Jaundice: The liver is not always to blame

Jaundice: The liver is not always to blame

Symptoms of jaundice (icterus) typically include yellowing of the eyes, skin and mucous membranes. An increased bilirubin concentration in the body triggers the discolouration. This can have various causes, including liver or gallbladder disease. Jaundice in adults must be distinguished from what is known as neonatal jaundice. This is not a symptom of a disease but occurs as part of a normal developmental process. If adults have jaundice, the treatment depends on the underlying disease.

Causes of jaundice

If the bile pigment bilirubin is increased in the blood, the eyes, skin and mucous membranes turn yellow. Bilirubin is a breakdown product of the red blood pigment haemoglobin. In specific diseases, its concentration in the blood increases and deposits in the tissue occur. These deposits then cause the yellowish shimmer. The yellow colour appears from a concentration of two milligrams per deciliter of blood.

Jaundice can have a variety of causes. These can be roughly divided into three categories:

  1. Blood disorders (prehepatic jaundice)
  2. Liver disease (hepatic jaundice)
  3. Disease of the bile (posthepatic jaundice)


Blood diseases as a cause

When a blood disorder is the cause of jaundice, it is called prehepatic jaundice because the cause predates the liver.

The increased bilirubin concentration can be triggered, among other things, by too many red blood cells breaking down. The level rises since bilirubin is a breakdown product of the red blood pigment haemoglobin. This is the case, for example, with viral infections, poisoning, diseases such as sickle cell anaemia or artificial heart valves. Problems with a blood transfusion can also be the cause.

If the liver cannot keep up with the breakdown of bilirubin, the dye is deposited in the tissue and causes the typical discolouration.

Liver disease as a cause

If the causes of jaundice lie in the liver, it is called hepatic jaundice. In most cases, liver inflammation is the trigger. This can be caused, for example, by taking certain medications, excessive consumption of alcohol or an infection with viruses such as the hepatitis B virus.

If an acute liver inflammation turns into a chronic one, liver cirrhosis or liver cancer can develop as a result.


Diseases of the bile as a cause

In post-hepatic jaundice, the causes of jaundice lie after the liver.

Bile congestion is then often responsible for the symptoms that occur. If the bile can no longer drain away due to a gallstone, for example, the liquid builds up, and some components – including bilirubin – can pass into the blood. In addition to gallstones, tumours and adhesions caused by surgery or inflammation can cause bile stasis.

Symptoms of jaundice

The most typical symptom of jaundice is a yellow discolouration of the eyes, skin and mucous membranes. In addition, there can be several other complaints.

Which symptoms occur always depends on the cause of the jaundice. Signs such as fatigue, fever, abdominal pain or itching can become noticeable depending on the condition. The colour of the stool and urine may also change.

neonatal jaundice

Neonatal jaundice in babies must be differentiated from pathological jaundice that occurs in adults. Because if the skin of babies turns yellowish, this is usually harmless. The symptom usually appears about two to three days after birth and disappears after a week or two.

As long as babies are in their mother’s womb, they are supplied with oxygen by their blood. To do this, they need a large number of red blood cells. After birth, however, not all blood cells are needed, and some break down. This produces bilirubin, which is converted into the liver and then excreted. If there is too much bilirubin, it can build up in front of the liver and, above a specific concentration, jaundice can occur.


It is correctly diagnosing the yellowing of the skin.

Because there are many different causes of yellowing of the skin, it is not always easy to diagnose jaundice. First of all, there is usually a detailed discussion in which the doctor asks about the medication you have taken, alcohol consumption or recent trips. Existing previous illnesses such as gallstones or cancer should also be mentioned.

Various physical examinations are then carried out, including:

  • blood test
  • a urine and stool test
  • a palpation of the liver and gallbladder
  • an ultrasound scan of the upper abdomen

Depending on the result, further investigations may then be necessary.

treat jaundice

Jaundice is not a disease but a symptom of another disease. Jaundice is, therefore, not contagious in itself, but certain underlying diseases can be. For the same reason, there is no vaccination against jaundice. However, specific causes, such as hepatitis B infection, can be prevented by vaccination.

If you discover yellowing of your eyes or skin, you should always consult a doctor and have them determine the cause. You cannot achieve anything with jaundice with medication or home remedies. The only way to cure it is to treat the underlying condition.

How exactly jaundice treatment looks like depends on the underlying disease. For example, the stone must be removed if there is a problem with the bile, such as a gallstone. If the causes of jaundice lie in the use of certain medications or excessive alcohol consumption, the triggering substance should be discontinued. Also, talk to your doctor about other treatment options.

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