Jaundice in Adults: Yellow Skin or Eyes, Causes and When to Be Seen

What it involves

MedlinePlus explains that jaundice is a yellow color in the skin, mucous membranes or eyes, caused by bilirubin, a yellow byproduct of the body processing old red blood cells. It describes jaundice as often a sign of disease, and as something that can occur at any age and may signal a problem.

Who this is for

• Adults who notice yellowing of the whites of the eyes or the skin
• Patients with dark urine or pale stools along with a yellow tint
• Patients with a known liver, gallbladder or blood condition who see a change
• Patients who recently started a new medicine or took more acetaminophen than intended

What to expect

• Questions about when you first saw the yellow color and what other symptoms came with it
• A physical exam and a review of medicines, alcohol use and recent illness
• Blood tests, such as a bilirubin level and liver panel, which the practice can draw
• Referral for imaging or a specialist if the pattern points to a blocked bile duct or liver disease

Where the yellow comes from

MedlinePlus explains that bilirubin is a yellow chemical in hemoglobin, the substance in red blood cells that carries oxygen. As red cells break down, the body makes new ones, and the liver processes the old ones. If the liver cannot keep up with the cells as they break down, bilirubin builds up and the skin can look yellow. So jaundice is not a disease in itself but a visible clue that something along that pathway is not working as it should.

Three places the problem can start

MedlinePlus groups causes by where the trouble is. Too many red blood cells may be dying or breaking down and sending bilirubin to the liver, the liver itself may be overloaded or damaged, or bilirubin from the liver may not be able to move properly into the digestive tract. That last group includes gallstones or gallbladder disorders that block the bile duct, which the gallstones guide describes. Sorting out which of the three is involved is the central job of the evaluation.

Conditions on the list

MedlinePlus names viral hepatitis A through E and parasite infections of the liver, certain medicines and poisons including an overdose of acetaminophen, inherited conditions that make it hard to break down bilirubin such as Gilbert syndrome, chronic liver disease, gallstones, blood disorders, pancreatic cancer, and cirrhosis. Many of those are manageable and some are serious, which is exactly why the color itself is never the answer. The hepatitis C screening guide covers one infection that can damage the liver silently for years.

How it is worked up

MedlinePlus lists the bilirubin blood test and liver function tests as the basic diagnostic tools for jaundice, and notes that blood tests will reveal an elevated bilirubin level. The liver function tests guide explains the panel a provider is likely to order, and the practice lists blood work among its services. Depending on what those numbers show, a provider may arrange imaging of the liver and bile ducts, which is done at an outside facility, or refer you to a liver specialist.

Clues that help narrow it down

The questions are practical ones. Is the urine dark, and are the stools pale? Has there been itching, belly pain, fever, loss of appetite, or weight loss? What medicines and supplements are you taking, how much alcohol do you drink, and has anyone around you had hepatitis? Have you had gallstones before? Writing the answers down before the visit gives the provider more to work with. Fever, severe belly pain or confusion along with yellowing is a reason to seek emergency care instead of waiting for an appointment.

Babies are a different story

MedlinePlus notes that many healthy babies have some jaundice during the first week of life and that it usually goes away. That is a newborn matter handled by a baby's own doctor, and this page is about adults. For an adult, MedlinePlus is clear that jaundice can happen at any age and may be a sign of a problem, so a yellow tint should be reported rather than put down to something temporary. Do not delay because the color seems mild.

Sources

• MedlinePlus — Jaundice causes
• MedlinePlus — Jaundice