Gilbert's Syndrome Treatment Milwaukee WI

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.

Anne Breitinger, MS
945 N 12th St Rm 4040
Milwaukee, WI
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Gastroenterology
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Graduation Year: 2007

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Nikhil Bhargava, MD
(312) 498-6389
945 N 12th St
Milwaukee, WI
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Graduation Year: 2007

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Dr.Aboud Affi
(414) 291-3100
1218 W Kilbourn Ave # 402
Milwaukee, WI
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Medical School: Univ Of Aleppo, Fac Of Med, Aleppo
Year of Graduation: 1989
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Gastroenterologist
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Accepting New Patients: Yes
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Dr.THANGAM VENKATESAN
(414) 805-3666
3070 North 51st Street
Milwaukee, WI
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Harry Jerome Kanin, MD
(414) 272-5966
1218 W Kilbourn Ave Ste 404
Milwaukee, WI
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Internal Medicine, Gastroenterology
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Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduation Year: 1947

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Christopher Todd Smith, MD
(414) 875-9950
3070 N 51st St Ste 100
Milwaukee, WI
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Medical School: Univ Of Wi Med Sch, Madison Wi 53706
Graduation Year: 1994

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Nitesh Ratnakar, MD
(414) 219-7695
945 N 12th Street P O Box 324
Milwaukee, WI
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Gastroenterology
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Male
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Graduation Year: 2007

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Dr.Helmut Ammon
(414) 805-3666
3070 North 51st Street
Milwaukee, WI
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Medical School: Med Fak Der Ludwig Maximiliams Univ, Munchen
Year of Graduation: 1962
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Gastroenterologist
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Accepting New Patients: Yes
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1.5, out of 5 based on 1, reviews.

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Atia Shireen Hashim, MD
(414) 416-5111
2224 W Wisconsin Ave Apt 208
Milwaukee, WI
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Gastroenterology
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Female
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Medical School: Dow Med Coll, Univ Of Karachi, Karachi, Pakistan
Graduation Year: 1984

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Thomas Slota
(414) 463-2459
3070 N 51st St
Milwaukee, WI
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Gastroenterology, Internal Medicine

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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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