Diagnosing Gilbert's Disease

There are times when people go through a certain stage in their lives when they need to understand and adjust to certain changes in the way that they live. Some people are burdened with adjusting to getting married, losing a loved one or acquiring a disease or a medical condition. Of all the three, getting diagnosed with a medical condition can be the hardest to adjust to especially if you found out that you have been living with it for all your life.

Hereditary diseases like Gilbert’s disease are one of those that we can acquire and not know about for a long time.

One of the reasons why we can live without knowing the presence of Gilbert’s disease is that the condition itself has no symptom or noticeable effect. Some people can even live through the rest of their lives without even knowing.

Just because it has no symptom it doesn’t mean that it should not be consulted. People sometimes have the wrong notion of not going to a specialist if they suspect that they have Gilbert’s disease. So why is it important to have your condition diagnosed? Well there are several reasons but let’s just look at one and that is for proper identification of the solution for the the problem, once we have the right diagnosis we can move on to taking care of the person who is sick.

Exclusion of other conditions

While this syndrome Gilbert’s disease is considered to be harmless by itself, it is clinically important to be diagnosed and identified correctly because it may be confused with much more dangerous liver conditions. However, these will show other indicators of liver dysfunction:

- Hemolysis can be excluded by a full blood count, haptoglobin, lactate dehydrogenase levels and the absence of reticulocytosis (elevated reticulocytes in the blood would usually be observed in haemolytic anaemia);

- Hepatitis can be excluded by negative blood samples for antigens specific to the different hepatitis vira;

- Cholestasis can be excluded by the absence of lactate dehydrogenase, low levels of conjugated bilirubin and ultrasound scan of the bile ducts;

- More severe types of glucoronyl transferase disorders like Crigler-Najjar syndrome (types I and II). These are much more severe and cause brain damage in infancy (type I) and teenage years (type II);

Other diseases of the liver can be exluded by the liver-enzymes ALAT, ASAT and albumin being within normal ranges.

Findings specific to Gilbert’s syndrome

Patients with Gilbert’s disease show predominantly elevated unconjugated bilirubin. While conjugated is usually within normal ranges and form less than 20 percent of the total. The level of total bilirubin is often increased if the blood sample is taken after fasting for two days, and a fast can therefore be useful diagnostically. If the total bilirubin does in fact increase while fasting, the patient can then be given low doses of phenobarbital when fasting has ended, and following samples should show a decrease in total bilirubin toward normal levels.

Once the findings have been reported, the patient with Gilbert’s disease should be more careful and should follow what the physician says. It will also be helpful for him or her to conduct a research so he or she can take care of themselves at home or if they cannot go to the doctor regularly. It is also best to watch diet carefully, conduct regular exercise, and take necessary medications or undergo treatments when needed.