Gilbert's Syndrome Treatment Manchester NH

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.

Robert Wilson Smith, MD
130 Tarrytown Rd
Manchester, NH
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Rochester Sch Of Med & Dentistry, Rochester Ny 14642
Graduation Year: 1972

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Blake Andrew Jones, MD
(603) 663-6760
88 McGregor St Ste 302
Manchester, NH
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Toronto, Fac Of Med, Toronto, Ont, Canada
Graduation Year: 1990

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Dr.Yuki Igari
(603) 695-2840
100 Hitchcock Way
Manchester, NH
Gender
M
Education
Medical School: Fukushima Prefectural Med Coll, Fukushima
Year of Graduation: 1982
Speciality
Gastroenterologist
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Accepting New Patients: Yes
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Blake A Jones
(603) 625-5744
88 Mcgregor St
Manchester, NH
Specialty
Gastroenterology

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Pamela M Hofley, MD
100 Hitchcock Way
Manchester, NH
Specialties
Gastroenterology
Gender
Female
Education
Medical School: Queens Univ, Fac Of Med, Kingston, Ont, Canada
Graduation Year: 1988

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Johann Rothwangl, MD
603-624-4366-6653
718 Smyth Rd
Manchester, NH
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Graz, Med Fak, Graz (407-27 3/1938 To 6/1945)
Graduation Year: 1971

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Aydamir Alrakawi
(603) 695-2840
100 Hitchcock Way
Manchester, NH
Specialty
Gastroenterology

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Pamela Hofley
(603) 695-2745
100 Hitchcock Way
Manchester, NH
Specialty
Pediatric Gastroenterology

Data Provided by:
Yuki Igari, MD
(603) 695-2840
100 Hitchcock Way
Manchester, NH
Specialties
Gastroenterology
Gender
Female
Education
Medical School: Fukushima Prefectural Med Coll, Fukushima, Japan
Graduation Year: 1982

Data Provided by:
Jeffrey R Harnsberger, MD
(603) 695-2840
100 Hitchcock Way
Manchester, NH
Gender
Male
Education
Medical School: Med Coll Of Ohio, Toledo Oh 43699
Graduation Year: 1987
Hospital
Hospital: Southern New Hampshire Regiona, Nashua, Nh; Elliot Hosp, Manchester, Nh
Group Practice: Dartmouth Hitchcock-Manchester

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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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