Gilbert's Syndrome Treatment Columbia SC

Should you worry about your GS? In Gilbert’s syndrome (GS), your liver loses some of its ability to eliminate bilirubin—a yellow pigment that results from the breakdown of red blood cells.

Benjamin D Massey
(803) 799-2219
2750 Laurel St
Columbia, SC
Specialty
Gastroenterology

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Walter J Bristow
(803) 799-4800
2739 Laurel St
Columbia, SC
Specialty
Gastroenterology

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Jorge L Galan
(803) 799-4800
2739 Laurel St
Columbia, SC
Specialty
Gastroenterology

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Walter J Bristow III, MD
(803) 799-4800
PO Box 4376
Columbia, SC
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Med Univ Of Sc Coll Of Med, Charleston Sc 29425
Graduation Year: 1983

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George T Postic
(803) 799-4800
2739 Laurel St
Columbia, SC
Specialty
Gastroenterology

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Walter J Bristow, MD
(803) 799-4800
PO Box 4376
Columbia, SC
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Med Univ Of Sc Coll Of Med, Charleston Sc 29425
Graduation Year: 1983

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John Kaveh Ryan III, MD
(413) 585-2575
2750 Laurel St Ste 201
Columbia, SC
Specialties
Gastroenterology, Hepatology
Gender
Male
Education
Medical School: Univ Of Sc Sch Of Med, Columbia Sc 29208
Graduation Year: 1995

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Sidney Emmett Morrison, MD
(803) 748-9966
1410 Blanding St Ste 102
Columbia, SC
Gender
Male
Languages
Spanish
Education
Medical School: Univ Of Fl Coll Of Med, Gainesville Fl 32610
Graduation Year: 1981
Hospital
Hospital: Providence Hospital, Columbia, Sc
Group Practice: Surgical Assoc Of SC

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Dr.Benjamin Massey
(803) 799-2219
2750 Laurel St # 201
Columbia, SC
Gender
M
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med
Year of Graduation: 1975
Speciality
Gastroenterologist
General Information
Accepting New Patients: Yes
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Benjamin Diehl Massey, MD
(803) 799-2219
2750 Laurel St Ste 201
Columbia, SC
Specialties
Gastroenterology, Internal Medicine
Gender
Male
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298
Graduation Year: 1975

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Ask the Doctor—Living with Gilbert's Syndrome

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By Robert Rountree, MD

Q After finding elevated bilirubin on a routine blood test, my doctor told me I had Gilbert’s syndrome, but it was nothing to worry about. Is that really true?

In Gilbert’s syndrome (GS), your liver loses some of its ability to eliminate bilirubin—a yellow pigment that results from the breakdown of red blood cells. A relatively common genetic condition, GS may affect as much as 10 to 20 percent of the population. Under normal conditions, the liver detoxifies bilirubin by combining it with a type of sugar called glucuronic acid in a process known as conjugation. The liver then releases the “conjugated” bilirubin into the bile ducts from whence it subsequently gets eliminated in the stool. For people with GS, the UGT1A1 enzyme that conjugates bilirubin works at only 20 to 70 percent of normal.

In a person with GS, situations that either increase the breakdown of red blood cells or overload the detoxifying ability of the liver can cause blood levels of “unconjugated” bilirubin to rise so high that the whites of her eyes will turn yellow—a condition called jaundice. This can occur with fasting, prolonged strenuous exercise, fatigue, surgery, infections, excessive alcohol intake, or menstruation.

Up until a few years ago, experts considered GS an innocuous condition, the only significant feature of which was abnormally high levels of unconjugated bilirubin on routine fasting blood tests. As it turns out, GS is not so benign: A significant percentage of people with this genetic abnormality also have an impaired ability to metabolize and excrete certain medications, including the pain-relieving drug acetaminophen (Tylenol) and a cancer chemotherapy agent called irinotecan. That makes them more susceptible to side effects, such as liver toxicity from acetaminophen or a severe drop in white blood cells from irinotecan. More recently, a groundbreaking study at the University of Washington in Seattle has shown that having a sluggish UGT1A1 enzyme can make it more difficult for people with the most severe form of GS to eliminate cancer-causing environmental toxins found in smoke, automotive exhaust, and charbroiled meat.

The study also reports another significant discovery, however: Eating a diet rich in cruciferous vegetables like broccoli, Brussels sprouts, cabbage and watercress can increase the activity of the UGT1A1 enyzme. (Onions, citrus fruits, and legumes also increase activity of the UGT1A1 enzyme, but not quite at the level as crucifers.) This implies that people with GS are particularly susceptible to the beneficial, cancer-preventive properties of broccoli and its edible relatives. Based on this research, I would recommend that you minimize the use of acetaminophen and avoid grilled meats, cigarette smoke, and exhaust fumes from petrochemical fuels as much as possible. In addition, eat at least one full serving of cruciferous vegetables every day. Or, if you aren’t particularly fond of this vegetable family, tr...

Author: Robert Rountree, MD

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