Jaundice is one of the most commonly encountered conditions in India, affecting newborns, children, and adults alike. You have probably seen someone with yellowish skin or eyes and immediately thought of jaundice. While jaundice itself is not a disease, it is an important warning sign that something is not right with your liver, bile ducts, or blood cells.
This article explains what jaundice is, why it happens, how to recognise its symptoms, and what treatment options are available.
What Is Jaundice?
Jaundice is a condition where the skin, whites of the eyes, and mucous membranes turn yellow due to elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment produced when red blood cells break down naturally at the end of their lifespan. Under normal circumstances, the liver processes bilirubin, which then passes through the bile ducts into the intestines and is eventually excreted from the body.
When this process is disrupted, either because the liver is not functioning properly, too many red blood cells are breaking down, or the bile ducts are blocked, bilirubin builds up in the blood. This buildup is what causes the characteristic yellow discolouration.
A normal bilirubin level is below 1.2 mg/dL. Jaundice typically becomes visible when levels exceed 2.5 to 3 mg/dL.
Types of Jaundice
There are three main types of jaundice, classified based on where the problem occurs.
Pre-hepatic jaundice occurs when there is excessive breakdown of red blood cells, producing more bilirubin than the liver can handle. This is commonly seen in conditions like malaria, sickle cell disease, thalassemia, and other haemolytic anaemias.
Hepatic jaundice occurs when the liver itself is damaged or inflamed, preventing it from processing bilirubin effectively. Causes include viral hepatitis (A, B, C, and E), alcoholic liver disease, drug-induced liver injury, and cirrhosis.
Post-hepatic jaundice, also called obstructive jaundice, occurs when the bile ducts that carry bilirubin from the liver to the intestines are blocked. This can happen due to gallstones, tumours of the pancreas or bile duct, or strictures in the bile duct.
Symptoms of Jaundice
The most obvious sign of jaundice is yellowing of the skin and the whites of the eyes. However, jaundice often comes with other symptoms depending on the underlying cause.
Common symptoms include dark yellow or brown urine, pale or clay-coloured stools, itching of the skin, fatigue and weakness, loss of appetite, nausea or vomiting, abdominal pain particularly in the upper right side, unexplained weight loss, and fever with chills in cases caused by infection.
In newborns, jaundice usually appears within the first few days of life. The yellowing typically starts on the face and spreads downward to the chest, abdomen, and legs as bilirubin levels rise. While mild newborn jaundice is common and usually resolves on its own, severe cases require medical attention as very high bilirubin can damage the brain.
Common Causes of Jaundice in India
Hepatitis A and E are the most common causes of acute jaundice in India. Both viruses spread through contaminated water and food, making them particularly prevalent during the monsoon season and in areas with poor sanitation. Hepatitis B and C, which spread through blood and bodily fluids, are more commonly associated with chronic liver disease.
Alcoholic liver disease is increasingly common due to rising alcohol consumption. Prolonged heavy drinking damages liver cells and impairs the liver’s ability to process bilirubin.
Malaria, which remains widespread in many parts of India, causes rapid destruction of red blood cells, leading to pre-hepatic jaundice.
Gallstones are another frequent cause, particularly in women above 40, where stones block the bile ducts and cause obstructive jaundice.
Drug-induced liver injury from overuse of paracetamol, certain antibiotics, anti-tuberculosis medications, and traditional herbal remedies can also lead to jaundice.
Diagnosis of Jaundice
When you visit a doctor with symptoms of jaundice, they will typically begin with a physical examination and then order blood tests.
Liver Function Test (LFT) is the primary diagnostic tool. It measures total and direct bilirubin levels, liver enzymes (ALT, AST, ALP), albumin, and total protein. The pattern of these results helps determine whether the jaundice is pre-hepatic, hepatic, or post-hepatic.
Complete Blood Count (CBC) helps identify conditions like anaemia or malaria that may be causing the jaundice.
Viral markers for hepatitis A, B, C, and E identify whether a viral infection is responsible.
An ultrasound of the abdomen is commonly performed to check for gallstones, liver enlargement, bile duct dilation, or tumours. In some cases, further imaging like a CT scan or MRCP may be required.
Treatment of Jaundice
Since jaundice is a symptom rather than a disease, treatment depends entirely on the underlying cause.
For hepatitis A and E, there is no specific antiviral treatment. Management focuses on rest, adequate hydration, and a nutritious diet while the body clears the virus. Most patients recover fully within 4 to 6 weeks. Hepatitis B and C may require antiviral medications prescribed by a specialist.
For obstructive jaundice caused by gallstones, surgical removal of the gallbladder (cholecystectomy) is the standard treatment. If a tumour is causing the blockage, treatment depends on the type and stage of the cancer.
For haemolytic conditions like malaria, treating the underlying infection resolves the jaundice. In severe cases of haemolytic anaemia, blood transfusions may be needed.
In newborns, mild jaundice is monitored and usually resolves without treatment. Moderate to severe cases are treated with phototherapy, where the baby is placed under special blue lights that help break down bilirubin in the skin. In rare, severe cases, an exchange transfusion may be required.
Home Care During Recovery
Rest adequately and avoid physical exertion until energy levels return. Drink plenty of water, fresh fruit juices, and coconut water to stay hydrated.
Eat a light, balanced diet with foods that are easy on the liver, such as rice, dal, fruits, vegetables, and curd. Avoid alcohol completely, even after recovery, until your doctor confirms your liver function is back to normal.
Avoid self-medicating with painkillers or herbal supplements, as these can put additional strain on the liver.
When Should You See a Doctor?
See a doctor promptly if you notice yellowing of your skin or eyes, your urine has turned dark yellow or brown, you experience persistent fatigue with loss of appetite, you have abdominal pain especially on the upper right side, or a newborn’s yellowish skin is deepening or spreading. Early diagnosis helps identify the cause and prevents potential complications like liver failure.
