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Definition
Gilbert's (zheel-BAYRZ) syndrome is a common, mild liver disorder in which the liver doesn't properly process a substance called bilirubin. Bilirubin is produced by the breakdown of red blood cells.
Gilbert's syndrome is caused by an inherited gene mutation. You're born with Gilbert's syndrome, though it often goes undiscovered for many years.
Gilbert's syndrome is often discovered by accident, such as when you have a blood test that shows elevated bilirubin levels. Gilbert's syndrome typically doesn't require treatment and doesn't cause serious complications.
Gilbert's syndrome is also known as constitutional hepatic dysfunction, benign unconjugated bilirubinemia and familial nonhemolytic jaundice.
Symptoms
Gilbert's syndrome typically doesn't cause signs and symptoms. If Gilbert's syndrome causes the level of bilirubin in your blood to rise enough, you may experience:
- A yellowish tinge to your skin and the whites of your eyes (jaundice)
- Abdominal pain
- Fatigue
- Weakness
When to see a doctor
Make an appointment with your doctor if you experience any signs or symptoms that worry you. Signs and symptoms such as jaundice, abdominal pain and fatigue have many possible causes.
Gilbert's syndrome typically doesn't cause signs or symptoms, so you may not realize you have the disorder until a blood test for some other disease or condition shows an elevated bilirubin level. If this occurs, discuss the results with your doctor.
Causes
Gilbert's syndrome is caused by an abnormal gene that you inherit from your parents. The gene controls an enzyme that helps break down bilirubin in your liver. With an ineffective gene, excess amounts of bilirubin build up in your blood.
How the body normally processes bilirubin
Bilirubin is a yellowish pigment that's made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver. Normally an enzyme in liver cells breaks down the bilirubin and removes it from the bloodstream. The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood.
How the abnormal gene is passed through families
The abnormal gene that causes Gilbert's syndrome is common. Many people carry one copy of this abnormal gene. Two abnormal copies are needed to cause Gilbert's syndrome. If two people who each carry one copy of the abnormal gene have a child, they may pass along the genetic defect that causes Gilbert's syndrome.
Risk factors
You have an increased risk of Gilbert's syndrome if both of your parents carry the abnormal gene that causes the disorder.
Factors that may increase the likelihood of signs and symptoms
Most people don't experience signs and symptoms of Gilbert's syndrome. But some other conditions may increase the likelihood that you'll have signs and symptoms. These may include:
- Illness, such as a cold or the flu
- Fasting or eating a very low calorie diet
- Dehydration
- Menstruation
- Stress
- Strenuous exercise
Complications
Jaundice
Gilbert's syndrome can cause episodes of jaundice. However, the jaundice is usually mild and goes away on its own. In some cases, your doctor may prescribe phenobarbital to lower extremely elevated bilirubin levels and reduce signs of jaundice.
More side effects with certain medications
The low level of the bilirubin-processing enzyme that causes Gilbert's syndrome may also cause increased side effects with certain medications, since this enzyme also plays a role in helping clear these medications from your body.
In particular, irinotecan (Camptosar), a cancer chemotherapy drug, can reach toxic levels if you have Gilbert's syndrome, causing severe diarrhea. The antiviral indinavir (Crixivan), which is used in people with HIV, may also cause complications in people with Gilbert's syndrome.
Because of this potential effect with certain medications, talk to your doctor before taking any new medications if you have Gilbert's syndrome.
Preparing for your appointment
If a recent blood test revealed that you may have Gilbert's syndrome, you may be worried what this means for your health. At your next appointment, be prepared with a list of questions for your doctor. Discussing Gilbert's syndrome with your doctor may help put your mind at ease or help you feel more in control of your condition.
Here are some questions that might help facilitate a discussion with your doctor:
- What is my bilirubin level?
- Is my bilirubin level significantly elevated?
- Should I have my bilirubin level tested again?
- I've been experiencing some unexplained symptoms, could these be caused by Gilbert's syndrome?
- Would you review the medications I'm taking for other conditions to make sure they're compatible with Gilbert's syndrome?
- Do I need treatment for Gilbert's syndrome?
- Can Gilbert's syndrome cause complications or lead to liver damage?
- Is there anything I can do to maintain a low bilirubin level?
- What signs or symptoms can I expect if my bilirubin levels increase?
- If I experience jaundice or other signs, should I make an appointment with you?
- What is the likelihood that my children or other relatives also have Gilbert's syndrome?
Tests and diagnosis
Often detected by accident
Your doctor may inadvertently discover you have Gilbert's syndrome if:
- A blood test for some other condition reveals high levels of bilirubin
- You experience jaundice with no obvious cause
Although it's present from birth, Gilbert's syndrome usually isn't diagnosed until puberty or later, since bilirubin production increases during puberty.
Blood tests
Your doctor may recommend blood tests to confirm your Gilbert's syndrome and rule out other conditions, such as liver problems. Common blood tests include:
- Bilirubin test
- Complete blood count (CBC)
- Liver function tests
Treatments and drugs
Gilbert's syndrome generally doesn't require treatment. The bilirubin levels in your blood may fluctuate over time and you may occasionally experience jaundice. But this usually goes away on its own and doesn't require treatment.
Lifestyle and home remedies
Certain events in your life can trigger episodes of higher bilirubin levels in Gilbert's syndrome, leading to jaundice. Doing what you can to manage those situations can help keep bilirubin under control and perhaps prevent bouts of jaundice.
These steps include:
- Tell every doctor about your Gilbert's syndrome. Gilbert's syndrome affects the way your body processes certain medications. This has the potential to worsen side effects. Tell each doctor you visit that you have Gilbert's syndrome, so any medications can be selected with this in mind.
- Eat a healthy diet. Choose a healthy diet full of fruits and vegetables. Avoid extremely low calorie diets. Stick to a routine eating scheduled and avoid fasting or skipping meals.
- Manage stress. Find ways to deal with the stresses in your life. Consider exercise or quiet time alone to cope with stress.
Last Updated: 2010-04-17
