Classified by the site of the problem - pre-hepatic, hepatocellular or cholestatic/obstructive

Or by the type of circulating bilirubin - conjugated or unconjugated

Unconjugated

  • Water insoluble - does not enter urine
  • Overproduction: haemolysis (malaria/DIC)
  • Impaired hepatic uptake - drugs (Paracetamol, rifampicin), ischaemic Hepatitis

Conjugated

  • Water soluble - excreted in urine making it darker
  • Failure of conjugated bilirubin to be excreted by the gall bladder into the intestines can cause pale stools