Causes of Jaundice

Jaundice has three broad groups of causes, depending on where the problem lies.

Before the liver: too much bilirubin made

• Haemolysis: red cells breaking down faster than normal, such as in thalassaemia, sickle cell disease, G6PD deficiency, malaria and some autoimmune conditions
• Blood group mismatch between mother and baby
• Large bruises or internal bleeding that break down

In the liver: the liver cannot process bilirubin

• Viral hepatitis A, B, C and E, spread by contaminated food and water or by blood and body fluids
• Alcohol-related liver disease and fatty liver disease
• Cirrhosis
• Medicine or toxin injury, including paracetamol overdose, some TB medicines, and some herbal products
• Autoimmune hepatitis
• Inherited conditions such as Gilbert syndrome and Wilson disease
• Leptospirosis, dengue and other infections

After the liver: bile cannot drain

• Gallstones in the bile duct
• Tumours of the pancreas, bile duct or gallbladder
• Narrowing or inflammation of the bile ducts
• Pancreatitis
• Pregnancy-related cholestasis

Newborn jaundice

Most is physiological because the baby's liver is still maturing. Prematurity, breastfeeding difficulties, infection and blood group mismatch can make it worse.

Ayurvedic view

Ayurveda links kamala to aggravated Pitta from hot, spicy and sour food, alcohol and daytime sleep. This is a traditional framework.

Key point

The treatment depends entirely on the cause, so finding it with tests comes first.

Before your appointment

Note when the yellow colour began and the colour of your urine and stools. List all medicines, herbs, supplements and alcohol use. Mention fever, itching, abdominal pain, weight loss, recent travel, injections, transfusions, tattoos and contact with others with jaundice. For a baby, note birth date, feeding pattern, wet nappies and the mother's blood group. Ask about tests, the likely cause and which signs need urgent care. Call 112 for confusion, bleeding or severe pain with fever.