Gilbert’s syndrome
Content date: 10 November 2026
A benign inherited condition in which the liver processes bilirubin more slowly. It does not damage the liver and usually needs no treatment once the diagnosis is confirmed.
Your next step
Keep the test results confirming your diagnosis and understand your usual pattern of jaundice.
Get urgent help: Jaundice with confusion, severe pain, fever, repeated vomiting or significant illness needs urgent assessment; do not attribute it to Gilbert’s syndrome.
What does benign mean?
- The issue is how quickly the bilirubin pigment is processed, not inflammation attacking liver cells or a bile duct blockage. Bilirubin may be mildly raised while other liver tests are normal. “Benign” means Gilbert’s syndrome itself does not damage the liver or progress to advanced fibrosis.
- You may only discover it after a test for another reason, or notice brief episodes of mildly yellow eyes. However, new jaundice should not be attributed to Gilbert’s without assessment, especially with dark urine, pale stool, marked itching or pain, which are not its usual pattern.
Why does yellowing occur?
- Bilirubin is a pigment produced as red blood cells are renewed. In Gilbert’s syndrome it is processed more slowly, causing mild, intermittent rises in unconjugated (indirect) bilirubin.
- Mild yellowing of the eyes can appear with illness, dehydration, reduced food intake, fasting or stress. Not every episode of jaundice means you have Gilbert’s syndrome.
How is it diagnosed?
- Your doctor reviews the bilirubin type and other liver tests, and may rule out red blood cell breakdown or other causes. Other liver tests are usually normal.
- Biopsy or genetic testing is usually unnecessary. Additional tests depend on whether results or symptoms are unusual.
A normal life without a special diet
- Eat regularly and drink an appropriate amount of fluid. Avoid dehydration and prolonged fasting that triggers symptoms for you.
- You do not need herbs or supplements to lower bilirubin. It is not infectious, does not cause advanced liver fibrosis and does not shorten life.
Medicines and follow-up
- Tell your doctor about Gilbert’s syndrome before new treatment. Some medicines, such as irinotecan, require particular attention. Do not stop prescribed medicine yourself.
- Once the diagnosis is confirmed, extensive repeat testing is usually unnecessary for a familiar mild elevation unless symptoms or results change.
When to get help
Jaundice with confusion, severe pain, fever, repeated vomiting or significant illness needs urgent assessment; do not attribute it to Gilbert’s syndrome.
First-time, unusually severe or persistent jaundice, particularly with dark urine, pale stool or new itching.