Adult Jaundice

What is jaundice?

Jaundice (hyperbilirubinemia) is when your skin, sclera (whites of your eyes) and mucous membranes turn yellow. Jaundice occurs when your liver is unable to process bilirubin (a yellow substance made when red blood cells break down) in your blood. This can either be caused by too much red blood cell breakdown or liver injury.

How jaundice develops:

• Red blood cell breakdown: Your body regularly breaks down old red blood cells and replaces them with new ones. This breakdown process makes bilirubin.
• Bilirubin processing: Normally, your liver processes bilirubin, making it a part of bile (a bitter, greenish-brown fluid that helps digest food). Your liver then releases the bile into your digestive system.
• Too much bilirubin: Jaundice happens when your liver can’t process all the bilirubin your body makes, or if your liver has a problem releasing bilirubin.
• Yellow color: When there’s too much bilirubin in your blood, it starts to leak into tissues around your blood vessels. This leaking bilirubin makes your skin and the whites of your eyes yellow. This yellow color is a common sign of jaundice.

What causes jaundice?

Jaundice can result from a problem in any of the three phases of bilirubin:

• Before your liver processes bilirubin (prehepatic jaundice). This type of jaundice happens before your body makes bilirubin. Too much red blood cell breakdown takes over your liver’s ability to filter out bilirubin from your blood.
• During the production of bilirubin (hepatic jaundice). This type happens when your liver can’t remove enough bilirubin from your blood. Hepatic jaundice can happen if you have liver failure.
• After production of bilirubin (posthepatic jaundice). Also called obstructive jaundice, this type happens when a blockage stops bilirubin from draining into your bile ducts.

Conditions that cause jaundice include:

Prehepatic jaundice causes

• Breaking down a large hematoma (bruise) and then reabsorbing it back into your bloodstream.
• Hemolytic anemias (when blood cells are destroyed and removed from the bloodstream before their normal lifespan is over).

Hepatic jaundice causes

• Viruses, including hepatitis A, chronic hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis).
• Alcohol-induced hepatitis.
• Autoimmune disorders.
• Rare genetic metabolic defects.
• Medicines, including penicillin, oral contraceptives, chlorpromazine (Thorazine R), estrogenic or anabolic steroids and acetaminophen toxicity.

Posthepatic jaundice causes

• Gallstones.
• Inflammation (swelling) of your gallbladder.
• Gallbladder cancer.
• Pancreatic tumor.

How do you know if you have jaundice?

You may not notice the yellow skin and sclera associated with jaundice. Your provider may find the condition when looking for something else. How serious your symptoms are depends on what causes them and how quickly or slowly they develop.

Symptoms that can be associated with jaundice include:

• Yellowish tint to your skin and the whites of your eyes.
• Fever.
• Chills.
• Pain in your belly.
• Flu-like symptoms.
• Dark-colored pee.
• Pale-colored poop.
• Being tired or confused.
• Itchy skin.
• Weight loss.

How can my provider tell I have jaundice?

Your provider can tell if you have jaundice by measuring the bilirubin levels in your blood and seeing whether it’s the type of bilirubin related to red blood cell breakdown (unconjugated) or liver injury (conjugated). They may also check for other signs of liver disease, including:

• Bruising.
• Spider angiomas (abnormal collection of blood vessels near the surface of your skin).
• Palmar erythema (red palms and fingertips).

Your healthcare provider will also examine you to decide your liver’s size and tenderness. They may use imaging (ultrasound and CT scanning) and liver biopsy (taking a tissue sample of your liver) to better understand what’s causing your liver injury.

How is jaundice treated?

There’s no specific treatment for jaundice. But your provider can treat the cause and the jaundice should improve. They can also treat complications the condition causes. For example, if itchy skin is a problem, your provider can prescribe medication.

What are the risks of not treating jaundice?

It depends on what’s causing your jaundice. If it’s a virus, the virus could spread or become chronic. But if you have jaundice because your liver is failing, complications from your liver disease can include coma and death.

Can you prevent jaundice?

Since there are many causes of jaundice, it’s hard to find ways to prevent it. Some general tips include:

• Avoiding hepatitis infection by getting vaccinated, having safe sex, using clean needles and practicing good personal hygiene like thorough hand-washing with soap and water.
• Staying within recommended alcohol limits.
• Maintaining a weight that’s healthy for you.
• Avoiding natural and herbal supplements.
• Managing your cholesterol.

When should jaundice be treated by a doctor or healthcare provider?

A healthcare provider should evaluate jaundice. It’s a sign that something’s not right with your liver. If you notice signs of jaundice, call your healthcare provider.

Do children get jaundice?

Jaundice is common in newborn babies. Like with adults, a buildup of bilirubin in your baby’s blood can cause jaundice. Since your baby’s liver is still developing, it can’t remove (or break down) all the bilirubin. Jaundice usually goes away on its own or providers treat it with phototherapy.

A note from Cleveland Clinic

It might be scary to see your skin and the whites of your eyes turning yellow. Or it might happen so gradually that you don’t notice until people around you point it out. It’s normal to worry but try not to worry too much. Keep in mind that jaundice is a sign of another health problem. That means your healthcare provider must treat your main illness before it clears up.

Be sure to tell your provider what prescribed medications you’re taking. They may have to adjust the dosage or prescribe a substitute.

It’s also a good idea to ask your family and friends for support. They can handle daily chores to let you focus on getting well. Be sure to rest, eat balanced meals and drink plenty of fluids. Also, avoid any substance that strains your liver, like alcohol, herbal supplements or over-the-counter pain relievers.

If you don’t feel better by the time your provider gave you, make an appointment to see them again right away.