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 tissues of the body.
The most common signs of jaundice are:
Always seek immediate medical advice if you develop the above signs of jaundice. They are an important warning sign that something is wrong with the normal processes of your body.
Speak to your doctor as soon as possible. If this isn't possible, contact your local out-of-hours service.
There are three types of jaundice, depending on what is causing disruption to the normal removal of bilirubin from the body.
The three main types of jaundice are described below.
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.
Certain lifestyle changes may help to prevent jaundice. For example, maintaining a healthy weight, managing how much alcohol you drink and minimising your risk of hepatitis.
Read more about preventing jaundice.
Treatment for jaundice in adults and older children depends on the underlying condition that's causing it.
Following tests to determine the cause of jaundice, the appropriate treatment will be recommended.
Read more about diagnosing jaundice.
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 then out of the body (see below) can cause jaundice.
Bilirubin is a waste product that's produced when red blood cells break down.
The bilirubin is transported in the bloodstream to the liver where specialised cells help to combine it with digestive fluid called bile.
The bile (and bilirubin) is converted by bacteria inside the digestive system into a substance called urobilinogen, which is passed out of the body in urine or in stools. It is bilirubin that gives urine its light yellow colour and stools their dark brown colour.
There are three types of jaundice, depending on what is affecting the movement of bilirubin out of the body.
The causes of each type of jaundice are described below.
Causes of pre-hepatic jaundice include:
Causes of intra-hepatic jaundice include:
Causes of post-hepatic jaundice include:
If you have jaundice, you'll have a number of initial tests to find out how severe it is and to determine the underlying cause.
These tests are described below.
It's likely that your doctor or the clinician in charge of your hospital care will want to take a detailed medical history in case it could provide clues as to why you have jaundice.
You may be asked whether:
It's likely that you'll also be given a physical examination to check for signs of an underlying condition, such as:
A urine test can be used to measure levels of a substance called urobilinogen. Urobilinogen is produced when bacteria break down bilirubin inside the digestive system.
Higher-than-expected levels of urobilinogen in your urine may suggest a diagnosis of pre-hepatic jaundice or intra-hepatic jaundice. Lower levels could suggest post-hepatic jaundice.
A liver function test is a type of blood test that can be 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 drop.
By measuring the levels of these enzymes and proteins, it's possible to build up a reasonably accurate picture of how well the liver is functioning.
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.
If it's suspected that your liver has been damaged by a condition such as cirrhosis or liver cancer, a liver biopsy may be recommended to assess the condition of the liver tissue.
During a liver biopsy, your abdomen (tummy) is numbed with a local anaesthetic (painkilling medication) 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 each of 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 the level of bilirubin to build up in the blood.
In cases of infections, such as malaria, the use of 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 the condition isn't particularly serious and doesn't pose a serious threat to health.
In cases of intra-hepatic jaundice, there's little that can be done to repair any liver damage, although the liver can often repair itself over time. Therefore, the aim of treatment is to prevent any further liver damage occurring.
For liver damage that's 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 due to exposure to harmful substances, such as alcohol or chemicals, avoiding any 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 is recommended to unblock the bile duct system.
During surgery, it may also be necessary to remove:
See the following topics for more information:
Due to the wide range of potential causes, it's not possible to prevent all cases of jaundice. However, you can take precautions to minimise your risk of developing jaundice.
These precautions include:
More information about each precaution is provided below.
Giving up drinking alcohol altogether is the most effective way of reducing your risk of developing jaundice, particularly if you've been drinking for many years.
As a minimum preventative measure, stick to the recommended daily amounts for alcohol consumption. The recommended daily amounts are:
A unit of alcohol is approximately equal to half a pint of normal-strength lager, a small glass of wine or a single measure (25ml) of spirits.
Many experts would recommend that as well as sticking to the recommended daily amounts, you also spend 2-3 days not drinking any alcohol.
Visit your doctor if you're finding it difficult to moderate your alcohol consumption. Counselling services and medication are available to help you reduce your alcohol intake.
Obesity and the resulting damage it can sometimes cause to the liver (non-alcoholic fatty liver disease) is an often-overlooked cause of cirrhosis (scarring of the liver) and jaundice. Therefore, achieving and maintaining a healthy weight is an effective way of preventing jaundice.
In addition, a diet that's high in fat can increase your blood cholesterol level, which in turn will also raise your risk of developing gallstones.
The most successful weight loss programmes include at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. cycling or fast walking) every week, eating smaller portions and only having healthy snacks in between meals. A gradual weight loss of around 0.5kg (1.1lbs) a week is usually recommended.
Read more about the treatment of obesity.
Vaccination is usually only recommended if you're travelling to parts of the world that are known to have high levels of both conditions. You may also be advised to have a vaccination if your job or lifestyle increases your risk of exposure to either type of virus.
For example, vaccination for hepatitis A is recommended for:
Vaccination for hepatitis B is recommended for:
Read more information and advice about preventing hepatitis A and preventing hepatitis B.
If you regularly inject drugs, such as heroin, the best way to avoid getting a hepatitis C infection is to not share any of your drug-injecting equipment with others. This doesn't just apply to needles but also to anything that could come into contact with other people's blood, such as:
As hepatitis C doesn't cause any noticeable symptoms for many years, many people may not realise that they're infected. It's therefore safer to assume that anyone may have the infection.
Even if you're not a drug user, it's important to take some common sense precautions to minimise your exposure to other people’s blood, such as avoiding sharing any object that could be contaminated with blood, such as razors and toothbrushes.
There's less risk of developing hepatitis C by having sex with someone who is infected, but as a precaution it's recommended that you use a barrier method of contraception, such as a condom.
It may also be possible to get hepatitis C by sharing banknotes or ‘snorting tubes’ with an infected person to snort drugs, such as cocaine or amphetamine. These types of drugs can irritate the lining of the nose, and small particles of contaminated blood could be passed on to the note or tube, which you could then inhale.
See Hepatitis C, get tested, get treated for more information and advice about hepatitis C.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.