Gilbert's Syndrome: Causes and Risk Factors

Gregory awoke half an hour early, eager to get to work and make his presentation to senior management. When he stepped up to his bathroom mirror, he got a shock. His eyes looked yellow.

Even though doctors consider it a common condition, Gilbert's syndrome usually takes its victims by surprise. While the disorder sometimes causes mild jaundice of a patient's eyes, many affected individuals never have any other signs or symptoms.

Overview

This condition occurs when a liver enzyme necessary for the disposal of bilirubin is abnormal, according to MedicineNet.com. Bilirubin is the chemical end product of the normal breakdown of hemoglobin from red blood cells. When this enzyme abnormality occurs, patients experience mild rises of bilirubin levels in the blood.

The disorder is also known as Gilbert disease, Gilbert syndrome, constitutional hepatic dysfunction and familial nonhemolytic jaundice. Doctors often discover it by accident, usually when reviewing the results of blood tests ordered to try to detect another problem.

The Mayo Clinic indicates that in patients who show symptoms of Gilbert's syndrome other than jaundice, the most common signs are abdominal pain, fatigue and weakness.

Causes

The cause of Gilbert's syndrome is genetic. Its pattern of inheritance is autosomal recessive, which means that for a child to have the disorder, both parents must carry the defective gene.

The specific cause of the illness is a mutation in what is known as the promoter region of a gene for the enzyme UGT1A, one of those important for bilirubin metabolism. This gene occurs on chromosome 2.

Bilirubin, a yellowish pigment, travels through the bloodstream to the liver, where the enzyme normally breaks it down and removes it from an individual's blood. The bilirubin then passes from the liver into the patient's intestines along with bile. While it eventually passes through the digestive tract and exits the body, a small amount remains in the blood. When the gene received from each parent is defective, this process goes awry. The bilirubin isn't processed properly.

Gilbert's syndrome occurs very frequently in the United States and Europe.

Risk Factors

Certain factors can increase the probability of developing signs and symptoms of this condition. An illness like a cold or the flu can trigger Gilbert's syndrome. Any degree of starvation, fasting or eating a diet very low in calories causes an elevated risk.

Other potential risk factors include dehydration, menstruation, stress and participating in strenuous exercise.

Prognosis

Patients typically don't require any specific treatment for Gilbert's syndrome. Over a period of time, the bilirubin levels in the blood typically fluctuate, causing occasional jaundice. This usually disappears on its own.

There are several things individuals with Gilbert's syndrome can do at home to keep bilirubin levels under control. Patients should tell every doctor who treats them that they have the disorder because it affects the way the body processes specific medications. Eating a healthy diet with plenty of fruits and vegetables is also helpful. It's important to avoid any diet extremely low in calories or skipping any meals. Most patients also find it helpful to find techniques like exercise or setting aside quiet moments to manage the stresses that creeps into their lives.

Sources:

http://www.medicinenet.com/gilbert_syndrome/article.htm

http://www.mayoclinic.com/health/gilberts-syndrome/DS00743