Table of ContentsView AllTable of ContentsCausesSymptomsDurationDiagnosisTreatmentPreventionComplicationsWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Duration
Diagnosis
Treatment
Prevention
Complications
When to Seek Care
This article describes the causes, symptoms, and diagnosis of jaundice in adults and children. It also explains how jaundice is treated and prevented, including when jaundice is a sign of a medical emergency.
This photo contains content that some people may find graphic or disturbing.See PhotoZayWin Htal / Getty Images
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
ZayWin Htal / Getty Images
Types and Causes of Jaundice
Jaundice occurs when there is too much bilirubin in the body, referred to ashyperbilirubinemia. There are three main reasons why this might occur, which are:
The other classification of neonatal jaundice is an otherwise normal occurrence in newborns but one that can turn serious in some.
Prehepatic Jaundice
Prehepatic jaundice is caused when hemolysis is increased, overwhelming the liver with more bilirubin than it can handle.
Possible causes of this include:
Hepatic Jaundice
Once unconjugated bilirubin enters the liver, it is exposed to enzymes that transform it into conjugated bilirubin. This form can be incorporated into a digestive fluid called bile and eliminated from the body as it is carried away in the stool.
Types of Liver Disease
Posthepatic Jaundice
Once bile leaves the liver, it is transported to the gallbladder for storage. Whenever food is eaten, it is released into the main duct, called the common duct, where it mixes with digestive fluids from the pancreas. These fluids are then released into the first part of thesmall intestine, called theduodenum, to break down fats and protein.
Posthepatic jaundice occurs when there is an obstruction in the pathway from the liver to the small intestine. This causes bile to back up into the liver, where bilirubin can escape.
Posthepatic jaundice may be due to an obstruction or a disease that causes bile ducts to become narrow or pinched. Examples include:
Neonatal Jaundice
Neonatal jaundice is caused when fetalhemoglobin(the protein in red blood cells that carries oxygen) is broken down and replaced with the post-birth form of hemoglobin. This breakdown causes the release of more bilirubin than a newborn’s liver can clear.
On rare occasions, neonatal jaundice is not normal. Some of the same conditions that cause jaundice in adults—like G6PD deficiency, spherocytosis, and A1AT deficiency—can also affect newborns, leading to potentially life-threatening complications,
Other serious causes in newborns include:
This photo contains content that some people may find graphic or disturbing.See PhotoJustin Paget / Getty Images
Justin Paget / Getty Images
What Is Breastfeeding Jaundice?
Another relatively benign cause of jaundice is “breastfeeding jaundice,” a casual term for suboptimal intake jaundice. This usually occurs in the second week of life when a newborn is not getting enough nutrition.
Increased breastfeeding or supplementation with bottled formula will almost invariably help resolve the condition.
Causes of Jaundice You May Not Know
Jaundice Symptoms
Jaundice symptoms can also differ in newborns.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from ©DermNet and ©Te Whatu Oradermnetnz.org2023.
Reproduced with permission from ©DermNet and ©Te Whatu Oradermnetnz.org2023.
Common Symptoms
On its own, jaundice does not cause anything other than yellowish discoloration. In many cases, it is the first sign of a disease and, in some, the only sign.
Hepatic and posthepatic causes of jaundice often manifest with symptoms ofhepatitis(liver inflammation), causing:
Is Jaundice the Only Cause of Yellow Eyes?
Symptoms in Newborns
Neonatal jaundice is most often physiological,meaning it is related to normal bodily functions. Symptoms tend to develop within two to three days of birth, starting at the face and moving downward to the chest, stomach, legs, and feet.
However, in some newborns, jaundice may be pathologic. This is typically the case when bilirubin levels are extremely high or when jaundice occurs immediately after birth or persists for weeks.
Persistent hyperbilirubinemia can lead to a potentially fatal condition calledkernicterus, in which bilirubin invades the brain, causing brain dysfunction known asencephalopathy. If not treated immediately, kernicterus can lead to seizures, brain damage, and complications such as:
How Long Does Jaundice Last?
The duration of jaundice varies based largely on whether the underlying condition isacute(sudden and severe) orchronic(persistent or long-lasting). Generally speaking, the discoloration will fade once the underlying cause is resolved—whether it be an acute infection, biliary obstruction, or toxic drug reaction.
Jaundice has a typical course with some diseases (likeacute viral hepatitis, which usually peaks in two weeks and starts to fade over two to three weeks).With other diseases, such as liver cancer, jaundice will only clear after aliver transplant.
With neonatal jaundice, the timeline is more consistent. In formula-fed babies, jaundice typically clears within two weeks. In breastfed babies, jaundice may last two to three weeks, sometimes longer.
How Jaundice Is Diagnosed
While jaundice is usually self-evident, a physical exam and lab tests are needed to help narrow the possible causes.
LFTs also measure liver enzymes calledalkaline phosphatase (ALP),alanine transferase (ALT), and aspartate transferase (AST), which tend to rise with liver or biliary disease.
These results, paired with the color of your urine and stool, can help determine if the cause is prehepatic, hepatic, or posthepatic.
Other tests and procedures may be ordered based on the initial findings, including imaging studies likeultrasound,computed tomography (CT), ormagnetic resonance imaging (MRI)to check for blockages. Aliver biopsymay also be performed to obtain a sample of liver tissue for evaluation in the lab.
Neonatal jaundice is monitored with blood tests that measure bilirubin in milligrams per deciliter of blood (mg/dL). Bilirubin can also be measured with a noninvasive, handheld device called atranscutaneous bilirubinometer, though blood testing remains the gold standard.
With physiological jaundice, newborns typically have unconjugated bilirubin levels between 12 and 15 mg/dL for the first two weeks, gradually decreasing to 2 mg/dL over the next month and eventually settling to a normal adult level of 0.2 to 0.8 mg/dL.
On the other hand, jaundice is considered pathologic if:
Jaundice Treatment
If a bile duct is blocked, surgery or procedures likeshock wave lithotripsycan help clear the obstruction.Surgery may also be needed for cancer of the liver, pancreas, gallbladder, or bile duct, along withchemotherapyandradiation.
When a chronic disease like cirrhosis or primary sclerosing cholangitis causesliver failure(meaning that the liver can no longer support the body’s needs), the only option may be aliver transplant.
In all other cases, the treatment is largely medical.
While most cases of jaundice in newborns resolve on their own, those with total bilirubins over 21 mg/dL should receive specializedphototherapy(sometimes referred to as “bili lights”).
Phototherapy involves exposure to a certain bandwidth of blue light (not ultraviolet light) that converts bilirubin in the skin into a water-soluble form that is more easily passed in urine. Home phototherapy machines allow home treatment outside of the hospital.
Do I Need a Hepatologist or Gastroenterologist?
How to Prevent Jaundice
Jaundice can’t always be prevented, but there are certain measures you can take to avoid some of the underlying causes, including:
Complications of Jaundice
Left untreated, the underlying causes of jaundice can turn serious and even life-threatening.
One of the key concerns is acute liver failure—also known as fulminant hepatic failure—which can sometimes develop rapidly in otherwise healthy individuals. This is especially true with severe drug-induced liver injury, in which a single event can cause irreparable damage requiring a liver transplant.
Autoimmune hepatitis and acute hepatitis A and B have also been known to cause acute liver failure.
Another concern is complications of hemolytic anemia, one of the most common causes of prehepatic jaundice. Severe cases have been known to cause life-threateningarrhythmia(irregular heartbeats),heart failure, and even death.
What Are the Signs of Liver Failure?
When to Contact a Healthcare Provider
No amount of jaundice is considered “normal.” Call a healthcare provider immediately if you develop jaundice for any reason—even if it is mild and you have no other symptoms. Early intervention can help you avoid potentially serious complications.
When to Call 911: Neonatal Jaundice
Summary
Jaundice can be prehepatic (related to the excessive breakdown of red blood cells), hepatic (related to the liver), or posthepatic (related to the impaired flow of bile from the liver). Neonatal jaundice in newborns is usually normal but can become life-threatening if bilirubin levels are persistently high.
Jaundice is diagnosed with blood tests and will usually clear once the underlying condition is resolved. Infants with very high bilirubin levels may benefit from phototherapy or an exchange transfusion.
26 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Jaundice.Fargo MV, Grogan SP, Saguil A.Evaluation of jaundice in adults.Am Fam Physician.2017;95(3):164-168.National Institute of Health and Care Excellence.Jaundice in babies born under 28 days.Markovic AP, Lalosevic MS, Mijac DD, et al.Jaundice as a diagnostic and therapeutic problem: a general practitioner’s approach.Dig Dis.2020;40(3):362–369. doi:10.1159/000517301Thiagarajan P, Parker CJ, Prchal JT.How do red blood cells die?Front Physiol.2021;12:655393. doi:10.3389/fphys.2021.655393Gondal B, Aronsohn A.A systematic approach to patients with jaundice.Semin Intervent Radiol.2016;33(4):253–258. doi:10.1055/s-0036-1592331Boyer JL, Soroka CJ.Bile formation and secretion: an update.J Hepatol.2021;75(1):190-201. doi:10.1016/j.jhep.2021.02.011Eghbalian F, Hasanpour-Dehkordi A, Raeisi R.The effects of clofibrate on neonatal jaundice: a systematic review.Int J Prev Med. 2022;13(3). doi:10.4103/ijpvm.IJPVM_407_20Ullah S, Rahman K, Hedayat M.Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article.Iran J Public Health.2016;45(5):558–568.Centers for Disease Control and Prevention.Breastfeeding: jaundice.American College of Surgeons Division of Education.Jaundice.Mitra S, Rennie J.Neonatal jaundice: aetiology, diagnosis, and treatment.Br J Hosp Med (Lond). 2017;78(12):699-704. doi:10.12968/hmed.2017.78.12.699National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis A.Pan JJ, Fontana RJ.CAQ corner: acute liver failure management and liver transplantation.Liver Transpl.2022;28(10):1664–1673. doi:10.1002/lt.26503March of Dimes.Newborn jaundice.Kemper AR, Newman TB, Slaughter JL.Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.Pediatrics.2022;150(3):e2022058859. doi:10.1542/peds.2022-058859Wang L, Yu WF.Obstructive jaundice and perioperative management.Acta Anaesthesiologica Taiwanica. 2014;52(1):22–29. doi:10.1016/j.aat.2014.03.002Tariq NUA, McNamara MG, Valle JW.Biliary tract cancers: current knowledge, clinical candidates and future challenges.Cancer Manag Res.2019;11:2623–2642. doi:10.2147/CMAR.S157092American Liver Foundation.Liver transplantation.Storck LJ, Imoberdorf B, Ballmer PE.Nutrition in gastrointestinal disease: liver, pancreatic, and inflammatory bowel disease.J Clin Med.2019;8(8):1098. doi:10.3390/jcm8081098National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.National Cancer Institute.New insights into why smoking causes fatty liver disease.National Institute of Diabetes and Digestive and Kidney Diseases.Clinical and research information on drug-induced liver injury: acetaminophen.National Institute of Diabetes and Digestive and Kidney Diseases.Herbal and dietary supplements.Wendon J, Cordoba J, Dhawan A, et al.EASL clinical practical guidelines on the management of acute (fulminant) liver failure.J Hepatol. 2017;66(5):1047-1081. doi:10.1016/j.jhep.2016.12.003National Heart, Lung and Blood Institute.Hemolytic anemia.
26 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Jaundice.Fargo MV, Grogan SP, Saguil A.Evaluation of jaundice in adults.Am Fam Physician.2017;95(3):164-168.National Institute of Health and Care Excellence.Jaundice in babies born under 28 days.Markovic AP, Lalosevic MS, Mijac DD, et al.Jaundice as a diagnostic and therapeutic problem: a general practitioner’s approach.Dig Dis.2020;40(3):362–369. doi:10.1159/000517301Thiagarajan P, Parker CJ, Prchal JT.How do red blood cells die?Front Physiol.2021;12:655393. doi:10.3389/fphys.2021.655393Gondal B, Aronsohn A.A systematic approach to patients with jaundice.Semin Intervent Radiol.2016;33(4):253–258. doi:10.1055/s-0036-1592331Boyer JL, Soroka CJ.Bile formation and secretion: an update.J Hepatol.2021;75(1):190-201. doi:10.1016/j.jhep.2021.02.011Eghbalian F, Hasanpour-Dehkordi A, Raeisi R.The effects of clofibrate on neonatal jaundice: a systematic review.Int J Prev Med. 2022;13(3). doi:10.4103/ijpvm.IJPVM_407_20Ullah S, Rahman K, Hedayat M.Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article.Iran J Public Health.2016;45(5):558–568.Centers for Disease Control and Prevention.Breastfeeding: jaundice.American College of Surgeons Division of Education.Jaundice.Mitra S, Rennie J.Neonatal jaundice: aetiology, diagnosis, and treatment.Br J Hosp Med (Lond). 2017;78(12):699-704. doi:10.12968/hmed.2017.78.12.699National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis A.Pan JJ, Fontana RJ.CAQ corner: acute liver failure management and liver transplantation.Liver Transpl.2022;28(10):1664–1673. doi:10.1002/lt.26503March of Dimes.Newborn jaundice.Kemper AR, Newman TB, Slaughter JL.Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.Pediatrics.2022;150(3):e2022058859. doi:10.1542/peds.2022-058859Wang L, Yu WF.Obstructive jaundice and perioperative management.Acta Anaesthesiologica Taiwanica. 2014;52(1):22–29. doi:10.1016/j.aat.2014.03.002Tariq NUA, McNamara MG, Valle JW.Biliary tract cancers: current knowledge, clinical candidates and future challenges.Cancer Manag Res.2019;11:2623–2642. doi:10.2147/CMAR.S157092American Liver Foundation.Liver transplantation.Storck LJ, Imoberdorf B, Ballmer PE.Nutrition in gastrointestinal disease: liver, pancreatic, and inflammatory bowel disease.J Clin Med.2019;8(8):1098. doi:10.3390/jcm8081098National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.National Cancer Institute.New insights into why smoking causes fatty liver disease.National Institute of Diabetes and Digestive and Kidney Diseases.Clinical and research information on drug-induced liver injury: acetaminophen.National Institute of Diabetes and Digestive and Kidney Diseases.Herbal and dietary supplements.Wendon J, Cordoba J, Dhawan A, et al.EASL clinical practical guidelines on the management of acute (fulminant) liver failure.J Hepatol. 2017;66(5):1047-1081. doi:10.1016/j.jhep.2016.12.003National Heart, Lung and Blood Institute.Hemolytic anemia.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Jaundice.Fargo MV, Grogan SP, Saguil A.Evaluation of jaundice in adults.Am Fam Physician.2017;95(3):164-168.National Institute of Health and Care Excellence.Jaundice in babies born under 28 days.Markovic AP, Lalosevic MS, Mijac DD, et al.Jaundice as a diagnostic and therapeutic problem: a general practitioner’s approach.Dig Dis.2020;40(3):362–369. doi:10.1159/000517301Thiagarajan P, Parker CJ, Prchal JT.How do red blood cells die?Front Physiol.2021;12:655393. doi:10.3389/fphys.2021.655393Gondal B, Aronsohn A.A systematic approach to patients with jaundice.Semin Intervent Radiol.2016;33(4):253–258. doi:10.1055/s-0036-1592331Boyer JL, Soroka CJ.Bile formation and secretion: an update.J Hepatol.2021;75(1):190-201. doi:10.1016/j.jhep.2021.02.011Eghbalian F, Hasanpour-Dehkordi A, Raeisi R.The effects of clofibrate on neonatal jaundice: a systematic review.Int J Prev Med. 2022;13(3). doi:10.4103/ijpvm.IJPVM_407_20Ullah S, Rahman K, Hedayat M.Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article.Iran J Public Health.2016;45(5):558–568.Centers for Disease Control and Prevention.Breastfeeding: jaundice.American College of Surgeons Division of Education.Jaundice.Mitra S, Rennie J.Neonatal jaundice: aetiology, diagnosis, and treatment.Br J Hosp Med (Lond). 2017;78(12):699-704. doi:10.12968/hmed.2017.78.12.699National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis A.Pan JJ, Fontana RJ.CAQ corner: acute liver failure management and liver transplantation.Liver Transpl.2022;28(10):1664–1673. doi:10.1002/lt.26503March of Dimes.Newborn jaundice.Kemper AR, Newman TB, Slaughter JL.Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.Pediatrics.2022;150(3):e2022058859. doi:10.1542/peds.2022-058859Wang L, Yu WF.Obstructive jaundice and perioperative management.Acta Anaesthesiologica Taiwanica. 2014;52(1):22–29. doi:10.1016/j.aat.2014.03.002Tariq NUA, McNamara MG, Valle JW.Biliary tract cancers: current knowledge, clinical candidates and future challenges.Cancer Manag Res.2019;11:2623–2642. doi:10.2147/CMAR.S157092American Liver Foundation.Liver transplantation.Storck LJ, Imoberdorf B, Ballmer PE.Nutrition in gastrointestinal disease: liver, pancreatic, and inflammatory bowel disease.J Clin Med.2019;8(8):1098. doi:10.3390/jcm8081098National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.National Cancer Institute.New insights into why smoking causes fatty liver disease.National Institute of Diabetes and Digestive and Kidney Diseases.Clinical and research information on drug-induced liver injury: acetaminophen.National Institute of Diabetes and Digestive and Kidney Diseases.Herbal and dietary supplements.Wendon J, Cordoba J, Dhawan A, et al.EASL clinical practical guidelines on the management of acute (fulminant) liver failure.J Hepatol. 2017;66(5):1047-1081. doi:10.1016/j.jhep.2016.12.003National Heart, Lung and Blood Institute.Hemolytic anemia.
MedlinePlus.Jaundice.
Fargo MV, Grogan SP, Saguil A.Evaluation of jaundice in adults.Am Fam Physician.2017;95(3):164-168.
National Institute of Health and Care Excellence.Jaundice in babies born under 28 days.
Markovic AP, Lalosevic MS, Mijac DD, et al.Jaundice as a diagnostic and therapeutic problem: a general practitioner’s approach.Dig Dis.2020;40(3):362–369. doi:10.1159/000517301
Thiagarajan P, Parker CJ, Prchal JT.How do red blood cells die?Front Physiol.2021;12:655393. doi:10.3389/fphys.2021.655393
Gondal B, Aronsohn A.A systematic approach to patients with jaundice.Semin Intervent Radiol.2016;33(4):253–258. doi:10.1055/s-0036-1592331
Boyer JL, Soroka CJ.Bile formation and secretion: an update.J Hepatol.2021;75(1):190-201. doi:10.1016/j.jhep.2021.02.011
Eghbalian F, Hasanpour-Dehkordi A, Raeisi R.The effects of clofibrate on neonatal jaundice: a systematic review.Int J Prev Med. 2022;13(3). doi:10.4103/ijpvm.IJPVM_407_20
Ullah S, Rahman K, Hedayat M.Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article.Iran J Public Health.2016;45(5):558–568.
Centers for Disease Control and Prevention.Breastfeeding: jaundice.
American College of Surgeons Division of Education.Jaundice.
Mitra S, Rennie J.Neonatal jaundice: aetiology, diagnosis, and treatment.Br J Hosp Med (Lond). 2017;78(12):699-704. doi:10.12968/hmed.2017.78.12.699
National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis A.
Pan JJ, Fontana RJ.CAQ corner: acute liver failure management and liver transplantation.Liver Transpl.2022;28(10):1664–1673. doi:10.1002/lt.26503
March of Dimes.Newborn jaundice.
Kemper AR, Newman TB, Slaughter JL.Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.Pediatrics.2022;150(3):e2022058859. doi:10.1542/peds.2022-058859
Wang L, Yu WF.Obstructive jaundice and perioperative management.Acta Anaesthesiologica Taiwanica. 2014;52(1):22–29. doi:10.1016/j.aat.2014.03.002
Tariq NUA, McNamara MG, Valle JW.Biliary tract cancers: current knowledge, clinical candidates and future challenges.Cancer Manag Res.2019;11:2623–2642. doi:10.2147/CMAR.S157092
American Liver Foundation.Liver transplantation.
Storck LJ, Imoberdorf B, Ballmer PE.Nutrition in gastrointestinal disease: liver, pancreatic, and inflammatory bowel disease.J Clin Med.2019;8(8):1098. doi:10.3390/jcm8081098
National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.
National Cancer Institute.New insights into why smoking causes fatty liver disease.
National Institute of Diabetes and Digestive and Kidney Diseases.Clinical and research information on drug-induced liver injury: acetaminophen.
National Institute of Diabetes and Digestive and Kidney Diseases.Herbal and dietary supplements.
Wendon J, Cordoba J, Dhawan A, et al.EASL clinical practical guidelines on the management of acute (fulminant) liver failure.J Hepatol. 2017;66(5):1047-1081. doi:10.1016/j.jhep.2016.12.003
National Heart, Lung and Blood Institute.Hemolytic anemia.
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