Jaundice: Causes, Symptoms and Treatment Options
陈俊海医生
上消化道专科医生，双院士培训外科医生
MBBS （墨尔本），医学硕士（外科），FRCS（爱丁堡），FAMS（普通外科）
目录
导言
What Is Jaundice?
Jaundice happens when there is too much bilirubin in the bloodstream. Bilirubin is a yellow-brown pigment produced when the body breaks down old red blood cells. Normally, the liver processes bilirubin and passes it out of the body through bile and stool.
When this process is disrupted, whether by too much bilirubin being produced, the liver being unable to process it or bile being unable to drain properly, bilirubin builds up and settles in the skin and the whites of the eyes, giving them a yellow tinge.
According to the NHS, jaundice can look different depending on skin tone. It is usually most visible in the eyes even when it is harder to notice on the skin. It is worth remembering that jaundice is a sign, not a diagnosis on its own. The real question is always what is causing it.
What Causes Jaundice?
Doctors generally group the causes of jaundice into three categories, based on where the problem occurs in the bilirubin pathway.
| Category | What happens | Common causes |
|---|---|---|
| Pre-hepatic (before the liver) | Red blood cells break down faster than the liver can keep up with | Haemolytic anaemia, certain inherited blood disorders |
| Hepatic (within the liver) | The liver itself is inflamed or damaged and cannot process bilirubin properly | Viral hepatitis, alcohol-related liver disease, cirrhosis, some medications, Gilbert’s syndrome |
| Post-hepatic (after the liver, also called obstructive) | Bile carrying bilirubin cannot drain into the intestine because the bile duct is blocked | Gallstones, bile duct strictures, tumours of the pancreas or bile duct |
Why the Cause Matters More Than the Jaundice Itself
Jaundice does not have a treatment of its own. Once a doctor identifies which of the three categories applies, treatment is directed at that underlying cause and the yellowing typically improves as the cause resolves. This is why an accurate diagnosis matters more than treating the yellow tinge directly.
Common Symptoms of Jaundice
Doctors generally group the causes of jaundice into three categories, based on where the problem occurs in the bilirubin pathway.
Jaundice rarely appears alone. Depending on the cause, it is often accompanied by:
- Yellowing of the skin and the whites of the eyes
- Dark-coloured urine
- 大便呈浅色或灰褐色
- Itchy skin (pruritus)
- Fatigue or low energy
- Abdominal pain or discomfort, particularly on the upper right side
- 发热或寒战
- Nausea or loss of appetite
- Unintended weight loss
CONSULTATION
Speak to a Specialist About Your Symptoms
How Is Jaundice Diagnosed?
Diagnosis usually starts with a physical examination and a conversation about your symptoms, medical history, alcohol use and any medications or supplements you are taking. From there, a doctor typically arranges:
- Blood tests, including liver function tests and a bilirubin level, to see how high it is and which type of bilirubin is elevated
- Ultrasound imaging, usually the first-line scan, to check the liver, gallbladder and bile ducts for gallstones or blockages
- CT or MRCP scans, if more detail is needed on the bile duct or pancreas
- Endoscopic evaluation (ERCP), which can be both diagnostic and used to treat a blockage in the same procedure
Sharing detailed, honest information with your doctor, including how long the yellowing has been present and any accompanying pain, fever or weight change, helps narrow down the cause faster.
Is Jaundice Serious?
This is understandably one of the first questions people ask. The honest answer is that it depends entirely on the cause.
Some causes, like Gilbert’s syndrome, are harmless and require no treatment beyond monitoring. Others, like a blocked bile duct or advanced liver disease, need prompt medical care but are very treatable when caught early.
A smaller number of cases, particularly painless jaundice with weight loss, can point to something more serious such as a tumour affecting the bile duct or pancreas, which is exactly why early evaluation matters.
Rather than guessing based on symptoms, the safest and most reassuring path is a proper diagnosis, so you know precisely what you are dealing with and what the next step should be.
诊断
When Should You See a Doctor?
Seek prompt medical attention if jaundice appears together with:
- 发热或寒战
- Severe abdominal pain
- Confusion or unusual drowsiness
- Vomiting blood or passing black, tarry stools
- Jaundice alongside unexplained weight loss
These combinations can point to conditions that need urgent evaluation, such as a blocked bile duct or a serious liver problem. Even without these warning signs, any new yellowing of the skin or eyes in an adult is worth having checked, since the cause is not something you can determine by symptoms alone.
Treatment Options for Jaundice
Treating the Underlying Cause
Because jaundice reflects an underlying issue, treatment is tailored to what is actually causing it.
Viral hepatitis may be managed with antiviral medication or supportive care. Alcohol- related liver disease is managed through abstinence and liver-focused care. Haemolytic causes are addressed by treating the blood disorder responsible.
Procedures for a Blocked Bile Duct
When jaundice is caused by a blockage, such as a gallstone lodged in the bile duct, an ERCP (endoscopic retrograde cholangiopancreatography) is often used. This procedure allows a doctor to locate and remove the obstruction or place a stent to keep the duct open, often relieving jaundice within days.
Surgical Treatment
If gallstones are the underlying cause, gallbladder removal surgery (cholecystectomy) is often recommended to prevent the problem recurring. You can read more about this on our page on 胆结石和胆囊疾病, which covers symptoms, surgical options and recovery in more detail.
Recovering After Treatment
Recovery time depends on what caused the jaundice and how it was treated. Once a bile duct blockage is cleared, whether by ERCP or surgery, bilirubin levels usually start falling within days and the yellowing fades gradually as the body clears the excess from the skin and eyes.
For causes such as hepatitis, recovery follows the course of the underlying infection or condition, which may take longer and is guided by your doctor’s treatment plan rather than the jaundice itself.
Your doctor will likely order a follow-up blood test to confirm bilirubin has returned to a normal range and that liver function has stabilised. Mild fatigue or itching can linger for a short while even after treatment, but this generally settles as recovery progresses. Contact your doctor if the yellowing does not start improving within the expected timeframe or if new symptoms appear.
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常见问题解答——患者须知
Jaundice itself is not contagious. However, if it is caused by viral hepatitis, the underlying infection can potentially be passed on, so your doctor
Not necessarily. Jaundice can result from a wide range of causes, only some of which involve the liver directly and even liver-related causes exist on a wide spectrum of severity. A doctor’s assessment is needed to know where you stand.
No. Most adult jaundice is caused by more common conditions such as gallstones or hepatitis. Cancer is one possible cause among several, which is precisely why a proper diagnosis, rather than assumption, is the right next step.
参考文献
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https://doi.org/10.1007/s10620-008-0572-8
2. 曹伟、侯刚、张晓、桑浩、郑杰（2018）。与胃息肉形成相关的潜在危险因素。.
《免疫药理学与免疫毒理学》，40(4)，338–343。. https://doi.org/10.1080/08923973.2018.1490317
