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Wednesday, February 26, 2020

Gilbert Syndrome: Causes, Symptoms, Diagnosis and Treatment


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Emmanuel Ekokotu
Ekokotu Emmanuel Eguono is a mass communicator and fashion designer. When he is not behind a laptop screen or on a sewing machine, he spends his time netflixing and swimming.

Gilbert Syndrome is sometimes referred to as Familial nonhemolytic jaundice or Constitutional hepatic dysfunction. It is an inherited liver condition where the kidney is unable to process bilirubin.


Bilirubin is a yellow substance that is naturally found in the blood when red blood cells are broken down by the liver. It is later eliminated from the body through urine or faeces.

Gilbert Syndrome causes the buildup of bilirubin in the bloodstream, thereby resulting in a condition known as ‘hyperbilirubinemia.’ Sometimes, this term may appear in results of a blood test; what it means is that the level of bilirubin in your body is high.

Is Gilbert’s Syndrome dangerous?

High levels of bilirubin, in some cases, imply that your liver isn’t functioning correctly. However, in the case of Gilbert’s syndrome, high bilirubin doesn’t affect your liver function.

This syndrome is not often a severe condition that needs to be treated, although it might cause some minor problems. About three to seven percent of people in the US are diagnosed with the condition. Some studies also show that it’s as high as thirteen percent.

What are the Causes of Gilbert’s Syndrome?

It is a genetic condition passed down from parents. Individuals with this syndrome must have inherited these genes that make it difficult for the liver to excrete bilirubin from the blood.

Usually, when red blood cells reach the end of their lives – at one hundred and thirty days – the red blood pigment (heamoglobin), which is responsible for transporting oxygen, the blood breaks down into bilirubin.

The liver turns bilirubin into a water-soluble form, which turns into bile and is later passed out as faeces or urine. Bilirubin gives faeces its dark brown colour and urine it’s light yellow colour.

In Gilbert syndrome, the mutated gene means that bilirubin is not turned into bile at the regular rate. Instead, It accumulates in the bloodstream, giving the whites of the eyes and the skin a yellowish tinge.

What are the Risk Factors for developing Gilbert’s Syndrome?

There are no known or established risk factors for developing the disease other than inheriting the mutated gene. It is also not related to any environmental factors, underlying severe liver problems, or lifestyle habits.


Symptoms of Gilbert’s Syndrome

The symptoms of this syndrome tend to be unnoticeable. Sometimes, people with the syndrome do not have any symptoms.

Most individuals don’t even know that they have the condition as it may not be diagnosed until adulthood.

For individuals that have it, the symptoms include;

  • Fatigue
  • Nausea and diarrhea
  • Loss of appetite
  • IBS(Irritable Bowel Syndrome)- it is a disorder that causes bloating, constipation and stomach cramps
  • The whitening of the eyes and yellowing of the skin (jaundice)
  • Problem of concentrating and not thinking clearly (brain fog)
  • A little discomfort in your abdominal area
  • A general sense of feeling unwell

These symptoms can be more noticeable if an individual does things that increase the bilirubin level, which includes;

  • Not drinking enough water
  • Menstruating
  • When experiencing emotional stress or physical stress
  • Having an infection or being sick
  • Exposure to cold
  • Exercising too much
  • Not sleeping enough
  • Not eating for an extended period
  • Recovering from surgical operations

Some people with the condition also find that taking alcohol may worsen their symptoms. For some, just a couple of shots can make them feel sick shortly afterward.

You might also experience what feels like a hangover for some days. Alcohol might temporarily increase bilirubin levels in people with Gilbert’s syndrome.

How is it Diagnosed?

Gilbert’s syndrome can be diagnosed when there are visible signs of jaundice without other symptoms of a liver problem. Even if there are no signs of jaundice, your doctor may detect high levels of bilirubin during a routine liver function blood test.

Your doctor may carry out tests such as ultrasound, CT scan, liver biopsy, or other blood tests to dismiss any other treats or underlying conditions that may cause or add to abnormal bilirubin levels.

Gilbert syndrome can occur side-by-side with other blood and liver conditions. You may likely be diagnosed with Gilbert’s syndrome if your test results show that you have an increased level of bilirubin in your blood but no signs of any liver diseases.

In some cases, a genetic test may be conducted to check for the gene mutation responsible for the condition.


Treatment of Gilbert’s Syndrome

Most cases of this disorder do not require treatment. However, if you start noticing significant symptoms like nausea of fatigue, your doctor might recommend taking daily phenobarbital (Luminal) to help lower the amount of bilirubin in your blood.

There are certain lifestyle changes you can make to help prevent the symptoms. These include;

  • Stay well hydrated: it is vital to stay hydrated when you are ill when exercising and during hot weather.
  • Get enough sleep: it is advisable to get up to seven or eight hours of sleep and also a follow up of a particular routine as closely as you can.
  • Avoid long period of intense exercise: you should get at least thirty minutes of light exercise each day and make intense workouts short (preferably five minutes).
  • Eat a balanced diet: you should eat often, do not skip meals, do not follow dietary plans that require you taking a little amount of calories, or even fasting.
  • Limit alcohol intake: you should avoid alcohol if you have any liver problem, but if you do take at all, it should be minimized to just a few drinks in a month.
  • Try relaxation techniques to cope with stress: you can do yoga, listen to different music, meditate, or try several activities that help you relax.
  • Learn how your medications work with Gilbert’s syndrome: some of the medicines you take, including the ones used to treat cancer, may work in a different way when you have this disorder. So you should talk to your doctor about medications to avoid complications.

Living with Gilbert’s Syndrome

This disorder is not dangerous to the health, and sometimes it doesn’t need to be treated. Jaundice and other related symptoms will pass eventually. The syndrome does not cause a change in life expectancy for any individual.

However, if you start experiencing symptoms, you may need to make specific lifestyle changes.


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