Bilirubin and jaundice during chemotherapy

It cannot tell you what is causing your bilirubin to rise or how serious it is. That needs examination, other blood tests and usually a scan. It also cannot tell you whether your treatment should be changed; your oncologist decides using limits set for each medicine.

It cannot advise on remedies for jaundice. Traditional treatments for jaundice, including herbal preparations, can harm the liver further or delay urgent care. Please do not use them without talking to your team.

Stents need care

If you have a bile duct stent, fever, shivering or returning yellowing may mean it is blocked or infected. This needs same-day attention.

Itching can be eased

Cool showers, moisturisers, loose cotton clothing and prescribed medicines can reduce itching. Ask your team before using creams.

Diet during jaundice

Small, light meals and enough fluids help. Avoid alcohol completely, and ask before changing your diet dramatically.

Skin colour can hide jaundice

On darker skin, yellowing is easier to see in the whites of the eyes, the palms and under the tongue.

Medicines may need changing

Some pain and anti-sickness medicines are processed by the liver and may need adjusting when bilirubin is high.

Gilbert syndrome is worth knowing about

If you have been told you have it, tell your team, as it affects how some medicines such as irinotecan are handled.

Children and newborn jaundice are different

This page is about adults on chemotherapy. Jaundice in babies has different causes and care.

Keep liver reports together

Trends in bilirubin and liver tests over several weeks help your team judge improvement.

Watch stool and urine colour

Pale, clay-coloured stools and dark, tea-coloured urine can appear before yellowing of the eyes is obvious. Noticing and reporting these changes early can speed up tests and treatment.

Blood clotting can be affected

When the liver is struggling, blood may clot less well. Report nosebleeds, bleeding gums or easy bruising, and tell any doctor before procedures that you have jaundice.

Why direct and indirect bilirubin are reported

Some reports split bilirubin into direct and indirect parts. A rise mainly in one part can point towards a problem with bile flow or the liver, while a rise in the other can suggest faster breakdown of red cells or Gilbert syndrome. Your team uses this split, together with scans and other tests, to narrow down the cause.

Rest and pacing during jaundice

Jaundice often comes with deep tiredness and poor appetite. Rest when you need to, eat small amounts often, and let family help with daily tasks while the cause is being treated.

What to do next

Call your team the same day for yellow eyes, dark urine or pale stools, and seek emergency care if yellowing comes with fever, confusion, bleeding or severe pain. Tell your team about all medicines and remedies, avoid alcohol and traditional jaundice treatments, and let your team interpret results and adjust treatment.