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Gastroenterology (Expert Forum)
Gilbert's Syndrome
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Gilbert's Syndrome
by shelley, Nov 09, 1999 12:00AM
Years ago I was diagnosed with probable Gilbert's Syndrome. At the time I was told not to use birth control pills.
A blood test recently taken showed normal liver function and elevated bilirubin.
My GYN has now told me that the doses (birth control pills) are now lower.
Would it be recommended for someone with Gilbert's to take the pill?
In addition, is there a connection between Gilbert's and a stone in my gallbladder that was found half a year ago?
Thanks for your help.
Shelley
A blood test recently taken showed normal liver function and elevated bilirubin.
My GYN has now told me that the doses (birth control pills) are now lower.
Would it be recommended for someone with Gilbert's to take the pill?
In addition, is there a connection between Gilbert's and a stone in my gallbladder that was found half a year ago?
Thanks for your help.
Shelley
Doctor's Answer
by HFHSm.D.-Gastro-rf, Nov 27, 1999 12:00AM
Dear Shelley,
Gilberts disease is a common condition thought to affect 5% of the population. The bilirubin i sslightly elevated because of increased breakdown of red blood cells and failure of the liver cells to rapidly takeup the bilirubin. Birth control pills can also give an increased bilirubin level but the mechanism is different from that of Gilberts disease. Your gynecologist is correct that there is a less frequent incidence of birth control pill related liver problems since the low dose pills have become accepted.
There is no relationaship between your gallstones and the Gilbert's disease.
Gilberts disease is a common condition thought to affect 5% of the population. The bilirubin i sslightly elevated because of increased breakdown of red blood cells and failure of the liver cells to rapidly takeup the bilirubin. Birth control pills can also give an increased bilirubin level but the mechanism is different from that of Gilberts disease. Your gynecologist is correct that there is a less frequent incidence of birth control pill related liver problems since the low dose pills have become accepted.
There is no relationaship between your gallstones and the Gilbert's disease.
According to that, Gilbert's syndrome is "a mild unconjugated hyperbilirubinemia" and "there appear to be complex defects in the hepatic uptake of bilirubin..." While Merck's does say that "Patients should be reassured that they do not have liver disease." , no etiology or treatment is mentioned.
I was curious about the birth control issue, so I also looked that up in Merck. Evidently, "about 1 to 2% of women taking oral contraceptives develop the syndrome..." of steroid-type cholestasis. From Taber's medical dictionary, cholecstasia is defined as "arrest of the bile excretion." Also, this condition sometimes develops during pregnancy.
In a nutshell, it appears that you have a condition in which your liver does not take in bilirubin and you tend to have higher bilirubin levels in your blood. Evidently, there is a very small chance that oral contraceptives can cause bile excretion to stop.
If I were you, I'd take that information and go talk to my doctor again. There might be new studies/information or maybe the new oral contraceptives are now not causing cholestasis. Also, I might want to talk to a hepatologist for the latest information.
Hope that helps a bit.
Thank you for your imput.
My baby which is 2 months old have a high bilirubin count
unto which the doctors diagnosis says that it may be
a biliary atresia.
Still they are unsure of this cause my baby stool is not
pale grey.
My baby have these
yellowish skin,
yellowish/green eyes,
not so dark urine (but still stains)
normal yellow stool
normal feeding
normal physical health
normal sleep
blood works all normal except for alkaline phosphatase
which is very high
do you got second opinion?
response will be greatly appreciated!
Thanks
that I have:
An irritable bowel (sometimes after eating I get a violent
reaction in my bowels that requires an immediate trip to the
bathroom and a good 10 minutes stay as my body gives up whatever
is in my bowels. Cold sweats and painful. Imbarrassing to be in
a public place when that happens. Also, I live in a roller-
coaster cycle of diarhea & constipation, and suffer with gas and
bloating sooooo much. I feel like I am the only one on earth
that puckers continuously. I thought for a long time that I was
lactose intollerant because milk products seemed to be the
culprit... but sometimes I get away with eating ice cream and
dairy, soooo ???? that's when I guessed it must be irritable bowel).
Acid Reflux (I guess that is the fancy term for heart burn? I
don't have it during the day much, but in the evenings mostly,
and especially if I drink iced tea - my favorite drink - near to
bedtime).
Hypoglycemic (If I don't eat something every few hours, I get the
shakes. I have to watch it with sugar - and caffeine, they seem
to intensify the effects. Sugar helps the shakes but they come
back in just a little while if all I have eaten is sugary stuff).
Elevated Bili Ruben (After having my last baby I discovered in a
blood test that my bili ruben was in the range 2.8. My doctor
had my bili ruben monitored for several months and saw it flux-
uating pretty near to that level throughout. He referred me to a
gastro-doctor, who diagnosed me with Gilbert's Syndrome, although
he never did any tests to confirm it. My baby was found to have
a bili ruben of 29 just three days after her birth and had to be
in the hospital in an incubator under 5 sets of lights for 4 days
to try and bring it down. I have wondered if her bili ruben was
high because my liver couldn't keep up with both of us??? )
Anyway.... I wonder if all of this is realated. And if I should
be telling my general doctor about it.
My grandmother had cancer of the abdominal area, and polops in
her colon for which she was treated with surgery and
radiation, but eventually died. She was in her 80's. I just
wonder if I should be worried???
I have been offered an opportunity at work (school district) to
have the Hepatitis B vaccination series. Would that be a good
thing to do, or not? Will it effect my bili ruben? or my liver?
The pubic health dept. suggested that it would be better to be
vaccinated against Hep.B than to risk catching it.