Bilirubin is a reddish yellow pigment produced by the normal breakdown of haemoglobin contained in red blood cell. Bilirubin enters the liver from the blood stream and then passes out via the bile duct down the bowel where it is excreted. It is responsible for giving to the motions or stools the typical yellow or brown colour.

Bilirubin will build up in the blood stream to abnormally high levels and produce jaundice if there is excessive destruction of red cells. This can occur in the case of certain anaemia’s and also with some drugs and blood infections.

A blockage of bilirubin excretion causes a build up of bilirubin in the blood stream to produce jaundice. In many young people hepatitis is the commonest cause. In older people gall stones which block the bile duct are the usual cause. This is called obstructive jaundice. Tumours affecting the liver or bile ducts are also a possible cause of obstructive jaundice.

Jaundice and particularly obstructive jaundice is associated with pale stools and dark urine.

The main types of jaundice apart from yellowing of the skin is itchiness. other symptoms associated with the particular cause will often be present. These include loss of weight in the case of a tumour, tiredness may indicate anaemia or infection, whereas liver inflammation will produce toxic affects such as nausea and vomiting and a rise in temperature. Diarrhoea may also be present. A gall stone in the common bile duct will often produce excruciating pain associated with obstructive jaundice.

All cases of jaundice should be thoroughly investigated and your doctor should be consulted.

Investigations may have to include blood examinations including liver function tests, liver biopsy, liver scans, ultrasound and magnetic resonance imaging.