Jaundice, also referred to as icterus, is the yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment, bilirubin. The yellowing extends to other tissues and body fluids and also may turn the urine dark. Yellowing of only the skin also can be caused by eating too many carrots or drinking too much carrot juice.
The bile pigment, bilirubin, comes from red blood cells. When old red blood cells are destroyed by the body (a normal process), the oxygen-carrying molecule within the cells, hemoglobin, is released into the blood. The hemoglobin is rapidly converted to bilirubin in the blood. The bilirubin is removed from the blood by the liver, modified, and excreted into the bile. The bile flows into the intestine so that the bilirubin is eliminated in the stool. (It is bilirubin that gives stool its brown color.) Jaundice can occur whenever this normal process of destruction of red blood cells and elimination of bilirubin is interrupted. This occurs when there is abnormally increased destruction of red blood cells (hemolysis), liver disease that reduces the ability of the liver to remove and modify bilirubin, or obstruction to the flow of bile into the intestine.
Other causes of jaundice
- Autoimmune Hepatitis
- Hemolytic Anemia (Including Spherocytosis, Glucose-6-Phosphate Dehydrogenase Deficiency)
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Causes of Jaundice
Acute and Chronic Pancreatitis
Pancreatitis is a rare disease in which the pancreas becomes inflamed. There are two types of pancreatitis: acute and chronic. Symptoms of pancreatitis include abdominal pain, fever, nausea, vomiting, and a rapid pulse. Treatment of pancreatitis often requires hospitalization.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
Bile Duct Cancer (Cholangiocarcinoma)
Bile duct cancer (cholangiocarcinoma) is a rare type of cancer that arises from cells that line the drainage system from the liver and gallbladder to the intestine. Symptoms of bile duct cancer include jaundice, itching, weight loss, and abdominal pain. Physical examination, specialized blood tests, and imaging tests may be used to diagnose bile duct cancer. Treatment for bile duct cancer may include chemotherapy, radiation therapy, and photodynamic therapy. Bile duct cancer typically has a poor prognosis. Preventing liver damage may decrease the risk of developing bile duct cancer.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin (jaundice), itching, and fatigue. The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
Cytomegalovirus (CMV) is a virus that is spread from person to person via spit, semen, vaginal secretions, urine, blood, sexual contact, breastfeeding, blood transfusions, organ transplants, and breast milk. Symptoms of CMV include fatigue, swollen glands, fever, and sore throat. You can take precautions to prevent CMV such as washing hands frequently and thoroughly and using condoms. If you work in a day care center, wash your hands thoroughly after contact with body secretions, and avoid oral contact with objects covered in saliva. Individuals with HIV infection are at most risk of contracting CMV.
Epstein-Barr Virus (EBV)
The Epstein-Barr virus (EBV) is a common cause of mononucleosis (viral pharyngitis). Symptoms and signs of an EBV infection include swollen lymph nodes, fever, rash, sore throat, malaise, and a swollen liver and/or spleen. Treatment focuses on reducing the severity of the symptoms and signs. There is no vaccine to prevent EBV infections.
Gallbladder cancer is a rare form of cancer with symptoms that include jaundice, abdominal pain, fever, nausea and vomiting, abdominal lumps, and bloating. Risk factors include being female and Native American. Treatment of gallbladder cancer depends upon the stage of the cancer, the type of gallbladder cancer, and whether the cancer can be removed by surgery.
Gallstones (Pain, Symptoms, Causes, Diet, and Treatment)
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause signs or symptoms; however, when they do occur the primary sign is biliary colic. Symptoms of biliary colic are constant pain for 15 minutes to 4-5 hours, and it may vary in intensity; nausea, severe pain that does not worsen with movement; and pain beneath the sternum. Treatment of gallstones depends upon the patient and the clinical situation.
Gilbert syndrome is a benign genetic condition that causes abnormal breakdown of bilirubin, a compound that is formed when hemoglobin from red blood cells degrades. Elevated bilirubin can cause, jaundice, which is yellowing of the eyes. Gilbert syndrome does not need to be treated and has a good prognosis.
Graft Versus Host Disease (GVHD)
Graft versus host disease (GVHD) is a condition that happens when immune cells from transplanted donor tissue attack the recipient's tissues. Signs and symptoms of acute GVHD include enteritis, hepatitis, and dermatitis. Chronic GVHD symptoms and signs include rash, skin discoloration, dry mouth or eyes, jaundice, fatigue, and wheezing, among others. The standard of GVHD treatment is immunosuppressant medications.
Hepatitis (Viral Hepatitis A, B, C, D, E, G)
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu-like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependent on the type of hepatitis.
Hepatitis B (HBV, Hep B)
The hepatitis B virus (HBV, hep B) is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Hepatitis C (HCV, Hep C)
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by blood transfusion, hemodialysis, and needle sticks, especially with intravenous drug abuse. Symptoms of chronic hepatitis include fatigue, fever, muscle aches, loss of appetite, and fever. Chronic hepatitis C may be cured in most individuals with drugs that target specific genomes of hepatitis C.
Hepatitis E Viral Infection
Hepatitis E (hep E) is a type of hepatitis viral infection that includes hepatitis A, B, C, D, F, which is caused by the hepatitis E virus. Usually, you get (transmitted) hepatitis E from eating or drinking dirty or contaminated water. Hepatitis E can be very serious, especially if a woman is pregnant. Up to ¼ of women who are pregnant with the hep E virus can die from the infection. The signs and symptoms of hepatitis E infection are nausea and vomiting, brown or dark urine, stool changes jaundice (yellow eyes and skin), pain in the right side of the abdomen, dark or brown urine, and light-colored stool. Some people with hep E don’t have any symptoms so they don’t know that they are contagious. It takes about 6 weeks to recover from hep E. A person who has any type of hepatitis, including hepatitis E, should not drink any alcohol. Hep E complications are rare, but when they do occur they include severe (“fulminant”) hepatitis, liver failure, and death. Currently, no specific drugs or treatments are available for hepatitis E. Moreover, the only hepatitis E vaccine currently is available in China. Avoid alcohol, keep hydrated, and getting rest are home remedies for hepatitis E. Talk to your doctor before taking any over-the-counter (medications), especially those containing acetaminophen (Tylenol and others). Usually, the prognosis and life expectancy for hepatitis E after recovery is good. Most people do not have long term liver problems from the infection.
Human Immunodeficiency Virus (HIV)
HIV (human immunodeficiency virus) infection left untreated causes AIDS (acquired immunodeficiency syndrome). Still incurable, AIDS describes immune system collapse that opens the way for opportunistic infections and cancers to kill the patient. Early symptoms and signs of HIV infection include flu-like symptoms and fungal infections, but some people may not show any symptoms for years. Highly active antiretroviral therapy (ART) is the standard treatment for HIV infection. These combination drug regimens have made HIV much less deadly, but a cure or vaccine for the pandemic remains out of reach. HIV is usually transmitted through sexual contact or sharing IV drug needles, but can also infect someone through contact with infected blood. Sexual abstinence, safe sex practices, quitting IV drugs (or at least using clean needles), and proper safety equipment by clinicians and first responders can drastically reduce transmission rates for HIV/AIDS.
Jaundice (Newborn, Kernicterus)
Jaundice in infants occur when the baby's liver may not be developed enough to efficiently rid the body of bilirubin. Symptoms of jaundice include yellowish colored eyes, and yellowing of the skin. Some babies are more at risk to develop jaundice. Kernicterus is a type of brain damage that occurs when a baby has jaundice and is not treated. Treatment of infant jaundice is generally with phototherapy so that kernicterus should not develop.
Leptospirosis is an infectious disease that causes symptoms such as fever, headache, and chills. Treatment for leptospirosis requires antibiotics.
Liver cancer is cancer of the liver cells (hepatocellular carcinoma) or of the ducts in the liver (cholangiocarcinoma). Liver cancer often arises due to liver damage, cirrhosis (scarring) caused by alcohol use/abuse, hepatitis B, or hepatitis C. Liver cancer may not cause any symptoms. Liver cancer is diagnosed with blood tests, imaging tests, and a liver biopsy. Treatment for liver cancer may include surgery, ablation, embolization, radiation, chemotherapy, and targeted therapy.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Malaria is a disease that is spread by the bite of an infected Anopheles mosquito. Malaria symptoms include fever, chills, nausea, vomiting, and body aches. Treatment involves supportive care and antibiotics.
Marburg Virus Disease
Marburg virus disease is a zoonotic infection that produces symptoms such as chills, headaches, fever, and muscle aches. The treatment for Marburg virus disease involves supportive care. Barrier and isolation techniques are the best preventive measures for Marburg infections.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause early symptoms. Typically, pancreatic cancer has metastasized (spread to adjacent organs, such as the liver) by the time most people receive a dignosis of pancreatic cancer. Symptoms and signs usually appear later in the course of the disease and include jaundice, back pain, nausea, weight loss, itching, and loss of appetite. Treatment depends upon the type of pancreatic cancer but may include surgery, chemotherapy, and/or radiation therapy.
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
There are many types of pancreatic neuroendocrine tumors (NETs): gastrinoma, insulinoma, glucagonoma, VIPomas, and somatostatinomas. Symptoms and signs vary with the type of pancreatic NET. Standard treatments include surgery, chemotherapy, hormone therapy, chemoembolization, targeted therapy, and supportive care.
Pregnancy (Week by Week, Trimesters)
Signs and symptoms of pregnancy vary by stage (trimester). The earliest pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue, and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Eating a healthy diet, getting a moderate amount of exercise, also are recommended for a healthy pregnancy. Information about the week by week growth of your baby in the womb are provided.
Primary Biliary Cirrhosis (PBC)
Primary Biliary Cirrhosis (PBS) is a liver disease in which bile building up in the organ damages bile ducts. Ultimately, this can cause liver failure. A number of drugs are available to treat this disease of unknown cause, but the only ultimate cure is a liver transplant.
Primary Sclerosing Cholangitis (PSC)
Primary sclerosing cholangitis or PSC is a disease of the liver. The cause of PSC is not known. Symptoms may include itching, fatigue, jaundice, fever, and confusion. The only treatment for Primary sclerosing cholangitis is a liver transplant.
Sickle Cell Disease (Anemia)
Sickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is caused by an inherited abnormal hemoglobin. Symptoms of sickle cell anemia may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
Small Cell Lung Cancer vs. Non-Small Cell Lung Cancer
Non-small cell lung cancers (NSCLC) consist of large cell carcinomas, adenocarcinomas, and squamous cell carcinomas. Small cell lung cancer (SCLC) usually starts in the bronchi and typically appears in those who smoke. SCLC and NSCLC are staged in different manners, and SCLC tends to metastasize more quickly than NSCLC. Signs and symptoms of NSCLC and SCLC include shortness of breath, coughing up blood, recurring lung infections, and chest pain. Treatment may involve radiation therapy, chemotherapy, and surgery.
Yellow fever is an infectious disease transmitted by infected mosquitoes. Side effects are rare with the yellow fever vaccine. Symptoms include fever, chills, back pain, nausea, vomiting, and headache. Treatment is aimed at relieving symptoms.
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