Gilbert’s Syndrome

Gilbert’s syndrome is a common, often inherited disorder that affects processing by the liver of the greenish-brown pigments in bile (called bilirubin). The resulting abnormal increase of bilirubin in the bloodstream can lead to yellowing of the skin (jaundice) but the liver itself remains normal. It is more common n men than women and is named after a French gastroenterologist.

What causes it?

About half the people affected inherit the condition which is probably due to decreased activity of an enzyme in the liver.

Who suffers?

Gilbert’s syndrome affects about 5% of the population. It is usually detected by chance often at a routine medical examination, in adolescence or early adult life.

What are the signs and symptoms?

Usually there are no symptoms but sufferers may experience mild jaundice, bouts of abdominal pain, loss of appetite, fatigue and weakness after suffering an infection. Repeated vomiting, missing meals, vigorous exercise or a feverish illness may also lead to these symptoms.

What investigations and treatment are necessary?

Blood tests are usually carried out simply to make a diagnosis and to exclude liver disease. No treatment is required.

Why bother about it?

People with Gilbert’s syndrome have a normal life expectancy. There is no hard evidence that the disorder is associated with other more serious diseases. But suddenly turning yellow (becoming jaundiced) can be extremely alarming in itself. However, more importantly, jaundice can be a sign of other more serious infectious illnesses (such as hepatitis) which rightly cause concern to doctors and also to sufferers and their families. Under these circumstances the urine usually become dark brown, and urgent medical attention would be required.

Knowing about the diagnosis of the harmless Gilbert’s syndrome, therefore, not only provides reassurance to sufferer, family and close associates, but also to the family doctor who would otherwise subject the yellow patient to a series of investigations out of concern to exclude more serious illnesses. At the same time, alarm about the possible spread of infection can also be dispelled.

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