Gilbert-Meulengracht disease or Gilbert syndrome is a metabolic disorder that manifests itself in an increased bilirubin level in the blood. The disorder is genetic but very rarely causes permanent damage.
What is Gilbert-Meulengracht disease?
Meulengracht disease is an effect characterized by an increased concentration of indirect bilirubin in the blood. This causes various symptoms such as yellowing of the eyes. Since indirect bilirubin is difficult to dissolve in water, it binds to albumins, which act as solubilizers. See homethodology for Chronic Intestinal Pseudo-obstruction Overview.
Gilbert-Meulengracht disease is therefore a metabolic disorder. It is caused by delayed biochemical conversion processes in the blood and is completely harmless. However, there are a number of symptoms that can be treated.
Causes
Meulengracht’s disease is triggered by reduced activity of the enzyme UDP-glucuronosyltransferase. This enzyme is responsible for converting fat-soluble metabolites into water-soluble end products.
If there is a disruption in this process, various metabolic products and exogenous substances such as drugs cannot be optimally prepared for elimination from the body. This causes the above symptoms to appear. In particular, the red blood pigment heme is disturbed.
The effect, which is triggered in particular by a reduced activity of the enzyme UDP-glucuronosyltransferase, only rarely has external causes. However, a low-fat diet can trigger the manageable symptoms. Fasting cures are also often associated with Gilbert-Meulengracht disease.
Symptoms, Ailments & Signs
Gilbert-Meulengracht disease is usually completely harmless. In the vast majority of cases, there are no symptoms at all. Yellowing of the white parts of the eyeball and, in very rare cases, also of the skin is only observed under certain conditions. The yellow discoloration is caused by an increased concentration of bilirubin in the blood, which is caused by the slow breakdown of bilirubin.
Because increased levels of bilirubin are formed during exercise, alcohol consumption, a low-fat diet or prolonged periods of fasting, the discoloration of the sclera and skin also increases under these conditions. However, these are usually the only symptoms of Gilbert-Meulengracht disease. Itching like jaundice associated with liver disease does not occur here.
Rarely, however, the yellowing can be accompanied by uncharacteristic symptoms such as tiredness, abdominal pain with nausea, migraine- like headaches, loss of appetite and irritability. However, these symptoms are not dependent on the level of bilirubin concentration. Another characteristic of Gilbert-Meulengracht disease is that it usually only affects young men after puberty.
Morbus Gilbert-Meulengracht has no disease value. Complications do not occur. The eye and skin discolorations become less and less common over the course of life, until they often disappear completely with age. In rare cases, however, the accompanying symptoms have an adverse effect on the quality of life. Even the first appearance of yellowing of the eyes and skin can have a worrying effect on those affected until they are informed that the disease is harmless.
Diagnosis & History
Gilbert-Meulengracht disease can be clearly diagnosed. To do this, it is necessary to talk to the person concerned to determine which symptoms are occurring. If it turns out that there is increased nausea in connection with yellow eyes, there can at least be a suspicion. Other symptoms may occur in connection with infections. The syndrome can be accompanied by liver problems, nausea and malaise. In particular, when fasting or stress occurs, the symptoms intensify.
Beyond that, however, the effect has no significant symptoms and usually does not cause any health complications for those affected. Therefore, it is difficult to diagnose Meulengracht’s disease by external examination. A blood test, on the other hand, can quickly provide information about the syndrome. In particular, the bilirubin levels are crucial. If only these values are increased and all other blood values are at a normal level, Gilber-Meulengracht disease can be assumed.
Although the syndrome is harmless, diagnosis is still crucial. In this way, serious liver diseases can be ruled out. Hemolysis can also be ruled out by the clear diagnosis. In some cases, doctors therefore resort to a genetic test in order to have 100% certainty.
The course of Gilbert’s syndrome is unproblematic. Symptoms such as yellow eyes and nausea usually disappear after a few days. Even with longer fasting cures, the syndrome rarely leads to health problems. Meulengracht’s disease is often not even noticed by those affected. However, the symptoms should not be underestimated. It could be a serious liver disease that must be treated in any case.
Complications
In most cases, Gilbert-Meulengracht disease does not lead to any special limitations or complications. Most patients live with the disease their entire lives and there is no reduction in life expectancy. Therefore, the disease does not need to be treated even if there are no symptoms.
However, if symptoms do occur, they are usually expressed in the form of tiredness and exhaustion on the part of the patient. Gilbert-Meulengracht disease also significantly reduces the patient’s resilience and can lead to impairments in everyday life. Some of those affected also suffer from nausea and yellow eyes. If the liver problems are severe, it can lead to severe discomfort.
Complications from Gilbert-Meulengracht’s disease can occur when the affected person is fasting, as the symptoms are even more severe in this case. As a rule, Gilbert-Meulengracht disease does not need to be treated. The symptoms can only be limited in the case of severe complaints. The patient’s life expectancy is not reduced by the disease and there are no further complications.
When should you go to the doctor?
The non-hemolytic jaundice, a metabolic disorder known as Gilbert-Meulengracht disease, is congenital. The symptoms that occur with it are noticeable relatively quickly, as they are associated with signs of jaundice. The first visit to the doctor is therefore usually early in life, often during puberty. Since there is no liver damage, an adapted diet is usually sufficient. The symptoms that the genetic defect can cause depend on several factors. Most of these can be influenced by the person affected by dietary adjustments. In this respect, those affected with Gilbert-Meulengracht disease have it in their own hands to remain almost symptom-free through an appropriate lifestyle.
It should be noted, however, that certain medications for other diseases or pain can worsen the symptoms of Gilbert-Meulengracht disease. Therefore, when taking cholesterol-lowering preparations such as simvastatin or atorvastatin, a doctor should be consulted for monitoring purposes. The same is recommended for the use of estrogen-containing contraceptives such as the birth control pill or widely used over-the-counter painkillers such as paracetamol or ibuprofen.
If your eyes turn yellow, you should definitely see a doctor. Jaundice or liver disorders must be ruled out. The presence of Gilbert-Meulengracht’s disease only requires that fasting cures and certain stimulants such as alcohol or nicotine be avoided. Doctor visits are therefore usually not necessary.
Treatment & Therapy
Meulengracht’s disease is a harmless metabolic disorder and therefore does not necessarily have to be treated. However, there is the possibility of remedying the symptoms and raising awareness. This is especially necessary when those affected are unsettled by yellow eyes or repeated nausea and thus feel a reduced quality of life.
Therefore, the most important pillar of treatment is a detailed discussion with the person concerned. In this, the individual symptoms can be discussed and traced back to the high bilirubin values.
Another pillar of treatment is testing for intolerable medication. Certain medications, such as paracetamol, can aggravate the symptoms and should be discontinued under certain circumstances.
It can therefore be said that Meulengracht’s disease does not normally cause any problems. At best, the uncertainty of those affected should be dispelled through education. In general, it is questionable whether Meulengracht’s disease is a disease at all. Recent studies have shown that Gilber’s syndrome can prevent colon cancer, arteriosclerosis and lung diseases.
Outlook & Forecast
The prognosis for patients with Gilbert-Meulengracht disease is very good. The life expectancy of those affected is just as high as the life expectancy of people who are not affected. Gilbert-Meulengracht disease is also completely harmless in most of the cases that occur. It is extremely rare for the symptoms of the disease to affect those affected. However, it is true that the older the affected person gets, the rarer and milder the symptoms of the disease appear. In a large number of cases, the symptoms even disappear completely in old age.
It is assumed that the mortality rate of those affected is not increased by the disease. There are even studies that indicate that the increased bilirubin level caused by the disease protects against certain diseases of the lungs and thus reduces overall mortality. Above all, this concerns protection against chronic obstructive pulmonary diseases and also against the dreaded lung cancer.
However, the cosmetic problem that can arise in those affected by yellowing of the eyes is often a very high burden. Often outsiders cannot correctly interpret the color of money and think of contagious diseases. In such cases, a doctor should be consulted to discuss possible treatment options. In general, however, treatment of Gilbert-Meulengracht disease is not necessary.
Prevention
Morbus Gilbert-Meulengracht has no disease value and therefore does not need to be treated preventively. If you want to avoid the characteristic yellowing of the eyes, it is advisable to avoid fasting cures and a low-fat diet as much as possible.
This should keep bilirubin levels normal. In addition, it is important to raise awareness about the syndrome. If other people suffer from the symptoms, Gilbert-Meulengracht disease should be pointed out as the cause.
Medications should only be taken after consulting a doctor. Despite the harmless symptoms, a comprehensive diagnosis should be made for yellow eyes. It is not uncommon for another disease to be involved.
You can do that yourself
Gilbert-Meulengracht disease is usually harmless. Treatment is neither possible nor necessary. However, it is advisable for those affected to obtain detailed information about the disease. There is a lot of information on how to deal with the disease and how to avoid symptoms, especially on the Internet.
With Morbus Gilbert-Meulengracht there is only an indirect health risk if those affected take certain medications and these are more difficult for the body to break down. In a few cases, this can lead to slight side effects. Symptoms of this kind are particularly well known when taking cancer and HIV medication. In order to clarify the tolerability, it is advisable to study the package leaflet before taking any new medication. In general, those affected should try to protect the liver as much as possible. For this reason, you should avoid nicotine and alcohol as much as possible. It is also particularly important that those affected should not consume any drugs.
In general, a healthy, balanced diet is advisable. To be on the safe side, it is advisable to only consume food supplements, foods with chemical additives, Ayurveda teas, Chinese herbs and herbal preparations in smaller doses. Those affected should generally avoid starvation. Planned diets and excessive starvation diets must be discussed with a doctor. In addition, those affected are advised to get enough sleep.
