Cause | Common Features* | Tests† |
---|---|---|
Liver and gallbladder disorders | ||
Jaundice that develops slowly A history of heavy alcohol consumption In men, development of feminine characteristics, including loss of muscle tissue, smooth skin, enlarged breasts, shrunken testes, and growth of pubic hair in a female pattern Sometimes swelling of the abdomen due to accumulation of fluid ( ascites Ascites Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood... read more ) | A doctor's examination Blood tests | |
Blockage of a bile duct by a gallstone Gallstones Gallstones are collections of solid material (predominantly crystals of cholesterol) in the gallbladder. The liver can secrete too much cholesterol, which is carried with bile to the gallbladder... read more or, less commonly, by a tumor of the pancreas or bile ducts | Dark urine and light-colored, soft, bulky, oily-looking, and unusually foul-smelling stool Usually pain in the upper right part or middle of the abdomen If the cause is a tumor, weight loss and sometimes chronic abdominal pain | Imaging such as
Biopsy if imaging results suggest cancer |
Severe itching Later, jaundice and dark urine Usually develops during late pregnancy | Blood tests Usually ultrasonography | |
Symptoms that occur before jaundice develops:
Often in people with risk factors, such as recreational use of injected drugs or participation in anal sex | Blood tests for hepatitis viruses | |
Primary biliary cholangitis Primary Biliary Cholangitis (PBC) Primary biliary cholangitis (PBC) is inflammation with progressive scarring of the bile ducts in the liver. Eventually, the ducts are blocked, the liver becomes scarred, and cirrhosis and liver... read more (an autoimmune disorder causing destruction of the small bile ducts in the liver) | Symptoms that often occur before jaundice develops:
Sometimes discomfort in the upper right part of the abdomen, darkening of the skin, and small yellow deposits of fat in the skin (xanthomas) or eyelids (xanthelasmas) | Blood tests to check for the antibodies that occur in most people with this disorder |
Primary sclerosing cholangitis Primary Sclerosing Cholangitis Primary sclerosing cholangitis is inflammation with progressive scarring and narrowing of the bile ducts in and outside the liver. Eventually, the ducts become blocked and then obliterated.... read more (scarring and destruction of small and large bile ducts) | Symptoms that occur before jaundice develops:
Pain in the upper right part of the abdomen Sometimes light-colored, soft, bulky, oily-looking, and unusually foul-smelling stool Often in people with inflammatory bowel disease Inflammatory Bowel Diseases (IBD) | |
Other disorders | ||
Breakdown of red blood cells (hemolysis), which may be caused by
| Symptoms of anemia (paleness, weakness, and fatigue) Sometimes use of a drug that causes hemolysis or presence of a red blood cell disorder in a family member | Blood tests |
Tremors, difficulty speaking and swallowing, involuntary movements, loss of coordination, and personality changes Gold or greenish gold rings in the cornea of the eyes ( Kayser-Fleischer rings Symptoms ) | Slit-lamp examination of the eyes to check for Kayser-Fleischer rings Blood tests to measure levels of copper and copper proteins Urine tests to measure the level of copper eliminated in the urine | |
Surgical complications such as
| Develops soon after surgery, particularly major surgery | A doctor’s examination Sometimes other tests, depending on the likely causes |
Drugs and toxins | ||
Acetaminophen Acetaminophen Poisoning Acetaminophen, a common ingredient in many prescription and non-prescription drugs, is safe in normal doses, but severe overdose can cause liver failure and death. People sometimes ingest too... read more (in high doses or as an overdose) Certain medicinal herbs such as germander, kava Kava Kava comes from the root of a shrub that grows in the South Pacific. It is ingested as a tea or in capsule form. The active ingredients are thought to be kavalactones. (See also Overview of... read more , green tea Green Tea Green tea is made from the dried leaves of the same plant as traditional tea. However, traditional tea leaves are fermented, and green tea leaves are steamed but unfermented. Green tea may be... read more extracts, or pyrrolizidine Certain prescription drugs such as amoxicillin/clavulanate, azathioprine, chlorpromazine, isoniazid, and oral contraceptives Iron when taken in large amounts | Use of a substance that can cause jaundice | A doctor's examination |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Doctors typically measure bilirubin levels in the blood and do blood tests to determine how well the liver is functioning and whether it is damaged (tests of liver function) and to assess the blood’s ability to clot. | ||
CT = computed tomography; ERCP = endoscopic retrograde cholangiopancreatography; G6PD = glucose-6-phosphate dehydrogenase; MRCP = magnetic resonance cholangiopancreatography; MRI = magnetic resonance imaging. |