Jaundice is a sign, and the cause is what matters.
Jaundice is yellowness of the eyes and skin, from a build-up of bilirubin, a yellow pigment. It is not an illness on its own: it tells you something is wrong in the blood, the liver or the bile ducts. Most causes can be treated, and some need hospital care quickly.
In plain words.
Bilirubin is made every day as old red cells are broken down. The liver takes it up and sends it out in bile, through the bile duct into the gut, where it colours the stool brown. Jaundice appears when this route is overwhelmed or blocked anywhere along the way.
In the liver. Viral hepatitis is the commonest cause: hepatitis A and E come from dirty water or food and usually settle on their own in a few weeks; hepatitis B and C can last. Alcohol, some medicines (TB medicines, some antibiotics, herbal remedies) and a scarred liver can also cause it.
In the bile duct. A gallstone stuck in the duct, or less often a narrowing or a growth in the duct or the pancreas. Bile backs up: the urine goes dark, the stools turn pale and the skin itches. Jaundice without pain, especially with weight loss in an older person, needs scans promptly.
Before the liver. Red cells breaking down too fast, as in malaria or some inherited blood conditions. And in Gilbert's syndrome, a harmless inherited quirk, the bilirubin rises a little with fasting or illness while the rest of the LFT stays normal.
There is no need to avoid turmeric, oil or any particular food. Eat normal, freshly cooked meals and drink clean water. Herbal jaundice remedies and charms can delay proper care, and some herbs harm the liver.
Where the yellow comes from
Old red cells are broken down into yellow bilirubin. The liver takes it up and sends it out in bile, down the bile duct into the gut, where it turns the stool brown. The eyes stay white.
When the liver is inflamed, most often by a hepatitis virus, alcohol or a medicine, it cannot clear the bilirubin. It builds up in the blood: the eyes turn yellow and the urine goes dark.
A stone or a growth blocks the bile duct. Bile backs up into the blood: yellow eyes, dark urine and itching, while the stools turn pale because no bile reaches the gut.
Go to hospital now if
- Yellowness with drowsiness, confusion or unusual behaviour: go to hospital now.
- Vomiting blood, or black, tarry stools: go to hospital now; call 112 if you feel faint.
- Any yellowness during pregnancy: go to hospital now.
- Yellowness with high fever and shivering, severe tummy pain, or passing very little urine: go to hospital now.
- Yellowness with bleeding gums, nosebleeds or easy bruising: go to hospital now.
- Yellowness with vomiting, and unable to keep fluids down: go to hospital now.
- A baby yellow in the first day of life, or a yellow newborn who is feeding poorly or very sleepy: go to hospital now.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
See a doctor the same day if
- You notice yellow eyes or dark urine for the first time
- Your stools turn pale, or you itch all over
- You are on TB medicines, or have started any new medicine, and your eyes turn yellow: do not take the next dose until a doctor has seen you and checked your LFT
- A newborn baby looks yellow
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Bilirubin with a full LFT | Confirms jaundice; the pattern points to the blood, the liver or the bile duct. |
| Ultrasound of the abdomen | Looks for stones, widened bile ducts (a sign of blockage) and the texture of the liver. |
| Hepatitis A, B, C and E tests | The viruses behind most jaundice. |
| INR (clotting test) and albumin | How well the liver is working; a rising INR is a danger sign. |
| Blood count, and a malaria test with fever | Look for red cells breaking down too fast. |
| MRCP, CT scan or endoscopic ultrasound | When the duct looks blocked, to find what is blocking it. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Jaundice looks the same whatever its cause, so the tests matter more than the colour. Do not wait on home remedies or charms for it to settle, and never give a yellow newborn anything without a doctor's advice.
A video call can
- Read your reports and judge how urgent it is
- Arrange the tests that find the cause
- Guide care at home for mild viral hepatitis, with regular tests
- Go through your medicines, and refer to a specialist when needed
Needs a visit in person
- Blood tests and the ultrasound
- Removing a stone from the bile duct by endoscopy (ERCP), or surgery
- Hospital care if the liver is failing
- Any sign in the red box: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759