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

Medical history and examination

It's likely your GP or hospital doctor will take a detailed medical history to try to determine why you have jaundice.

You may be asked whether:

• you had any flu-like symptoms before jaundice (this may indicate hepatitis)
• you're currently experiencing 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 alcohol misuse
• you're currently taking drugs or have taken them in the past
• your occupation could have exposed you to harmful substances

It's likely you'll also have 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), or 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's produced when bacteria break down bilirubin inside the digestive system.

Higher-than-expected levels of urobilinogen in your urine may suggest 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 used to help diagnose certain liver conditions including:

• hepatitis
• cirrhosis
• alcoholic liver disease 

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 fall.

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

Imaging tests

If intra-hepatic jaundice or post-hepatic jaundice is suspected, imaging tests can be used to check for abnormalities inside the liver or bile duct systems. These include:

• ultrasound scan
• computerised tomography (CT) scan
• magnetic resonance imaging (MRI) scan
• 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

A biopsy may be recommended to assess the condition of the liver tissue if it may have been damaged by a condition such as cirrhosis or liver cancer.

During a liver biopsy, your tummy is numbed with a local anaesthetic, 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.