Gilbert's Syndrome is a very mild liver condition characterized by a lack of the enzyme needed to break down bilrubin, a yellowish pigment found in red blood cells. This condition is so mild that it does not usually require treatment, and it is also extremely common. In fact, many people have Gilbert's Syndrome and don't even realize it because symptoms do not manifest in all people with this condition. People may find out by accident during routine medical examinations which reveal elevated bilrubin levels.
This disorder is genetic, caused by a missing gene, and it appears to be more common in men than in women. Without that gene, the body does not know how to code the enzyme it needs to break down bilrubin, so bilrubin remains “unconjugated,” meaning that it does not bind with other materials in the body which can hold on to the bilrubin while it is flushed out of the body as waste material. As a result, it remains in circulation in the body.
Bilrubin is a normal byproduct of the breakdown of old red blood cells. In people with the necessary enzyme, the bilrubin is broken down and expressed from the body or re-used. In people with Gilbert's Syndrome, the bilrubin builds up in the blood. The most common symptom is jaundice, a yellowing of the skin and eyes. Some people also have trouble processing certain medications, because the missing enzyme is also necessary for successful breakdown of some drugs.
People usually seek medical attention for Gilbert's Syndrome when they develop jaundice, which does not occur in all people with this genetic disorder. A doctor will typically perform tests to rule out other causes of jaundice before diagnosing the patient with Gilbert's Syndrome. Phenobarbital can be used in carefully measured amounts to treat the jaundice if it has become severe, but usually no treatment is recommended.
Certain factors appear to increase the buildup of bilrubin in the blood, leading to jaundice. Stress, infections, dehydration, overexertion, hunger, and menstruation, for example, can all contribute. Eating a healthy diet, exercising, and keeping stress levels down is usually enough to address the issue, although doctors should be made aware of it so that they do not prescribe medications which someone might have trouble breaking down.
