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Yellowing in the whites of the eyes or the skin is known as jaundice. It is not a disease on its own. Rather, it develops when bilirubin, a yellow-orange substance produced when red blood cells break down, accumulates in the blood. The reason may be temporary and relatively harmless, but conditions involving the liver, gallbladder, bile ducts, pancreas, or blood can also cause jaundice.
For that reason, a doctor should assess new or unexplained jaundice. Medical attention is particularly important when the yellowing appears suddenly, becomes more noticeable, or is accompanied by fever, confusion, or persistent vomiting.
The first sign of jaundice is often a yellow tint in the whites of the eyes, known as the sclera. Yellowing of the skin may follow as bilirubin builds up in the bloodstream faster than the liver can remove it.
Bilirubin is part of a normal process in the body. When old red blood cells break down, they release bilirubin into the bloodstream and carry it to the liver. The liver processes bilirubin and excretes it into bile, which passes into the intestine and eventually leaves the body mainly in stool. If the liver cannot process bilirubin properly, something blocks a bile duct, or red blood cells break down unusually quickly, bilirubin begins to collect. The yellow color of jaundice then appears in the eyes and skin.
To narrow down the cause, doctors consider where this process has gone wrong. The problem may begin before bilirubin reaches the liver, as with rapid red blood cell breakdown; within the liver, as with hepatitis or cirrhosis; or after the liver, when a blockage prevents bile from draining through a duct. The causes below fall broadly into these three groups.
Since jaundice is a sign rather than a disease, the first step in treatment is finding out why it has developed.
Several conditions can cause jaundice. The likely explanation often depends on where the problem occurs along the bilirubin and bile pathway:
The chance of developing an underlying condition associated with jaundice may be higher in people who drink alcohol heavily or have done so for many years. Obesity and metabolic disorders raise the risk of fatty liver disease, while exposure to contaminated food or water, shared needles, or unscreened blood products can increase the risk of viral hepatitis. Family history also matters in inherited bilirubin disorders. Gallstones, meanwhile, are more common with advancing age and during pregnancy.
Many of these conditions cause similar symptoms at first. Blood tests and, in many cases, imaging are therefore needed to establish the cause rather than relying on symptoms alone.
Yellow skin and yellowing in the whites of the eyes are the clearest signs of jaundice. Other changes can help a doctor understand what may be happening beneath the surface.
| Yellow skin or eyes | A problem in the liver or blood, a blocked bile duct, gallstones, or other condition that raises bilirubin |
| Dark-colored urine | Hepatitis, liver disease, or disrupted bile flow |
| Pale or clay-colored stools | A bile duct blockage, gallstones, bile duct cancer, or a pancreatic condition that interferes with bile flow |
| Itchy skin | Cholestasis (slow or blocked bile flow), an obstructed bile duct, or certain liver conditions |
| Abdominal pain | Gallstones, hepatitis, pancreatitis, or other r disorder of the liver, gallbladder, or pancreas |
| Fever and chills | An infection such as cholangitis or hepatitis |
| Fatigue or weakness | Hepatitis, liver disease, anemia, or other underlying illnesses |
| Nausea or vomiting | Hepatitis, gallbladder disease, pancreatitis, or other digestive conditions |
| Unexplained weight loss | Some cancers or other serious conditions, which should be medically assessed |
| Abdominal swelling | Advanced liver disease, cirrhosis, or fluid collecting in the abdomen |
No single symptom points to a single cause, and some people notice nothing other than the yellowing. A medical assessment is needed to distinguish the conditions.
When Jaundice Needs Prompt Medical Attention
Seek prompt care if jaundice appears with severe abdominal pain, a high fever, confusion, ongoing vomiting, or yellowing of the skin which is becoming noticeably worse. These symptoms may be caused by a serious blockage or an infection in the bile ducts that needs urgent treatment. Confusion or marked drowsiness in a person with jaundice can also signal severe illness and should never be ignored.
Diagnosis usually begins with a review of symptoms and a physical examination. Questions may cover when the yellowing started, whether you have pain or fever, changes in appetite, and any difference in the color of your urine or stool. Your medicines and supplements will also be reviewed. During the examination, the doctor will look for signs that may be related to the liver, gallbladder, bile ducts, or blood.
What happens next depends on these initial findings. Tests may include:
The most suitable tests will vary with the symptoms, blood results, suspected cause, and the patient’s general condition.
Jaundice does not have one standard treatment. Care is directed at the condition responsible for the rise in bilirubin, to help the liver process bilirubin properly or restore bile flow.
Depending on what the tests show, this may involve:
In short, treatment is aimed at the reason bilirubin has built up, not simply at the yellow color itself.
Prevention cannot address some causes of jaundice, including inherited disorders and certain cancers. Even so, several everyday measures can reduce the likelihood of other common causes:
Make an appointment with your doctor if your skin or the whites of your eyes become yellow and there is no clear reason. Do not delay if jaundice is accompanied by:
Get urgent medical help for severe abdominal pain, a high fever or shaking chills, confusion, repeated vomiting, significant bleeding, or symptoms that are quickly getting worse.
An early assessment can separate milder explanations from liver, bile duct, pancreatic, or blood conditions that need treatment without delay.
Patients with unexplained jaundice or other liver and digestive symptoms can be assessed at the Gastroenterology and Hepatology Center at Vejthani International Hospital. Gastroenterologists, hepatologists, and hepatobiliary surgeons work as a team to manage disorders of the liver, gallbladder, bile ducts, and pancreas. Ultrasound, CT, gastrointestinal endoscopy, and ERCP are among the tools available to investigate the cause. Once the diagnosis is clear, the team develops a treatment plan around the patient’s condition and clinical needs.
No. Jaundice is a sign that bilirubin has increased due to another condition. The problem may come from the liver, gallbladder, bile ducts, pancreas, or blood cells.
There is no single cause of jaundice. It may occur when the liver is inflamed or scarred, as in hepatitis or cirrhosis. A gallstone can also cause yellowing if it becomes stuck and blocks the flow of bile. Other cases may be related to the pancreas, a blood disorder, certain medicines, or a condition passed down through families.
That depends on why it has developed. Although the cause is sometimes minor, jaundice can be a sign of a condition that needs treatment. A doctor may use blood tests or imaging to find out what is causing it.
It may disappear once a temporary illness has passed. Even so, yellowing that is new, lasts for some time, or has no clear explanation should be checked by a doctor.
Yellowing in the eyes may be the first sign of jaundice, even if you feel well. Make an appointment with a doctor if the change is new or unexplained.
Yes. If a gallstone enters the bile duct and blocks it, bile cannot drain normally. Bilirubin then rises in the blood, and jaundice may appear.
It can. Hepatitis, cirrhosis, and other liver diseases may make it harder for the liver to remove bilirubin. As bilirubin collects in the blood, the skin and eyes may begin to look yellow.
Yellowing of the eyes or skin should not be ignored when there is no obvious cause. Arrange a medical check-up, especially if your urine has become darker, your stools look unusually pale, or you are also experiencing abdominal pain, fever, vomiting, or weight loss. Confusion, intense pain, a very high fever, or vomiting that does not stop needs immediate medical attention.
Gastroenterology and Hepatology Center, Vejthani Hospital
Call: (+66)2-734-0000 Ext. 2960, 2961, 2966
English Hotline: (+66)85-223-8888
Internal Medicine
Gastroenterology and Hepatology
