Gilbert's Syndrome Treatment Omaha NE

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.

Alexander B Bernal, MD
(402) 559-4356
982000 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Graduation Year: 2007

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Matthew James Hrnicek, MD
(402) 559-4356
982000 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1999

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Rowen Kent Zetterman, MD
(402) 559-4875
16405 Leavenworth Circle,
Omaha, NE
Specialties
Internal Medicine, Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1969
Hospital
Hospital: N H S Univ Nebraska Med Ctr, Omaha, Ne; Veterans Affairs Medical Ctr, Omaha, Ne
Group Practice: University Medical Associates Univ Of Nebraska Medical Ctr

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Fedja A Rochling, MD
(402) 559-6209
982000 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Royal Coll Of Surgeons In Ireland, Med Sch, Dublin, Ireland
Graduation Year: 1989

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John Lachlan Gollan, MD
(402) 559-4204
986545 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Adelaide, Fac Of Med, Adelaide, So Australia, Australia
Graduation Year: 1966

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Grant Farley Hutchins, MD
(402) 559-4356
600 S 42nd St
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1996

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Timothy Mark Mc Cashland, MD
(402) 559-8859
18638 Gold Circle,
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1987

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Trevor J Pearson, MD
(402) 559-4356
982000 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Graduation Year: 2007

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Mark Edward Mailliard, MD
(402) 559-5509
982000 Nebraska Medical Ctr
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1980

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Michael Floyd Sorrell, MD
(402) 559-7912
983285 Nebraska Med Center CTR,
Omaha, NE
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1959

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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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