Jaundice - Diagnosing jaundice

If you have jaundice, you'll have a number of initial tests to find out how severe it is and determine the underlying cause.

These tests are described below.

Medical history and examination

It's likely that your GP or the clinician in charge of your hospital care will want to take a detailed medical history in case it could provide clues as to why you have jaundice.

You may be asked whether:

you had any flu-like symptoms before your jaundice (this would point towards a diagnosis of hepatitis)
you're currently experiencing any other symptoms, such as abdominal pain, itchy skin or weight loss
you've recently travelled to a country where conditions such as malaria or hepatitis A are widespread
you've noticed a change of colour in your urine and stools
you have a history of prolonged alcohol misuse
you're currently taking recreational drugs or have taken them in the past
your occupation could have exposed you to any harmful substances

It's likely that you'll also be given a physical examination to check for signs of an underlying condition, such as:

swelling of the legs, ankles and feet (a possible sign of cirrhosis)
a noticeable swelling of your liver (a possible sign of hepatitis)

Urine test

A urine test can be used to measure levels of a substance called urobilinogen. It is produced when bacteria break down bilirubin inside the digestive system.

Higher-than-expected levels of urobilinogen in your urine may suggest a diagnosis of pre-hepatic jaundice or intra-hepatic jaundice. Lower levels could suggest post-hepatic jaundice.

Liver function and blood tests

A liver function test is a type of blood test that can be used to help diagnose certain liver conditions, including:

When the liver is damaged it releases enzymes into the blood. At the same time, levels of proteins that the liver produces to keep the body healthy begin to drop.

By measuring the levels of these enzymes and proteins, it's possible to build up a reasonably accurate picture of how well the liver is functioning. In addition, your blood can be tested for infections known to trigger the symptoms of jaundice, such as malaria and hepatitis C.

Imaging tests

If intra-hepatic jaundice or post-hepatic jaundice is suspected, it's often possible to confirm the diagnosis using imaging tests to check for abnormalities inside the liver or bile duct systems.

These include:

ultrasound scan – where high-frequency sound waves produce an image of the inside of your body
computerised tomography (CT) scan – a series of X-rays build up a more detailed, three-dimensional image of your body
magnetic resonance imaging (MRI) scan – this uses strong magnetic fields and radio waves to produce a detailed image of the inside of your body
endoscopic retrograde cholangiopancreatography (ERCP) – a small, flexible fibreoptic camera (endoscope) is used to inject a special dye into the bile ducts; the dye shows up on X-ray and is useful in helping to confirm a diagnosis of pre-hepatic jaundice

Liver biopsy

If it's suspected that your liver has been damaged by a condition such as cirrhosis or liver cancer, a liver biopsy may be recommended to assess the condition of the liver tissue.

During a liver biopsy, your abdomen (tummy) is numbed with a local anaesthetic (painkilling medication) and a fine needle is inserted so that a small sample of liver cells can be taken and sent to a laboratory for examination under a microscope.