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EspañolWhat causes jaundice? Diagnosis, prevention, and treatment
Overview: What is jaundice?
Jaundice, which means “yellow,” is an accumulation of excess bilirubin in the body. Bilirubin is a waste product naturally produced from the breakdown of dead red blood cells. The liver normally removes bilirubin from the bloodstream and eliminates it through the bile ducts and out of the intestines. That means there are three ways bilirubin can build up in the bloodstream. It can go up if the body produces too much bilirubin for the liver to handle. It can also build up if the liver fails to remove it, usually because it is damaged or sick. It can also build up if the bile ducts are blocked. In that case, it has nowhere to go but back into the bloodstream.
High levels of bilirubin—called hyperbilirubinemia—will first turn the whites of the eyes a yellowish pigment, and then the skin will turn yellow to bright yellow. Jaundice is usually not a health threat unless bilirubin gets very high. Excessive bilirubin can cause nerve and brain damage, particularly in newborns. A normal serum bilirubin level would be less than 1 mg/dl. However, the first sign of jaundice, the yellowing of the eyes, is not usually visible until your bilirubin is above 3 mg/dl.
Even though it’s not a threat, jaundice may be a symptom of a serious or life-threatening medical condition. It’s a sign that medical help is needed.
Key takeaways:
Jaundice is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Jaundice is caused by excessive red blood cell death, liver disease, pancreas problems, bile obstruction, chronic alcohol use, autoimmune disorders, genetic conditions, drugs, toxins, and immature liver function (in newborns).
Risk factors for jaundice include age (newborns and seniors), chronic alcohol use, exposure to toxins, or certain prescription medications.
Symptoms of jaundice include yellowing of the skin, the whites of the eyes, and mucus membranes.
Jaundice usually requires a medical diagnosis.
Jaundice generally does require treatment. Depending on the cause, it may or may not resolve with treatment. In some cases, it will resolve without treatment.
Treatment of jaundice will be based on the underlying cause and could involve prescription medications, antiviral medications, or surgery. The jaundice itself is usually not treated except in newborns.
Lifestyle changes can prevent some causes of jaundice.
Save on prescriptions used to treat causes of jaundice with a SingleCare prescription discount card.
What causes jaundice?
Jaundice happens when something goes wrong with the body’s processing of bilirubin, a natural byproduct of the death of red blood cells. The body makes bilirubin every single day, about 250 mg worth. What can go wrong? Too many blood cells may die, or there may be other problems. The liver may be sick and unable to process bilirubin. The bile ducts may be blocked. Since there are so many places where the process can go wrong, there are various and unrelated causes of jaundice.
Blood problems that can cause jaundice include:
Hemolytic anemia
Blood cancers like polycythemia vera
Gilbert syndrome
Red blood cell enzyme or membrane disorders
Surgery
Blood leakage
Liver problems are the cause of 55% of jaundice cases. The most common include:
Viral hepatitis (hepatitis A, hepatitis B, and hepatitis C)
Alcoholic liver disease
Fatty liver
Liver cirrhosis
Autoimmune disorders such as autoimmune hepatitis
Genetic disorders such as Wilson’s disease
Liver cancers
Drug side effects
Poisons (toxic hepatitis)
Bile duct blockages can be due to:
Gallstones (14% of jaundice cases)
Pancreatic cancer
Gallbladder cancer
Strictures
Biliary atresia (in infants)
Infections including bacterial infections, HIV/AIDS, cytomegalovirus (CMV), and parasites
Risk factors for jaundice
The most common risk factors for developing a condition that causes jaundice include:
Extremely young age (newborns or infants)
Advancing age
A family history of jaundice or certain medical conditions that cause jaundice such as sickle cell disease
Use of certain prescription drugs
Exposure to toxins
Illicit drug use
Is jaundice serious? When to see a doctor
Jaundice can be a symptom of a serious illness, so see a doctor immediately if the skin or eyes start turning yellow. If there are other symptoms, such as fever, abdominal pain, dark urine, racing heartbeats, fast breathing, or a change in mental status, go to an emergency room.
RELATED: Jaundice symptoms: What are the early signs of jaundice?
How is jaundice diagnosed?
Jaundice is a symptom, not a medical condition. Diagnosis involves finding the cause. This will start with a thorough medical history and a physical examination.
The medical history is critical because it will help narrow the diagnostic focus. Be prepared to answer questions like:
When did the yellowing start?
How quickly did the yellowing happen? Days? Weeks?
Are there other symptoms?
Do you use any prescription or other drugs?
Do you drink?
Are you exposed to chemicals or other substances at home or at work?
Have you had contact with anyone else with jaundice?
Have you traveled recently? Where?
Have you recently had surgery?
What medical conditions do you have?
Do you have a family history of jaundice, liver disease, or blood disease?
Other symptoms are crucial for making the diagnosis, so make a list of all the symptoms you’re experiencing before seeing a doctor. Some might appear relevant, such as weight loss, fever, or abdominal pain. Some vitally important symptoms might seem unrelated but aren’t, such as itching, hives, or joint pain. Don’t leave anything out.
Drug and toxin exposure is also very important. Again, don’t leave anything out. It may not seem important, but tell the clinician about all prescription drugs, over-the-counter medications, and supplements being taken, including pain relievers and birth control pills. Regarding poisons, the list is topped by alcohol, so be honest about how much you drink.
Tests can confirm or zero in on a diagnosis, including complete blood count, other blood tests, urine tests, liver function tests, CT scans, MRI scans, or ultrasound scans. A liver biopsy may be necessary if a cause cannot be found.
RELATED: Understanding your liver panel tests
Is jaundice contagious?
Most causes of jaundice are not contagious. However, when an infection causes jaundice, that infection can be spread. The most common infectious cause of jaundice is viral hepatitis, particularly hepatitis C. This virus is spread through the feces. People contract the hepatitis virus through contaminated food, water, surfaces, and sexual contact. Parasite infections can also cause jaundice and are highly transmissible. However, these infections are uncommon in developed countries.
RELATED: Hepatitis 101: How to prevent and treat an infection
Is jaundice curable?
Jaundice is a symptom. It’s not treated, except in newborns, but the cause will be treated. Some causes are benign, some curable, and others not.
Some medical conditions, such as Gilbert syndrome, are benign and don’t require any treatment.
Some conditions get better on their own. For instance, jaundice in newborns will go away as their liver matures. Postoperative jaundice usually goes away over time without treatment.
Some curable conditions, such as gallstones or bile blockage, are usually handled with surgery.
Some conditions, like fatty liver, can be partly reversed with lifestyle changes.
Some conditions, such as liver cirrhosis, are chronic and lifelong problems.
Cancers such as pancreatic and gallbladder cancer have a high mortality rate even with treatment.
How to prevent jaundice
Since 55% of cases of adult jaundice are due to liver problems, the most effective way to prevent jaundice is to preserve liver health and liver function. Here’s what you can do:
Lose weight and maintain a healthy weight
Eat a healthy diet
Drink alcohol in moderation or not at all
Do not eat raw or uncooked shellfish
Limit your use of over-the-counter medications and be aware of medications such as acetaminophen that can damage the liver
Use medications as directed and never take more than the recommended or prescribed dose
Avoid unnecessary exposure to household or workplace organic chemicals or toxins such as bleach
Use a mask and wear gloves when around toxic chemicals, including many household chemicals
Quit smoking and avoid secondhand smoke
Do not use illicit drugs, and never share needles if you do
Practice safe sex
Get vaccinated for viral hepatitis
RELATED: Should you get the hepatitis A vaccine? | Should you get a hepatitis B vaccine?
Most importantly, see a doctor
When the eyes or skin turn a yellow color, see a healthcare provider as soon as possible. If the yellowing is due to hyperbilirubinemia, a serious medical condition may be causing it. Or it may mean nothing. You won’t know until a healthcare professional evaluates it. Many of the conditions that cause jaundice can be successfully treated. The most frightening and life-threatening conditions that cause jaundice—like cancer—can also be treated. However, earlier treatment of these more problematic conditions has a better prognosis than later treatment.
FAQs about jaundice causes
What causes jaundice in newborns?
Neonatal jaundice is common. Between 60% and 80% of newborn babies have jaundice in their first week, usually due to immature liver function, a typical condition called physiological jaundice. Eventually, the liver will fully mature, and the jaundice will clear up in a few days. For more severe newborn jaundice—called pathological jaundice—doctors will use treatments, such as phototherapy, to reduce bilirubin levels or, in an extreme case, an exchange transfusion.
What causes jaundice in older adults?
Jaundice in older adults can be due to all the exact causes of jaundice in younger adults. Bile obstruction, however, is more common in people over 40. Older adults are also likely to have decreased liver function simply due to age. Liver function in older adults may be more seriously compromised because of chronic alcohol use or long-term exposure to toxins.
Can dehydration cause yellow eyes?
Dehydration does not cause eye yellowing. High bilirubin levels do, and dehydration does not increase bilirubin levels in the bloodstream except in newborns, usually due to poor breastfeeding.
Dehydration can bring on jaundice in adults with Gilbert syndrome, an inherited defect in a single liver enzyme. It’s very common—about 3% to 7% of the population are born with this defect. Many people have no symptoms and don’t know they have the disease. However, some people have occasional and temporary bouts with jaundice. These can be brought on by dehydration. Other triggers include stress, exercise, infection, or drinking alcohol.
What’s next? Additional resources for people with jaundice
Test and diagnostics
Evaluation of jaundice in adults, American Family Physician
Jaundice, Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition
Jaundice, StatPearls
Jaundice symptoms: what are the early signs of jaundice?, SingleCare
Treatments
Cholestatic jaundice, StatPearls
Gilbert syndrome, National Organization for Rare Disorders (NORD)
Jaundice, StatPearls
Jaundice and your baby, American Family Physician
Scientific studies and clinical trials
Bilirubin chemistry and metabolism; harmful and protective aspects, Current Pharmaceutical Design
More information on related health conditions
Anemia treatments and medications, SingleCare
Gallstones treatments and medications, SingleCare
Hepatitis 101: how to prevent and treat an infection, SingleCare
Pancreatitis treatments and medications, SingleCare
What is sickle cell disease (and how is it treated)?, SingleCare