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Gilbert Syndrome

(Hyperbilirubinemia)

Definition

Gilbert syndrome is a disorder of the liver. It makes it difficult for the liver to break down a toxin called bilirubin. If bilirubin is not changed to a nontoxic version by the liver, then it can build up in the blood. Gilbert syndrome is a mild condition for most people.

The Liver
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Causes

Genes are plans for cells to tell them how to work and how to grow. Gilbert syndrome is caused by a problem with a specific gene. The problem gene is inherited from the parent or parents. One gene defect has to be present in both parents in order for a child to inherit the defect. A second version of the gene only need to be present in one parent for it to pass on to the child. In both cases, the parent may not have the condition and not every child will be affected.

Bilirubin is made when old blood cells break down. In its original form it is toxic. The liver has a process that can turn toxic bilirubin into a nontoxic form which can then pass from the body. The gene defect makes it hard for the liver to change the toxin form to a nontoxic form. As a result, the toxic version can build up in the blood. Very high levels of the toxic bilirubin can cause symptoms.

Risk Factors

Gilbert syndrome is more common in males, and in those with a family history.

Symptoms

Often, there are no symptoms of Gilbert syndrome. However, people who do have symptoms may experience:

  • Yellowing of the skin known as jaundice
  • Jaundice of the whites of the eyes
  • Abdominal pain
  • Loss of appetite
  • Fatigue and weakness
  • Darkening of the urine

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Blood tests will show abnormal level of bilirubin. Because the levels can vary, multiple tests may be needed over a period of time. Blood tests will also show the overall health of liver. If all other liver tests are normal except for bilirubin, than Gilbert syndrome may be suspected.

Treatment

No treatment is necessary for Gilbert syndrome. Usually, symptoms come and go. Symptoms may get worse after:

  • Skipping meals or fasting
  • Dehydration
  • Vigorous exercise
  • Repeated bouts of vomiting
  • Stress or trauma

Prevention

There is no way to prevent Gilbert syndrome. If Gilbert syndrome is present in the family genetic testing can help determine the odds of offspring having the condition.

RESOURCES:

American Liver Foundation
http://www.liverfoundation.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Liver Foundation
http://www.liver.ca

Health Canada
https://www.canada.ca

REFERENCES:

Gilbert syndrome. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/gilbertsyndrome. Accessed January 29, 2021.

Gilbert syndrome. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T115578/Gilbert-syndrome. Accessed January 29, 2021.

Gilbert syndrome. Genetics Home Reference website. Available at: http://ghr.nlm.nih.gov/condition/gilbert-syndrome. Accessed January 29, 2021.

Last reviewed March 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC