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Gilbert's Syndrome
Introduction
Gilbert's (zheel-BAYRZ) syndrome is a common, mild liver disorder in which the liver doesn't properly process a substance called bilirubin, which is produced by the breakdown of red blood cells. Also known as constitutional hepatic dysfunction, unconjugated benign bilirubinemia and familial nonhemolytic jaundice, Gilbert's syndrome typically doesn't require treatment or pose serious complications.
In fact, Gilbert's syndrome is usually not considered a disease because of its benign nature. Most people who have the disorder find out by accident, when they have a blood test that shows elevated bilirubin levels.
Gilbert's syndrome affects 3 percent to 10 percent of the U.S. population. More males than females have the condition.
Signs and symptoms
As an inherited condition, Gilbert's syndrome is present from birth. Although it rarely causes symptoms, it may raise bilirubin enough to produce mild jaundice.
While the bilirubin does not reach a dangerous level, jaundice, if it occurs, may look disconcerting. Typically, excess bilirubin turns the whites of your eyes yellow before affecting your skin. If the bilirubin level keeps rising, your skin may develop a yellowish tinge.
A number of factors may increase bilirubin if you have Gilbert's syndrome. These may include:
- Illness, including infections, such as the cold or flu.
- Menstruation.
- Fasting or skipping meals.
- Dehydration.
- Overexertion.
Causes
Your liver naturally produces bilirubin, which is a yellowish pigment. It's a normal waste product from the breakdown of old red blood cells. Bilirubin travels through your bloodstream to the liver. In normal functioning, an enzyme in liver cells helps break down the bilirubin and remove it from the bloodstream. The bilirubin passes from the liver into the intestines with bile. It's then excreted by the body through stool. A small amount of bilirubin remains in the blood.
People with Gilbert's syndrome, though, inherit an abnormal gene that controls the enzyme that helps break down bilirubin. This gene abnormality results in a lower level of the enzyme. Consequently, excessive amounts of a form of bilirubin called unconjugated bilirubin can build up in the blood.
Some experts believe that Gilbert's syndrome is simply a normal variation in the range of bilirubin levels.
Treatment
Because Gilbert's syndrome is essentially a mild, harmless condition, it doesn't require treatment. The level of jaundice associated with Gilbert's is typically harmless as well, and goes away on its own.
People with Gilbert's syndrome don't typically need long-term monitoring of their condition or repeat blood tests. But consult your doctor if you notice worsening jaundice or other symptoms.
If you're distressed by jaundice, the barbiturate medication phenobarbital may reduce bilirubin levels.
Prevention
Gilbert's syndrome is an inherited genetic disorder. Development of the disorder isn't related to lifestyle habits or environment.
The only way to theoretically prevent the condition is to keep parents from passing the abnormal gene that causes it on to their children. But more than half the people in the general population carry one copy of this abnormal gene, making it very common. If two people with this abnormal gene have a child, they may pass along the genetic defect that causes Gilbert's — but not always. Not everyone who has two copies of this abnormal gene gets Gilbert's syndrome. This means you may have the condition without a family history of it. In contrast, everyone with Gilbert's does have two copies of this abnormal gene.
Information obtained from National Institute of Health