jaundice

Overview
Jaundice is a yellowing of the skin, eyes (sclera), and mucous membranes caused by an excess buildup of bilirubin, a yellow pigment formed when red blood cells break down. Normally, the liver processes bilirubin and helps eliminate it from the body through bile. When this process is disrupted, by liver disease, bile duct obstruction, or rapid red blood cell destruction, bilirubin accumulates, leading to visible discoloration. Jaundice itself is not a disease, but a symptom of an underlying condition.

Why It’s Important
Jaundice can signal serious liver or blood disorders, such as hepatitis, cirrhosis, gallstones, or hemolytic anemia. In newborns, jaundice is common and usually harmless, but in adults, it often indicates impaired liver function or bile flow obstruction that requires medical evaluation. Prompt diagnosis helps prevent complications like liver failure or brain damage (in newborns with severe jaundice).

Quick Facts

  • Caused by: Elevated bilirubin in the blood (hyperbilirubinemia)

  • Visible when: Bilirubin exceeds 2–3 mg/dL in the blood

  • Types:

    • Pre-hepatic: Excess breakdown of red blood cells

    • Hepatic: Liver cannot process bilirubin (e.g., hepatitis, cirrhosis)

    • Post-hepatic: Blockage of bile ducts (e.g., gallstones, tumors)

  • Common in: Newborns (physiologic jaundice) and adults with liver disease

  • Not contagious, but often linked to infections like hepatitis

What Happens in the Body
When old red blood cells are broken down, hemoglobin is converted into bilirubin. The liver normally conjugates (processes) bilirubin, making it water-soluble so it can be excreted in bile through the intestines. If any part of this process is disrupted, due to liver dysfunction, bile duct blockage, or excessive red blood cell breakdown, bilirubin levels rise in the bloodstream and deposit in tissues, causing the yellow coloration characteristic of jaundice.

Common Signs and Symptoms

  • Yellowing of skin and eyes

  • Dark urine (tea-colored)

  • Pale or clay-colored stool

  • Fatigue or weakness

  • Itching (pruritus)

  • Abdominal pain or swelling (if liver or gallbladder involved)

  • Nausea or loss of appetite

Diagnosis

  • Physical examination: Detects yellowing of skin and eyes

  • Blood tests:

    • Bilirubin levels (total and direct)

    • Liver function tests (LFTs)

    • Complete blood count (CBC)

  • Imaging: Ultrasound, CT, or MRI to check liver, gallbladder, and bile ducts

  • Additional tests: Hepatitis panel, Coombs test (for hemolysis), or biopsy if liver disease is suspected

Treatment and Management
Treatment depends on the underlying cause:

  • Pre-hepatic jaundice: Manage hemolytic disorders (e.g., anemia or infections).

  • Hepatic jaundice: Treat liver inflammation, viral infections (hepatitis), or avoid toxins/alcohol.

  • Post-hepatic jaundice: Remove blockages such as gallstones or tumors via surgery or endoscopy.

  • Newborn jaundice: Managed with phototherapy (light therapy) or exchange transfusion in severe cases.

  • Supportive measures include hydration, nutrient support, and avoiding alcohol or hepatotoxic drugs.

Risks and Complications

  • Chronic liver disease (cirrhosis, hepatitis progression)

  • Biliary obstruction leading to infection (cholangitis)

  • Hepatic encephalopathy (toxin buildup affecting the brain)

  • In newborns: Kernicterus, a rare but serious brain injury from excess bilirubin

  • Malnutrition and vitamin deficiencies in prolonged liver disease

Who Is at Risk

  • Individuals with liver disease (hepatitis, cirrhosis, fatty liver)

  • Heavy alcohol users

  • Newborns, especially premature infants

  • People with gallstones or pancreatic cancer

  • Those taking hepatotoxic drugs (certain antibiotics, acetaminophen overdose)

  • People exposed to hepatitis viruses or parasites

Related Conditions

  • Hepatitis (A, B, C, D, E)

  • Gallstones or bile duct obstruction

  • Hemolytic anemia

  • Cirrhosis

  • Gilbert’s syndrome (a benign liver condition)

When to See a Doctor
Seek immediate medical attention if you experience:

  • Sudden yellowing of skin or eyes

  • Dark urine or pale stool

  • Severe abdominal pain or vomiting

  • Confusion, fatigue, or swelling in the abdomen or legs

  • Persistent jaundice in newborns beyond two weeks
    Prompt evaluation is crucial to identify and treat the underlying cause before complications develop.

Last Updated: October 5, 2025