Gilbert’s Syndrome: The Harmless Liver Disorder

~ by Jo Jordan

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For all of its many intimidating names, Gilbert's Syndrome (GS) is merely a harmless liver disorder in which a slightly elevated level of a specific liver enzyme – necessary in the disposal of blood waste matter – is present. Not a disease at all, GS is considered to be a finding...i.e. a genetic condition present in three to seven per cent of Americans.¹

An extremely common condition, Gilbert’s syndrome has more names associated with it than pharmacies have pills! GS is also known as constitutional hepatic dysfunction, familial nonhemolytic jaundice, unconjugated benign bilirubinemia, unconjugated hyperbilirubinemia, Gilbert's disease, Gilbert-Lereboullet syndrome, Gilbert-Meulengracht syndrome, Meulengracht’s disease, Meulengracht's icterus, and Meulengracht's syndrome.

Genetics 101: The Cause of Gilbert’s Syndrome

GS is caused by mildly elevated levels of a liver enzyme essential to the disposal of bilirubin. A natural pigment, bilirubin is the resulting chemical from the body’s normal breakdown of hemoglobin from red blood cells. The liver enzyme abnormality associated with GS most often occurs after starvation or dehydration.

While both sexes are affected, GS occurs twenty-five percent more often in men than in women.²

GS is passed on genetically, which is why it’s more commonly found among family members. More than fifty percent of the general population carries one copy of the inherited, abnormal gene that controls the enzyme that assists in the breakdown of bilirubin.³

If parents who each possess the abnormal gene have a child, the genetic defect that causes GS may be passed along; but not in all cases. And not everyone who has two copies of the abnormal gene develops GS, so it’s possible to have the condition without a family history of the disorder.

Gilbert's Syndrome Signs, Symptoms, and Risk Factors

Opinions regarding the symptoms associated with this disorder vary somewhat. While some experts say there are GS patients who don’t develop any symptoms whatsoever, other research reports that jaundice is a constant factor.

In general, GS is documented as a chronic disorder that – in the absence of any specific symptoms – presents with fluctuating jaundice.

Other Possible Symptoms:

Abdominal pain
Anxiety
Fatigue
Nausea
Weakness

Factors that Sometimes Increase Symptoms:

Alcohol
Dehydration
Fasting
Illness, including infections such as a cold or the flu
Menstruation
Overexertion

Gilbert's Syndrome Complications

Other than jaundice – which normally comes and goes, disappearing on its own – there are no other known complications for GS, and the disorder doesn’t damage the liver. The condition does not require treatment.

When a person with GS is ill with, say, the flu, sometimes the bilirubin level may further increase (as noted above in Factors that Sometimes Increase Symptoms). Often, this is when jaundice occurs, and the condition actually gets diagnosed.

There may be increased side effects with certain medications. Irinotecan (Camptosar) – a colon cancer treatment – for example, can reach toxic levels if the patient has GS, resulting in severe diarrhea.⁴

Diagnosing Gilbert's Syndrome

Cases of GS are often discovered by chance when routine testing such as a complete blood count (CBC) or liver function tests indicate an elevated level of bilirubin in the blood. Typically, test results will be normal except for a slightly elevated level of unconjugated bilirubin.

While GS is not serious at all, it’s important – especially if you’re experiencing jaundice – to rule out more problematic liver conditions such as an excessive breakdown of red blood cells, hepatitis, or an obstructed bile duct.

Managing Gilbert's Syndrome

Since GS is an inherited genetic disorder, it’s not possible to prevent the disorder. However, by avoiding and being aware of factors that trigger bilirubin levels to rise, it’s possible to reduce the number of jaundice bouts you experience.

Try to avoid alcohol, becoming dehydrated, fasting, infectious illnesses such as colds or the flu, and overexertion. Eat regular, nutritious meals, and consider a multi-vitamin to ensure adequate vitamin, mineral, and nutrient intake, and to promote overall health. And be sure to manage your stress level each day.

For maintaining healthy liver functioning throughout life, liver cleansings are sometimes recommended. An aid to improving overall digestion, a liver cleanse can be a boon to optimum health.

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Notes:
1. Mayo Foundation for Medical Education and Research (MFMER), “Gilbert syndrome,” http://www.mayoclinic.com/health/gilberts-syndrome/DS00743 (accessed February 10, 2009).
2. Whonamedit.com, Who Named It?, “Gilbert’s syndrome,” http://www.whonamedit.com/synd.cfm/2877.html (accessed February 10, 2009).
3. Mayo Foundation for Medical Education and Research (MFMER), “Gilbert syndrome,” http://www.mayoclinic.com/health/gilberts-syndrome/DS00743 (accessed February 10, 2009).
4. Ibid.