15367 Adult Jaundice

Overview

Jaundice is yellowing of the skin and the whites of the eyes. It happens when a yellow substance called bilirubin builds up in the blood. Bilirubin is made when old red blood cells are broken down. The liver normally processes it and removes it from the body. Jaundice is not a disease itself. It is a sign that something is affecting the liver, the bile ducts, or the breakdown of red blood cells.

Jaundice is common in newborn babies, but it is much less common in adults. In adults, it is an important sign that should always be checked by a healthcare professional.

Jaundice can affect any adult. It is more likely in people with liver disease, gallstones, certain blood disorders, heavy alcohol use, some infections, or who take certain medicines. It can also happen after travel to areas where hepatitis is common.

Symptoms

Common symptoms

• Yellowing of the skin and the whites of the eyes
• Dark urine that may look like tea or cola
• Pale or clay-coloured stools
• Itchy skin
• Feeling very tired or weak
• Feeling sick or being sick
• Pain or discomfort in the upper belly
• Loss of appetite or weight loss

Symptoms in children

• This article is about adults. In children, yellow skin or eyes should always be checked by a doctor, because causes and tests can be different.
• In babies, jaundice is common but needs review, especially if the baby is very sleepy, feeds poorly, or looks unwell.

Symptoms in older adults

• Yellowing may be harder to notice, especially on darker skin; check the eyes and gums.
• Confusion, new weakness, or falls can be signs of infection or liver problems.
• Appetite loss and dehydration can make symptoms worse.
• Fever or shaking chills need urgent medical advice.

Causes

Main causes

• Liver inflammation, such as from viral hepatitis, alcohol, or autoimmune conditions
• Liver disease, including cirrhosis
• Gallstones or other blockages in the bile ducts
• Blood disorders that break down red blood cells too quickly
• Certain medicines or herbal products that affect the liver
• Infections, including some that are more common in certain parts of the world
• Cancer of the liver, pancreas, or gallbladder
• Gilbert's syndrome, a common and usually harmless condition that can cause mild jaundice

Risk factors

• Heavy or long-term alcohol use
• Viral hepatitis infection or close contact with someone who has it
• Family history of liver disease or blood disorders
• Gallstones or a history of gallstone problems
• Obesity or diabetes
• Taking certain medicines or herbal supplements
• Travel to areas where hepatitis is common
• Unprotected sex or sharing needles

When to see a doctor

See a doctor urgently if:

• You notice new yellowing of your skin or eyes
• You have fever, severe belly pain, or vomiting with jaundice
• You have black stools, vomit blood, or unusual bleeding or bruising
• You feel confused, very sleepy, or much weaker than usual
• You cannot keep fluids down

Book a routine appointment if:

• You have dark urine or pale stools without an obvious reason
• You feel very tired, itchy, or have lost weight without trying
• You have risk factors for liver disease, such as heavy alcohol use or viral hepatitis
• You have been told before that your liver tests were abnormal

Diagnosis

Your doctor will ask about your symptoms, health history, alcohol use, medicines, travel, and any possible contact with hepatitis. They will examine you, including checking your eyes and skin. Blood and urine tests are usually the first step. Sometimes scans or special tests are needed to look at the liver and bile ducts.

Tests that may be done

• Blood tests to check liver function and bilirubin levels
• Full blood count to look for anaemia or blood disorders
• Tests for viral hepatitis and other infections
• Urine tests
• Ultrasound scan of the liver and bile ducts
• CT or MRI scan if more detail is needed
• A camera test called endoscopy or ERCP to look at or open the bile ducts
• Liver biopsy in some cases, where a tiny sample of liver is checked

What to expect at your appointment

You may need more than one visit or test. Some tests need you to fast (not eat) for a few hours beforehand. Ask your doctor or nurse what each test is for and how long results may take. Write down your questions so you can ask them at your appointment.

Treatment

Treatment depends on the cause of jaundice. Your doctor will first find out why bilirubin is building up. Some causes need only monitoring, while others need specific treatment. In all cases, the goal is to treat the underlying problem and protect your liver.

Self-care at home

• Avoid alcohol completely until your doctor says it is safe
• Do not start new medicines, herbal remedies, or supplements without asking your doctor or pharmacist
• Rest and drink enough fluids
• Eat regular, balanced meals and avoid long periods without food
• Keep a note of your symptoms and any changes
• Attend all follow-up appointments and tests

Medical treatments

Your doctor may stop a medicine that is affecting your liver, treat an infection, or manage a liver condition. If a bile duct is blocked, a procedure may be used to open it. You may be referred to a liver or digestive specialist. Treatment is always tailored to your specific cause and needs.

When is surgery considered?

Surgery or a camera procedure may be needed if a gallstone, scar tissue, or growth is blocking the bile ducts. Your specialist will explain the benefits, risks, and other options before any procedure.

Living with this condition

Jaundice can make you feel tired and uncomfortable. Follow your healthcare team's advice, go to your appointments, and tell them if symptoms change. It can help to plan rest into your day and ask family or friends for practical support.

Lifestyle tips

• Avoid alcohol, especially if you have liver disease
• Maintain a healthy weight through balanced eating and gentle activity
• Practise safe sex and never share needles
• Ask your doctor about hepatitis vaccination if you are at risk
• Avoid contact with household chemicals or toxins that can harm the liver
• Tell your doctor or pharmacist about all medicines and supplements you take

Diet and exercise

There is no single special diet for jaundice. A balanced diet with plenty of vegetables, fruit, whole grains, and lean protein is good for general health. Gentle exercise, such as walking, can help you feel better if you are able. Ask your doctor if you need a special diet for your liver condition.

Mental health and emotional wellbeing

Jaundice and the tests that follow can feel worrying. It is normal to feel anxious or low. Talk to your doctor, a trusted friend, or your family. If worry is overwhelming or you have thoughts of harming yourself, contact your local emergency number or a crisis support service right away.

Prevention

Some causes of jaundice can be prevented or their risk lowered, but not all. You can reduce your risk by limiting alcohol, avoiding viral hepatitis, maintaining a healthy weight, and reviewing medicines with your doctor.

Vaccines

Vaccines are available for hepatitis A and hepatitis B. Ask your doctor or pharmacist whether they are recommended for you, especially if you travel, work in healthcare, or have other risk factors.

Screening programmes

There is no general screening test for jaundice. If you have risk factors for liver disease, your doctor may suggest liver blood tests. Pregnant women and newborn babies are routinely checked for jaundice in many health systems.

Complications

If left untreated

• Liver failure, where the liver stops working properly
• Serious infection
• Bleeding problems
• Kidney problems
• Long-term liver disease or liver cancer if the cause is not treated

Long-term outlook

Most causes of jaundice can be treated or managed. Early review helps find the cause and start the right care. Many people recover well, and long-term liver conditions can often be controlled with the right support. Your healthcare team will explain what to expect for your situation.

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