Gilbert Syndrome, Symptoms, Cause, Diagnoses and Ayurvedic Treatment

ABSTRACT

Gilbert syndrome is an inherited genetic disorder that occurs when there is a high level of bilirubin in the blood. Bilirubin is a red orange color compound that occurs in the normal catabolic pathway which breaks down the heme in the vertebrates. Bilirubin is broken down within the body and its metabolites are excreted from urine and bile and elevated levels indicate certain diseases. It is only responsible for the yellowish discoloration of the skin commonly seen in jaundice. Bilirubin is the breakdown of red blood cells which the liver excrete, commonly seen in children. The bilirubin gets to the liver with help of albumin and becomes conjugated which the body can excrete but unconjugated bilirubin is toxic to brain damage and nervous system which is followed by yellowish coloration of skin, itchy skin, pale stool. We will study about its causes, symptoms and its ayurvedic aspect later in this topic in detail.

INTRODUCTION

Gilbert syndrome is a common, harmless liver condition in which the liver doesn’t work properly which affects the liver ability to process bilirubin (waste product of red blood cells). In gilbert syndrome liver doesn’t produce enough enzymes to keep bilirubin at normal level which results in excess buildup of bilirubin in the body, excess bilirubin is known as hyperbilirubinemia. Bilirubin is removed from the body which converts  unconjugated bilirubin to conjugated but in this syndrome there is accumulation of unconjugated bilirubin in the blood, is usually seen in adolescence and usually experience abdominal discomfort and tiredness. It is also known as constitutional hepatic dysfunction and familial non hemolytic jaundice.

CAUSES

1. Changes in the UGT1A1 gene causes gilbert syndrome; the body produces less bilirubin than UGT, an enzyme that breaks down the bilirubin.
2. Is inherited gene
3. Males are more prone to gilbert syndrome.

SYMPTOMS

1. It is usually a yellow tinge of skin with white eyes.
2. Dehydration
3. Stress
4. Dizziness
5. Gastrointestinal problems such as abdominal pain, diarrhea, nausea.
6. Dark colored urine
7. Fever and chills.
8. Infections
9. No proper sleep
10. Experiencing emotional stress
11. Menstruation
12. Diarrhea

DIAGNOSIS

1. Liver function test
2. Genetic tests
3. PCR or DNA fragment sequencing
4. Liver biopsy
5. CT scan
6. Blood tests
7. Ultrasound

DIFFERENTIAL DIAGNOSIS

1. Dubin johnson syndrome (in which there is yellowish coloration of skin and white of eye), Rotor syndrome (is a mild condition by elevated levels of bilirubin in the blood) are rare autosomal disease by increased level of conjugated bilirubin.
2. Viral hepatitis is associated with increase in conjugated bilirubin
3. Vitamin B12 deficiency has elevated bilirubin levels.
4. Crigler Najjar syndrome which are more severe affects brain damage which results in high bilirubin
5. Hemolytic anemia – Bilirubin levels are increased and red blood cells are destroyed prematurely.
6. Acute inflammation of liver- It causes elevated bilirubin due to viral infection, fatty liver.

TREATMENT

In most of the cases Gilbert syndrome does not require treatment, as bilirubin fluctuates over time.

LIFESTYLE AND HOME REMEDIES

1. Get plenty of sleep
2. Avoid long period of intense exercise
3. Stay hydrated
4. Try relaxation techniques to cope up with stress such as Yoga and meditation. ‘
5. Eat a balanced diet – Eat regularly, don’t skip meals.
6. Limit alcohol intake

AYURVEDIC VIEW

In ayurveda Gilbert Syndrome is inherited so it is due to beej dushti. In ayurveda the human body is made up of seven dhatu and 7th dhatu is shukra which takes part in the formation of garbha. Ayurveda considered three genetic units in the form of beeja (germinal cell), beej bhag (chromosome), beejbhagvyava (gene). The shukra (sperm) shonita (ovum) is considered as beej. The hereditary diseases are due to defects in the beej (sperm and ovum). The beej bhaga (chromosome which lies inside beej) is responsible for defective parts of the body and organs. Gilbert syndrome is beej dushti of liver where vata and kapha dosha get prakopa where they are circulated by pitta vaha srotas. Avarodha of pittavaha srotas by vitiated kapha, then vitiated vata dosha removes pitta and gets accumulated in the liver and causes yellow discoloration of eyes, nails, skin.

SAMPRAPTI GHATAKA

• Dosha – pitta
• Dushya- rakta, mamsa
• Adhisthana- Kostha and shakha
• Srotas- Annavaha, pureshvaha
• Srotodushti- Vimargagamana, sanga.

CAUSATIVE FACTORS

1. Alcohol intake
2. Suppression of natural urge
3. Night awakening
4. Injury
5. Intake of spicy food
6. Day sleep

SYMPTOMS

1. Eyes becomes turmeric colured
2. Bloody red or yellow colour faeces
3. Yellow colour of urine
4. Weakness
5. Tiredness
6. Burning sensation
7. Anorexia
8. Indigestion

TYPES OF KAMALA

1. Obstructive jaundice (shakhashrita kamala)
2. Hepatic jaundice (kosthashrita kamala)
3. Haemolytic jaundice (kosthshakaha ashrita)

TREATMENT

1. Snehana (oleation therapy)
2. Mridu tikta virechana (mild purgation)
3. Pathya anna includes-
4. Old rice
5. Green gram soup
6. Old barley
7. Cow ghee and cow milk
8. Haritaki
9. Amalaki
10. Pomegranate
11. Meat soup of animals and birds who are living in desert areas.
12. Pathya vihaar includes-
13. Virechana
14. Snehan
15. Agnikarma
16. Apathya anna includes-
17. heavy, sweet food
18. Hing
19. Til
20. Peas
21. Apathya vihara includes-
22. Leech therapy
23. Dhumpan
24. Vamana
25. Raktmokshan
26. Sweden

HERBS USEFUL IN GILBERT SYNDROME

• Triphala- Triphala is made up of 3 dried fruits of different plants. It acts as a laxative, anti inflammatory, anti viral, analgesic. Triphala is used to treat fatigue and infectious disorders like AIDS. Triphala lowers the levels of cytokines and lipid peroxides and restores the level of antioxidant enzymes and reduces liver damage.
• Kutuki- It is a very helpful herb in liver disorders as it protects the liver against cell damage caused by free radicals due to its antioxidant property. It has anti diabetic, anti inflammatory, immuno modulatory activities. Kutuki is a liver stimulant, useful in urinary tract disorders, skin disorders and relieves intestinal worm infestation.
• Pippali- It is a useful herb in indigestion, asthma, and cough. Useful in vata doshas, abdominal tumor, COPD, chronic lung disorders and tuberculosis. It tones the brain, improves intellect and memory. It is helpful in curing hepatomegaly, splenomegaly.

HERBAL REMEDIES BY PLANET AYURVEDA GILBERT SYNDROME

Planet ayurveda is an herbal pharmaceutical company that deals with the production of many herbal remedies used for treating many numerous ailments. All the medicines prepared are of best quality free from any chemicals, preservatives, resins. Ayurvedic doctors prepare these formulations and keep strict check on the quality of the medicines and there is no compromise with patient health. For Gilbert Syndrome planet ayurveda provides many herbal formulations which are free from any side effects.

PRODUCTS LIST

1. YAKRIT PLIHANTAK CHURNA
2. AROGYAVARDHINI VATI
3. LIVER DETOX FORMULA
4. GANDHAK RASAYAN       

PRODUCTS DESCRIPTION

1. Yakrit Plihantak Churna

Yakrit plihantak churna is a herbal formulation by planet ayurveda in the form of chooran using ingredients such as – Bhumi amla (Phyllanthus niruri), Bhringraj (Eclipta alba), Kalmegh (Andrographis paniculata), and many more. It is a useful herbal remedy for liver damage due to toxins, infections and jaundice. This chooran has bhumi amla which regenerates the liver and is useful in liver enlargement. Yakrit plihantak churna is balancing hormones and is useful in pitta disorders and constipation.

Dosage– 1 tsp twice daily with plain water after meals.

2. Arogyavardhini Vati

These are herbal tablets formulated by planet ayurveda using ingredients like Haritaki (Terminalia chebula), Amalaki (Emblica officinalis), Shudh shilajit (Asphaltum), Chitrak mool (Plumbago zeylanica) and many more. It is useful in fever, skin disease, and balances tridosha in the body. It improves digestion and is a great detoxifier so it removes toxins from the body and is helpful in jaundice.

Dosage– 2 tablets twice daily with lukewarm water.

3. Liver detox formula

Liver support are herbal capsules formulated by planet ayurveda using ingredients like Katuki (Picrorhiza kurroa), Makoy (Solanum nigrum), Jhavuka (Tamarix gallica), Haritaki (Terminalia chebula) and many more. These capsules are useful in treating liver cirrhosis, jaundice and beneficial in treatment of dyspepsia. It provides strength to the stomach and promotes its action. This capsule contains kalmegh which is a natural blood purifier used to treat torpid liver, jaundice and in many dermatological diseases.

Dosage–  2 capsules twice daily with plain water after meals.

4. Gandhak Rasayan

They are herbal tablets formulated by planet Ayurveda using a single extract of shuddha gandhak (Sulphur). This rasayan is helpful in the female reproductive system, which supports healthy skin. Gandhak rasayan is well known for its immunity booster. It is known as a broad spectrum antibiotic, has anthelmintic, enhances body strength, and provides nourishment.

Dosage– 2 tablets twice daily with lukewarm water.

CONCLUSION

Gilbert syndrome is an inherited genetic disorder that occurs when there is a high level of bilirubin in the blood. Bilirubin is removed from the body which converts unconjugated bilirubin to conjugated but in this syndrome there is accumulation of unconjugated bilirubin in the blood, is usually seen in adolescence and usually experience abdominal discomfort and tiredness’. Planet ayurveda provides many herbal remedies for the treatment of Gilbert syndrome.