The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen — beneath the diaphragm and above your stomach — but a small portion extends into the upper left quadrant.
Gilbert's (zheel-BAYRS) syndrome is a common, harmless liver condition in which the liver doesn't properly process bilirubin. Bilirubin is produced by the breakdown of red blood cells.
If you have Gilbert's syndrome — also known as constitutional hepatic dysfunction and familial nonhemolytic jaundice — you're born with the condition as a result of an inherited gene mutation. You might not know you have Gilbert's syndrome until it's discovered by accident, such as when a blood test shows elevated bilirubin levels.
Gilbert's syndrome requires no treatment.
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The most frequent sign of Gilbert's syndrome is an occasional yellowish tinge of the skin and the whites of the eyes as a result of the slightly elevated levels of bilirubin in the blood. In people with Gilbert's syndrome, bilirubin levels may increase and jaundice may become apparent because of:
- Illness, such as a cold or the flu
- Fasting or eating a very low-calorie diet
- Strenuous exercise
- Lack of sleep
When to see a doctor
Make an appointment with your doctor if you have jaundice, which has many possible causes.
An abnormal gene you inherit from your parents causes Gilbert's syndrome. The gene normally controls an enzyme that helps break down bilirubin in your liver. When you have an ineffective gene, your blood contains excess amounts of bilirubin because your body doesn't produce enough of the enzyme.
How the body normally processes bilirubin
Bilirubin is a yellowish pigment made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver, where the enzyme breaks down the pigment and removes it from the bloodstream.
The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood.
How the abnormal gene is passed through families
The abnormal gene that causes Gilbert's syndrome is common. Many people carry one copy of this gene. In most cases, two abnormal copies are needed to cause Gilbert's syndrome.
Although it's present from birth, Gilbert's syndrome usually isn't noticed until puberty or later, since bilirubin production increases during puberty. You have an increased risk of Gilbert's syndrome if:
- Both your parents carry the abnormal gene that causes the disorder
- You're male
The low level of the bilirubin-processing enzyme that causes Gilbert's syndrome may also increase the side effects of certain medications, since this enzyme plays a role in helping clear these medications from your body.
These medications include:
- Irinotecan (Camptosar), a cancer chemotherapy drug
- Some protease inhibitors used to treat HIV
If you have Gilbert's syndrome, talk to your doctor before taking new medications. Also, having any other condition that impairs the destruction of red blood cells may increase your risk of developing gallstones.