Merck Manual

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Some Causes and Features of Jaundice

Some Causes and Features of Jaundice


Common Features*


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

A doctor's examination

Blood tests

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:

  • Nausea or vomiting

  • Loss of appetite

  • Fatigue

  • Constant pain in the upper right part of the abdomen

  • Fever

  • Sometimes joint pain

Often in people with risk factors, such as recreational use of injected drugs or participation in anal sex

Blood tests for hepatitis viruses

Symptoms that often occur before jaundice develops:

  • Fatigue

  • Itching

  • Dry mouth and eyes

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

Symptoms that occur before jaundice develops:

  • Worsening fatigue

  • Itching

Pain in the upper right part of the abdomen

Sometimes light-colored, soft, bulky, oily-looking, and unusually foul-smelling stool

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 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

  • Scarring of the bile ducts due to surgery on or near these ducts

  • Reduced blood flow to the liver due to blood loss or other complications of major surgery

Develops soon after surgery, particularly major surgery

A doctor’s examination

Sometimes other tests, depending on the likely causes

Drugs and toxins

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.