to harmful substances, reducing alcohol consumption or avoiding further exposure to the substance is recommended.
In severe cases of liver disease, a liver transplant is another possible option. However, only a small number of people are suitable candidates for a transplant and the availability of donated livers is limited.
See the following topics for more information:
In most cases of post-hepatic jaundice, surgery to unblock the bile duct system is recommended.
During surgery, it may also be necessary to remove:
See the following topics for more information: