Gilbert's syndrome

Gilbert's syndrome represents the harmless hereditary disease which is not demanding special treatment. The disease is shown by periodic or continuous increase in bilirubin of blood, jaundice, and also some other symptoms.

Etiologies of Gilbert

The mutation of the gene which is responsible for liver enzyme work – glyukuroniltransferaza is a cause of illness. It is the special catalyst which participates in exchange of the bilirubin which is hemoglobin decomposition product. In the conditions of a lack of a glyukuroniltransferaza at Gilbert's syndrome bilirubin cannot contact a molecule глюкуроновй acids in a liver, and, as a result, its concentration in blood increases.

Indirect (free) bilirubin poisons an organism, the central nervous system especially suffers. Neutralization of this substance is possible only in a liver and only by means of special enzyme then it in the connected look is removed from an organism with bile. At Gilbert's syndrome bilirubin decreases artificially by means of special drugs.

The disease is inherited on autosomal dominantly type that is in case one of parents is sick, the probability of the birth of the child with the same syndrome is equal to 50%.

The factors provoking an exacerbation of a disease of Gilbert are:

• Reception of certain medicines – anabolic steroids and glucocorticoids;
• Excessive exercise stress;
• Alcohol abuse;
• Stress;
• Operations and injuries;
• Viral and catarrhal diseases.

Can cause Gilbert's syndrome of a diet, especially unbalanced, starvation, an overeating, and also the use of greasy food.

Symptoms of a syndrome of Gilbert

The general condition of people with this disease, as a rule, satisfactory. Treat symptoms of a syndrome of Gilbert:

• Emergence of jaundice;
• Feeling of weight in a liver;
• Not megalgia in right hypochondrium;
• Bitterness in a mouth, nausea, an eructation;
• Disturbance of a chair (ponosa or locks);
• Abdominal distention;
• Fatigue and bad dream;
• Dizziness;
• The suppressed mood.

Stressful situations (psychological or physical stress), infectious processes in biliary tract or a nasopharynx in addition provoke emergence of these signs.

The main symptom of a syndrome of Gilbert is jaundice which can periodically arise (after influence of certain factors), or to have chronic character. Degree of its expressiveness is also various: from yellowness only scleras before rather expressed diffusion coloring of skin and mucous membranes. Pigmentation of the person, small yellowish plaques on centuries and scattered spots on skin is sometimes observed. In rare instances even at the raised bilirubin jaundice is absent.

At 25% of sick people increase in a liver comes to light. At the same time she on 1-4 cm acts from under an edge arch, the consistence usual, at palpation morbidity is not felt.

At 10% of patients the spleen can be increased.

Diagnosis of a disease

Treatment of a syndrome of Gilbert is preceded by his diagnosis. It is simple to find this hereditary disease: complaints of the patient, and also the family anamnesis are taken into account (identification of carriers or patients among close relatives).

For diagnosis of a disease the doctor will appoint the general blood test and urine. Existence of a disease is demonstrated by the reduced level of hemoglobin and presence of unripe erythrocytes. In urine no changes should be, but if in it urobilinigen and bilirubin are found, it speaks about existence of hepatitis.

Also the following tests are carried out:

• With phenobarbital;
• With niacin;
• With starvation.

For the last test the analysis on Gilbert's syndrome is carried out in the first day, and then in two days during which the patient eats low-calorie food (no more than 400 kcal a day). Increase in level of bilirubin for 50-100% says that the person really has this hereditary disease.

Test with phenobarbital means reception of a certain dose of drug within five days. Against the background of such therapy bilirubin level considerably decreases.

Administration of niacin is carried out intravenously. In 2-3 hours concentration of bilirubin increases several times.

The genetic analysis on Gilbert's syndrome

This way of diagnosis of diseases with damages of a liver which are followed by a hyperbilirubinemia is the most bystry and effective. It represents research DNA, namely UDFGT gene. If polymorphism of UGT1A1 is found, the doctor confirms Gilbert's disease.

The genetic analysis on Gilbert's syndrome is carried out also for prevention of hepatic crises. This test is recommended to take to persons who should accept drugs with hepatotoxic effect.

Treatment of a syndrome of Gilbert

As a rule, special treatment at Gilbert's syndrome is not required. If to observe the corresponding mode, then the level of bilirubin remains normal or slightly raised, without causing at the same time disease symptoms.

Patients should exclude heavy exercise stresses, to refuse greasy food and alcohol-containing drinks. Big breaks between meals, starvation and reception of some medical supplies are undesirable (anticonvulsant drugs, antibiotics, etc.).

Periodically the doctor can appoint a course of gepatoprotektor – drugs which positively influence work of a liver. Such drugs as Geptral, Liv 52, Hofitol, Essentiale forte, Karsil and vitamins concern to them.

The diet at Gilbert's syndrome is an indispensable condition as healthy food and the favorable mode positively affect work of a liver and process of removal of bile. In days there have to be not less than four meals of small portions.

At Gilbert's syndrome it is allowed to include vegetable soups, skim cheese, low-fat chicken and beef, friable porridges, white bread, not acid fruit, tea and compote in a diet. Such products as fat, fat meat and fish, ice cream, fresh fancy bread, spinach, a sorrel, pepper and black coffee are prohibited.

It is impossible to exclude completely meat and to adhere to vegetarianism as at such type of food the liver will not receive necessary amino acids.

In general the forecast at Gilbert's syndrome favorable as this disease can be considered one of norm options. People with this disease do not need treatment and though the increased level of bilirubin remains for life, it does not lead to mortality growth. From possible complications it is possible to note chronic hepatitis and a zhelchekamenny disease.

To married couples where one of spouses is an owner of this syndrome, before planning of pregnancy consultation of the specialist geneticist who will define probability of developing of a disease at future child is necessary.

Specific prevention of a disease of Gilbert does not exist as it is caused genetically, but adhering to a healthy lifestyle and regularly undergoing medical examination, it is possible to stop timely diseases which provoke a syndrome aggravation.