What jaundice and hepatitis mean
Jaundice is not a disease by itself. It is a sign that a yellow substance called bilirubin has built up in the blood. Bilirubin comes from the normal breakdown of old red blood cells, and the liver clears it into the bile. When the liver is inflamed, or the bile flow is blocked, bilirubin rises and the eyes and skin turn yellow.
Hepatitis means inflammation of the liver. In India, the most common cause of jaundice in older children and adults is viral hepatitis, especially hepatitis A and E. These spread through contaminated food and water, and outbreaks are common during and after the monsoon, when drinking water supplies can get mixed with sewage.
Main causes
Jaundice has many possible causes, and finding the exact one matters, because treatment is very different for each. A doctor will use your history, an examination and a few blood tests and scans to work it out. The common causes are listed below.
- Hepatitis A and E: spread through unsafe water and street food; usually short illnesses
- Hepatitis B and C: spread through blood, unsafe injections, unscreened transfusions, sex and from mother to baby; can become long-term
- Alcohol-related liver disease and fatty liver
- Medicines and some herbal or unregulated remedies that harm the liver
- Gallstones or growths that block the bile duct
- Breakdown of red blood cells, as in malaria or some inherited conditions
- Newborn jaundice, which is common in the first days of life
Symptoms to watch for
Early viral hepatitis often feels like flu: tiredness, fever, body ache, loss of appetite, nausea and vomiting. A few days later the urine turns dark yellow, the eyes become yellow and stools may turn pale. Some people have itching and pain in the upper right side of the belly.
Hepatitis B and C often cause no symptoms for years while slowly damaging the liver, and can lead to scarring (cirrhosis) or liver cancer if not treated. This is why testing is important for people at risk, such as those who had blood transfusions, dialysis or unsafe injections, even when they feel perfectly well.
Tests for jaundice
A liver function test (LFT) measures bilirubin and liver enzymes and shows how inflamed the liver is. Blood tests for hepatitis viruses, such as anti-HAV IgM, HBsAg, anti-HCV and anti-HEV IgM, identify the cause. A prothrombin time (PT/INR) checks how well the liver is making clotting proteins.
An ultrasound of the abdomen looks for gallstones, a blocked bile duct, fatty liver or changes of long-term liver disease. A complete blood count helps detect infections and breakdown of red blood cells, and a malaria test may be done if there is high fever. Your doctor will decide which tests you need.
Treatment and home care
There is no special medicine for hepatitis A and E; the liver usually heals by itself over a few weeks with rest and good nutrition. Doctors treat symptoms such as vomiting and itching and repeat liver tests to track recovery. Hepatitis B and C need a specialist, and effective antiviral medicines are available, only on a doctor's prescription.
Eat normal, freshly cooked, balanced home food, drink plenty of safe fluids, and rest until you feel stronger. Avoid alcohol completely for as long as your doctor advises. Do not take any medicine, including paracetamol, supplements or herbal remedies, without asking your doctor, because an inflamed liver handles medicines poorly.
Preventing jaundice and hepatitis
Most jaundice from viral hepatitis can be prevented with safe water, hygiene and vaccines. Special care is needed in pregnancy, because hepatitis E can be serious for pregnant women. All pregnant women are tested for hepatitis B, and babies born to mothers with the infection need the vaccine and protective injection at birth.
- Drink boiled or properly filtered water, especially in the monsoon
- Wash hands with soap before eating and after using the toilet
- Avoid cut fruit and uncovered street food
- Get vaccinated against hepatitis B; hepatitis A vaccine is also available
- Never share razors, needles or toothbrushes, and insist on sterile needles
When to see a doctor for jaundice and hepatitis
See a doctor as soon as you notice yellow eyes or dark urine, so the cause can be found with tests. Do not rely on untested local remedies, which can delay treatment or harm the liver. Newborns with yellow skin spreading to the legs, or jaundice in the first day of life, need a paediatrician urgently. A doctor or pharmacist can advise on safe medicines while the liver recovers.
Medicines doctors commonly use
Only your doctor can decide which medicine, dose and combination is right for you.
- Antiviral medicines for hepatitis B (such as tenofovir or entecavir)Suppress the hepatitis B virus to protect the liver from long-term damage.Only on a doctor's prescription; never stop suddenly without specialist advice.
- Direct-acting antivirals for hepatitis C (such as sofosbuvir-based combinations)Clear the hepatitis C virus from the body in most people.Only on a specialist's prescription after proper tests.
- Anti-nausea medicines such as ondansetronReduce vomiting so you can keep food and fluids down.Only on a doctor's advice while the liver is inflamed.
- Oral rehydration solution (ORS)Replaces fluids and salts lost through vomiting or poor intake.Follow the pack instructions for mixing with safe water.
See a doctor urgently if
- See a doctor urgently if the person becomes confused, very sleepy or behaves strangely.
- See a doctor urgently if there is bleeding from the gums, nose, vomit or black stools.
- See a doctor urgently if vomiting is constant and no fluids stay down.
- See a doctor urgently if a pregnant woman develops jaundice.
- See a doctor urgently if a newborn has jaundice in the first 24 hours or yellow colour reaching the palms and soles.
- See a doctor soon if the belly or legs become swollen.
Tests that may help
This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.