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GILBERT'S SYNDROME

Gilbert's syndrome is a common and harmless genetic disorder of the liver in which the liver does not process or excrete the bilirubin (a yellow-colored compound formed by the breakdown of red blood cells) completely. This causes increased levels of bilirubin in the body, resulting in yellowing of the eyes and skin. Gilbert’s syndrome is commonly seen in men than in women; it cannot be noticed until puberty, as the production of bilirubin increases at this stage. It is a normal condition and usually does not require treatment.

Symptoms

Most of the patients with Gilbert’s syndrome do not show symptoms, however, few people develop mild jaundice and yellowing of the eyes. Other non-specific symptoms of Gilbert’s syndrome include:

However, these signs and symptoms may not directly indicate Gilbert’s syndrome as they are also seen in other health conditions.

Gilbert's syndrome is mainly caused by genetic mutation in the promoter region of the gene for the enzyme UGT1A. This gene mainly helps in the breakdown of bilirubin in the liver and ineffective gene causes excess levels of bilirubin in the body. Generally, 2 copies of this gene are needed to cause Gilbert’s syndrome.

Gilbert's syndrome is usually present during birth but it is not noticed until puberty as bilirubin increases during this stage. The risk of Gilbert’s syndrome increases if the patient is a man or if both the parents carry abnormal gene causing the disorder.

Complications

Reduced levels of bilirubin processing enzyme may affect the side effects of certain medications such as irinotecan and some protease inhibitors used to treat HIV as these enzymes play a major role in drug metabolism.

Patients with Gilbert's syndrome are also at increased risk of developing gallstones.

Diagnosis

Looking at the symptoms, the doctor would recommend blood tests to check the levels of bilirubin. If the test reports show increased levels of bilirubin, the doctor suspects Gilbert’s disease. However, other tests such as liver-function tests to confirm the disease. If the test results show high levels of bilirubin but the liver function is normal, it indicates Gilbert’s syndrome is confirmed.

In few cases, genetic testing may be required to confirm the diagnosis of Gilbert's syndrome.

Treatment

Treatment is usually not required for Gilbert’s syndrome. The bilirubin levels may fluctuate over time and may occasionally have jaundice, which usually resolves on its own with no ill effects.

Prevention

Certain conditions like stress can increase the levels of bilirubin resulting in jaundice. Therefore, it should be managed by exercising, meditation, listening to music etc. Eating low-calorie diet also plays a key role in maintaining bilirubin levels.

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