What Causes Jaundice?
Key takeaways:
Jaundice is when the skin or whites of the eyes turn yellow. It happens when there’s a high level of bilirubin, a byproduct of red blood cell breakdown.
Jaundice often signals a problem with the liver, which is responsible for getting rid of excess bilirubin. But there are many reasons someone may develop jaundice, and they may be completely unrelated to the liver.
The causes of jaundice can range from harmless to serious. If you or someone you know has new jaundice, see a healthcare provider to figure out the cause.
Jaundice occurs when bilirubin starts to build up in the blood. Bilirubin contains a yellow pigment, so a high level in the blood leads to a yellowing of the white part of the eye and/or the skin. Bilirubin is a waste product that is created during the destruction of old red blood cells.
The liver removes bilirubin from the blood so it can then leave the body through urine and stool. If you’ve ever wondered why your pee is yellow and your poop is brown — it’s because of bilirubin!
Many things can go wrong during this process. And if something goes wrong, the bilirubin gets stuck in the blood and causes jaundice. Since there are many steps in this process, there are many different causes of jaundice. It can help to think of the reasons you might develop jaundice in three broad categories:
The body breaks down red blood cells faster than normal, which creates too much bilirubin.
The liver doesn’t remove the bilirubin fast or well enough.
The liver removes the bilirubin, but something blocks the bilirubin from leaving the body.
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Now that you have a general understanding of how the body processes bilirubin, let’s get into the specifics about the most common reasons for bilirubin buildup and jaundice.
What are the most common causes of jaundice in adults?
The list of things that can lead to jaundice is long. But most causes fit into the broader categories below.
Inherited genetic conditions
Genetic conditions that affect the structure and function of red blood cells can lead to jaundice. This is because with these conditions, red blood cells are more likely to break down (and release bilirubin into the blood). Examples include:
People with these conditions don’t always have high bilirubin levels or jaundice. But when they get sick or are exposed to certain triggers, they often experience increased blood cell breakdown.
Other inherited conditions can affect the way the liver processes bilirubin. These conditions include:
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Autoimmune conditions
Two autoimmune conditions that often cause jaundice are:
Both of these conditions prevent bilirubin from draining from the gallbladder, where it’s temporarily stored before it leaves the body through urine and stool.
Liver disease
The liver plays a crucial role in removing bilirubin. Any condition that affects the liver can impact its ability to remove bilirubin from the body the way it normally would. Examples of liver conditions that commonly lead to jaundice are:
Alcoholic liver disease can develop after years of excess alcohol consumption.
Non-alcoholic fatty liver disease is when excess fat starts to build up in the liver.
Liver cirrhosis occurs when chronic liver conditions cause scarring of liver tissue.
Hepatocellular carcinoma is a type of liver cancer.
Infections
Jaundice can also occur with liver infections. Many different infections can affect the liver. But viral hepatitis refers to a group of different viruses that directly injure liver tissue. And they’re more likely than other viruses to lead to jaundice. These include:
Hepatitis A usually spreads via contaminated food. This infection resembles gastroenteritis. Most people fully recover, and there’s no long-lasting damage to the liver.
Hepatitis B spreads through body fluid and can happen through sexual contact or contaminated intravenous (IV) needles. Most people make a full recovery, but a small number will develop a more long-term, chronic infection.
Hepatitis C spreads through direct blood transmission. It’s the most likely to lead to a chronic condition, but there are medications for treatment.
Hepatitis D is a rare form of hepatitis, and it only affects people who already have hepatitis B.
Hepatitis E can spread through contaminated food and water, direct blood transmission, or from mother to baby during childbirth. Most people make a full recovery.
Bile duct blockages
The liver removes bilirubin from the blood. But the gallbladder and its tube system — the bile ducts — actually move the bilirubin from the liver to the intestines so that the bilirubin can leave the body in stool. If anything blocks this bile duct system, it can lead to jaundice. Examples include:
Gallstones: These can form in the gallbladder and get stuck in the bile ducts when they’re excreted with bile.
Scarring of the bile ducts: This can occur after surgery on your gallbladder.
Tumors or cysts: These can form in the liver, gallbladder, bile ducts, or pancreas.
Medications and treatments
Commonly prescribed medications that may cause jaundice include:
Oral contraceptive pills (OCPs): These can slow the flow of bile from the ducts to the intestine. This is a rare side effect that usually goes away once you stop the OCP.
Anabolic steroids: These can also impact bile flow and cause jaundice.
Penicillins: Similar to OCPs and steroids, penicillins may interfere with bile flow and cause mild inflammation of the liver. Most cases are mild or moderate and resolve quickly.
Why does jaundice happen in newborns?
Newborns can also develop jaundice. But this happens for different reasons, including:
Physiologic jaundice: In the first few days of life, a baby’s liver is still getting up to speed and can’t remove bilirubin as quickly as an adult liver.
Breastfeeding jaundice: Some babies don’t get enough fluid for the first few days of life. This leads to fewer wet diapers and stooling. Bilirubin builds up in the body when the normal removal process isn’t working as fast. This naturally improves as breast milk production increases and babies are more hydrated.
Breast milk jaundice: The cause of this may be the breast milk itself. It leads to jaundice around 10 to 15 days after birth. It generally goes away on its own within the first few weeks of life and isn’t harmful to the baby.
Different blood types between mother and baby: This can occur if a mother has Type O blood and a baby has Type A or B. It can also occur if the mother is Rh negative and the baby is Rh positive. In both cases, the mother’s body produces antibodies that attack the baby's red blood cells, which rapidly breaks them down and leads to excess bilirubin production.
Birth trauma: Babies may experience trauma to the head while exiting the birth canal, which can cause bruises. As the bruises heal and the blood is reabsorbed into the baby’s body, bilirubin levels can temporarily rise.
The bottom line
Jaundice occurs when there’s a buildup of bilirubin in the body. This can happen for a lot of reasons. It can be a problem with the breakdown of red blood cells, which is the process that releases bilirubin in the blood. It can also be a problem with the liver, which has the job of removing it from the blood and preparing it for excretion. Or it can be a problem with the final step in the process, which is getting the processed bilirubin into the intestine so it can be removed along with other waste.
So if you or someone you know starts to notice new jaundice, the most important next step is to see a provider so they can run tests and begin to figure out the exact cause.
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