I was recently diagnosed with Gilbert's disease, but I was given very little information. The doctor only told me that it is genetic, that it is not life-threatening, and that it causes the bilirubin count to be high. Can you tell me more about this disorder?

S.

Gilbert's disease is a relatively common genetic disorder of liver function. While it may be present in up to 7 percent of the U.S. population, it often goes undetected because many patients have no symptoms. In Gilbert's, there is a malfunction in the liver's ability to take up and/or to metabolize a component of blood called bilirubin. Bilirubin is continuously formed when old red blood cells are destroyed and recycled. The liver normally takes up this bilirubin, allowing the recycling process to begin. When the bilirubin is not picked up by the liver, it stays in the blood and can accumulate in certain tissues such as the white of the eye (sclera) and the skin, leading to a yellowish coloring that doctors call jaundice.

The diagnosis of Gilbert's is often made after a young person, usually in the adolescent years, is noted to be jaundiced. In other cases, it is made when blood tests are taken for other reasons and the elevated bilirubin is found. Many patient with Gilbert's have levels of bilirubin in the blood that are not high enough to cause noticeable jaundice. However, certain events, such as stress or fasting, can lead to further bilirubin elevations that later make their jaundice noticeable.

Gilbert's does not lead to any complications and is not a progressive disorder. The importance of making the diagnosis is to rule out other potentially more serious causes of jaundice, such as hepatitis. The liver performs its functions related to digestion and metabolism normally in patients with Gilbert's. There is no treatment needed and, other than yellowish skin and eyes, patients experience no ill effects as a result of Gilbert's.