You glance in the mirror and notice the whites of your eyes look a little yellow. At first it's easy to brush off — maybe you're just tired. But if you're being treated for something in the liver, bile ducts, or pancreas, this small change can be a fairly important signal. When a yellow pigment called bilirubin can't drain out of the body properly and starts building up, it stains the skin and the whites of the eyes yellow. That's jaundice. It often shows up when the path bile flows through is blocked or when liver function drops, so new jaundice during treatment is worth taking a serious look at.
Jaundice is easy to miss if you only look at your eyes, so there are a few other things worth checking alongside it. The classic ones are urine turning a dark brown, almost cola-colored, or stools going the opposite way and fading to a pale grayish-white. When bile can't make its way down into the intestine, the stool loses its color, and the bilirubin loops back to the kidneys instead, which darkens the urine. If you add to that an all-over itch, a heavy, full feeling in the upper right belly, or your appetite suddenly dropping off, it's hard to chalk it all up to just feeling run-down. Sometimes the person themselves barely notices, so a family member glancing over and saying "your eyes look a bit yellow" can be a surprisingly big help.
So when should you call? First, if yellowing of the eyes or skin is something you're seeing for the first time, even if it looks very faint, it's better to let your care team know rather than wait until your next appointment. Especially if a fever over 38 degrees comes with it, or you get chills and start shivering, this can be an emergency where the bile duct has become inflamed — no reason to hesitate. The same goes if the upper belly pain keeps getting worse, if you're vomiting so much you can't keep down medicine or even water, or if you notice yourself feeling foggy and slurring your words in a way that isn't normal for you. You might think "is it really okay to call over this?" — but in the face of these signs, asking early is almost always the right move.
Making a few notes before you call makes the conversation go a lot smoother. Write down when the yellow tint first showed up, what color your urine and stool are, what your temperature was and when you took it if you had a fever, and where and how it hurts if there's pain. Putting together a list of the medications you're taking and the dates of your recent treatments helps your care team grasp the situation quickly too. If you can, taking a photo of your eyes in natural light at around the same time each day is useful for comparing changes. Color gets distorted under fluorescent lighting, so daylight by a window is best.
Jaundice showing up doesn't automatically mean something terrible has happened. In many cases, once the cause is found and a blocked bile duct is reopened or medication is adjusted, it settles back down. The key, though, is confirming that cause quickly — so rather than digging around the internet on your own and toughing it out for a few days, a single phone call to talk it over with your care team is far more reassuring. Writing your emergency contact number somewhere easy to spot, like on the fridge or in your phone, means you won't be scrambling in the moment when things feel overwhelming.
This article is put together as a reference to help you understand the symptoms, and any actual judgment and treatment must be made together with your own care team.