Jaundice causes your skin and sometimes the whites of your eyes to become yellow. Other jaundice symptoms include:
Jaundice can be caused by a benign (non-harmful) condition but it can also be a symptom of several serious conditions. You should therefore always see a doctor for a diagnosis and to investigate the underlying cause. The treatment and outcome of treatment will vary depending on the cause.
Jaundice occurs when your body has too much bilirubin, a yellow waste product expelled by your liver.
How is bilirubin made?
Bilirubin is made from the breakdown of red blood cells. Your red blood cells last for about 120 days before they are broken down into various waste chemicals. The part of your red blood cells which carries iron is called haemoglobin; haemoglobin is broken down into heme and bilirubin. This type of bilirubin (unconjugated bilirubin) can’t dissolve in water and is carried to your liver.
Your liver changes unconjugated bilirubin into conjugated bilirubin, which can dissolve in water. Conjugated bilirubin passes from your liver into your gallbladder via small tubes called bile ducts, where it becomes a part of your bile.
Your gallbladder stores bile and drips it into your small intestine to help digest fat in the food you have eaten. The bilirubin in bile is what causes your stools to be brown in colour.
When levels of conjugated or unconjugated bilirubin in your blood become too high, you develop jaundice. Bilirubin can then leak into your tissues, causing yellow skin and eyes (hyperbilirubinemia). If bilirubin levels become very high, instead of yellowing, your skin and eyes may start to appear brownish. Jaundice can be caused by a problem at any stage of bilirubin production.
Types of jaundice
There are three main types of jaundice:
There are a variety of health conditions that can cause jaundice, including:
Conditions that affect your red blood cells
If your red blood cells are broken down at a faster rate than normal, the bilirubin levels in your blood will rise, causing jaundice. Conditions that increase the rate of red blood cell breakdown include:
Conditions that affect your liver
Conditions that damage your liver can increase your bilirubin levels. In some cases, high bilirubin levels can then scar your liver (liver cirrhosis).
Liver conditions that can increase your bilirubin levels include:
Alcoholic liver disease can also cause jaundice.
Conditions that affect your bile ducts
The liver contains many small bile ducts which carry bile out of the liver via a larger bile duct called the common bile duct. If the small ducts are damaged or narrow, bile flow is reduced. This causes a backlog of bile which leaks into your bloodstream. As bile contains bilirubin, this causes jaundice.
Certain medications can damage or narrow your small bile ducts, as can the following conditions:
If your common bile duct is damaged or narrowed, you can also develop jaundice.
Gallstones are small, fatty lumps that form in your bile. They don't usually cause problems but can sometimes block the common bile duct, causing jaundice.
Certain types of cancer
Other jaundice causes
This is not caused by increased levels of bilirubin but by excess beta-carotene. It is not harmful and is usually caused by eating large amounts of foods high in beta-carotene eg carrots, melons and pumpkins.
One of the first symptoms of jaundice is often the whites of your eyes turning yellow. This can occur even if your bilirubin levels are only mildly raised and in this case, it may be the only area of your body that turns yellow. Higher bilirubin levels cause your skin to become yellow too.
If your jaundice is caused by an infection and is therefore short-term, you may also have:
If your jaundice is not caused by an infection, you may also have itchy skin (pruritus) and unintentional weight loss.
You are at greater risk of jaundice if you:
Pruritus ie itchy skin caused by jaundice can be so severe that you may develop insomnia and/or scratch your skin until it is raw.
In most cases, jaundice complications are not due to jaundice per se but the underlying condition that is causing jaundice. For example, if your jaundice is caused by a blocked bile duct, you may develop uncontrolled bleeding due to a lack of vitamins needed for clotting.
If your skin or the whites of your eyes look yellow, contact your GP immediately. As there are many causes of jaundice, your GP will need to ask you a lot of questions to investigate the underlying cause.
They will ask about any other jaundice symptoms, your general health and your medical history. They will also discuss your lifestyle, including any travel abroad, alcohol intake, diet and drug use.
They may perform a physical examination to check:
Your GP will also test your urine to check bilirubin levels and may do blood tests. If necessary, your GP will refer you for further investigations, such as an ultrasound scan or MRI scan of your liver.
In some cases, they may refer you for a liver biopsy. This is where a sample of your liver tissue is collected by inserting a needle into your liver. This tissue is sent to a lab and examined under a microscope to check for cancer, cirrhosis, inflammation and fatty liver.
Depending on your results, your GP may arrange for you to see a consultant. If the above tests are not conclusive, your doctor may recommend further tests.
Jaundice in adults requires prompt diagnosis and treatment for the underlying cause.
Once the cause of your jaundice has been diagnosed, your GP or consultant will arrange treatment for your underlying condition. This may involve medical or surgical treatment and, if needed, you’ll be admitted to hospital.
Jaundice has many different causes, so there are few general prevention tips. However, you can reduce your overall risk by:
Can jaundice be cured?
This depends on the underlying cause of your jaundice and how effectively it can be treated eg taking antibiotics to treat hepatitis-induced jaundice, taking iron tablets to treat anaemia-induced jaundice or having surgery to remove your gallbladder if your jaundice was caused by a gallstone.
Is jaundice a serious disease?
Jaundice can be serious if the underlying cause is a serious health condition, such as liver, pancreatic or gallbladder cancer, liver disease or liver cirrhosis.
How long can you live with jaundice?
Jaundice is not usually life-threatening and is usually the symptom of an underlying health condition that needs treatment. However, if you have chronic (long-term) jaundice, it can become fatal.
Which organ is affected by jaundice?
The main organ usually affected by jaundice is the liver. However, severe jaundice that goes untreated can affect other organs, such as the brain.
Does sunlight help jaundice?
In newborn babies with jaundice, a special type of light is used to change the bilirubin into a form that is more easily broken down by the liver (phototherapy). However, sunlight is not an effective treatment in adults.
What are signs your liver is bad?
Early symptoms of liver disease include fatigue, feeling generally unwell, loss of appetite, loss of muscle tone, unintentional weight loss, nausea and vomiting. You may also feel tenderness in your abdomen (near where your liver is located), have disturbed sleep and blotchy red palms.
At what stage of liver disease does jaundice occur?
Jaundice usually occurs in the advanced stages of liver failure. However, it is also a sign of acute liver failure.
Can you live a long life with liver disease?
Your life expectancy with liver disease depends on when you get treatment and the effectiveness of your treatment. Once you enter the final stage of liver disease or liver cirrhosis, your doctor will assess your liver function and can give you an idea of your life expectancy based on different assessment scores (CPT and MELD scores).
Can you recover from liver failure?
Liver failure can occur suddenly (acute) or come on gradually (chronic). In the early stages of either type, treatment and lifestyle changes can help your liver heal. However, in the late stages of liver failure, treatment does not offer a cure but can help relieve symptoms — at this point, a liver transplant is needed.