Gilbert’s syndrome in adults
What are the main symptoms and treatments for Gilbert’s syndrome in adults? Together with the general practitioner, we discussed what kind of ailment it is, whether it can be avoided and what tests for Gilbert’s syndrome exist

What is Gilbert’s syndrome

Gilbert’s syndrome is an inherited liver disease. For him, the characters are the alternation of the stage of remission and episodes of jaundice, as well as an increase in the level of free bilirubin in the blood serum.

Most often, the syndrome manifests itself during puberty and proceeds in a benign form.

Causes of Gilbert’s syndrome

With the breakdown of red blood cells (erythrocytes), a person produces a substance toxic to his body – unbound bilirubin. It must be neutralized by liver cells, which bind it to glucuronic acid and convert it into water-soluble direct bilirubin. Further, with waste products, this compound is excreted from the body through the bile ducts and gallbladder.

The cause of Gilbert’s syndrome lies in the genetic mutation of the enzyme UDP-glucuronyltransferase. Because of this defect, the intracellular transport of unbound (free) bilirubin to the site of its junction with glucuronic acid is disrupted. As a result, the content of free bilirubin in the body increases, which is toxic to humans. It is the accumulation of indirect bilirubin in the skin that provokes the appearance of a yellow tint.

Symptoms of Gilbert’s syndrome

Not all experts attribute Gilbert’s syndrome to diseases. Many rank it among the physiological characteristics of the body. Until about 11-12 years of age, the syndrome may not manifest itself and proceed in an asymptomatic form. However, during puberty, the main signs may begin to appear.1.

Symptoms of Gilbert’s syndrome include:

  • the formation of yellow papules on the eyelids (xanthelasma of the eyelids);
  • yellowing of the skin and mucous membranes;
  • cyclicity of symptoms.

Due to a violation of the outflow of bile and changes in its composition, other symptoms of Gilbert’s syndrome can also be observed: stool changes, digestive disorders, increased gas formation and belching. In some cases, a person has increased fatigue, bad mood, decreased concentration, a feeling of bitterness in the mouth and pain in the right hypochondrium, sleep disturbance.

Treatment of Gilbert’s syndrome

There is no cure for Gilbert’s syndrome. In addition, the presence of this physiological feature outside the period of exacerbation of this treatment does not require2.

It is enough to follow simple recommendations:

  • eliminate mental and physical overload;
  • avoid taking oral contraceptives;
  • observe the drinking regime;
  • avoid prolonged exposure to sunlight;
  • limit the consumption of alcoholic beverages;
  • avoid long-term fasting;
  • eliminate complex fats and preservatives from the diet.

Diagnostics

To diagnose Gilbert’s syndrome, the existing complaints and their clinical manifestations are analyzed. The presence of episodes of jaundice in close relatives is established, and laboratory and instrumental diagnostic methods are used3.

Analysis for Gilbert’s syndrome

There is no single analysis that defines Gilbert’s syndrome. To make a diagnosis, the doctor will need a number of laboratory tests:

  • general blood analysis;
  • blood chemistry;
  • general urine analysis;
  • markers of hepatitis B, C, D viruses;
  • analysis remains.

In some cases, genetic testing may be ordered. To exclude other liver diseases, an ultrasound of the abdominal organs is prescribed. Other functional studies are prescribed if necessary and to get a clearer picture.

Prevention of Gilbert’s syndrome in adults at home

In order to avoid exacerbations, it is necessary to remember the negative impact on the body of excessive physical and mental stress, fasting and the use of certain medications. In more detail, the methods of prevention are prescribed by the doctor, based on the results of the tests.

Popular questions and answers

The most common questions regarding Gilbert’s syndrome, we discussed with therapist, gastroenterologist Tatyana Polyakova.

What is the danger of Gilbert’s syndrome?

If you follow the doctor’s recommendations and follow preventive measures, the presence of Gilbert’s syndrome will not pose a danger to humans.

In case of intentional non-compliance with the established rules, there is a risk:

● development of cholelithiasis;

● reduction or cessation of bile secretion (intrahepatic or extrahepatic cholestasis);

● biliary motility disorders;

● drug or toxic hepatitis;

● decrease in general immunity.

Do they take in the army with Gilbert’s syndrome?

Persons with Gilbert’s syndrome are not granted a deferment from military service by conscription. An indulgence in the form of a delay of 6 months can serve as a period of exacerbation of the syndrome at the time of the passage of the military commission4.

After passing the commission, the conscript is assigned the category “B-3”, which makes it possible to avoid strong physical exertion.

Do I need a special diet for Gilbert’s syndrome?

Compliance with the rules of nutrition when making this diagnosis is one of the fundamental foundations of good health. Products that provoke a load on the liver and stagnation of bile should be minimized or eliminated altogether.

Under a strict ban, fried and fatty foods, vinegar, pickles and marinades, smoked foods and fast food, coffee, sugary sodas and alcohol.

Recommended products:

● low-fat varieties of fish;

● young beef;

● chicken fillet;

● low-fat dairy products;

● cereals;

● unrefined vegetable oil;

● bran;

● non-acid fruits and berries;

● vegetables.

Meals should be fractional and frequent from 4 to 6 times a day. It is advisable to stick to the same diet. Dishes should be boiled, baked or steamed.

What is the prognosis for Gilbert’s syndrome?

The presence of a symptom does not affect life expectancy in any way. Progressive structural changes in the liver are often not observed. An elevated level of bilirubin is noted throughout a person’s life, but does not have a negative effect.

Sources of

  1. Volkov A.N., Tsurkan E.V. The study of gender and age characteristics of patients with Gilbert’s syndrome // Fundamental and Clinical Medicine. 2021. №2. https://cyberleninka.ru/article/n/izuchenie-polovozrastnyh-osobennostey-patsientov-s-sindromom-zhilbera
  2. Ipatova M.G. Features of the metabolism of drugs in patients with Gilbert’s syndrome // Bulletin of the National Medical and Surgical Center. N. I. Pirogov. 2016. No. 1. https://cyberleninka.ru/article/n/osobennosti-metabolizma-lekarstvennyh-preparatov-u-patsientov-s-sindromom-zhilbera
  3. Melnikova L.I., Ilchenko L.Yu., Dunaeva E.A., Kozitsyna M.V., Dribnokhodova O.P., Mironov K.O. Identification of Gilbert’s syndrome by pyrosequencing in patients in real clinical practice. Archives of Internal Medicine. 2019. No. 6 (50). https://cyberleninka.ru/article/n/vyyavlenie-sindroma-zhilbera-metodom-pirosekvenirovaniya-u-patsientov-v-realnoy-klinicheskoy-praktike
  4. Galkin A. V. Examination of persons of military age with chronic liver diseases // Medical Bulletin of Bashkortostan. 2011. No. 4. https://cyberleninka.ru/article/n/ekspertiza-lits-prizyvnogo-vozrasta-s-hronicheskimi-zabolevaniyami-pecheni

Leave a Reply