Diagnosis and Tests for Jaundice

Doctors aim to find out why jaundice is present and how serious it is.

History and examination

The doctor asks about the start of symptoms, urine and stool colour, itching, fever, alcohol, medicines and herbs, travel, injections or transfusions, contact with others with jaundice, and family history. They check the eyes, skin, abdomen, liver and spleen.

Blood tests

• Total, direct and indirect bilirubin
• Liver enzymes (SGOT, SGPT, ALP, GGT) and albumin
• Complete blood count and reticulocytes for haemolysis
• Prothrombin time (INR) to see how well the liver makes clotting factors
• Hepatitis A, B, C and E tests
• Malaria, dengue or leptospirosis tests when relevant
• Autoimmune markers, iron and ceruloplasmin in selected cases

Urine and stool tests

Urine bilirubin and urobilinogen help distinguish the type. Stool colour is recorded.

Imaging

• Ultrasound of the abdomen to look for gallstones, a dilated bile duct, liver changes or a mass
• CT or MRI/MRCP when more detail is needed
• ERCP or endoscopic ultrasound for bile duct problems, sometimes with treatment at the same time

Liver biopsy and elastography

Used in selected cases to assess liver damage.

Newborn testing

Bilirubin is measured with a skin meter or a blood test. Blood group and Coombs tests may be done.

Key point

Do not delay tests for jaundice, and avoid starting herbal or home treatment before a diagnosis.

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.