Patients, however, often do well even in the absence of therapy. As with Crigler-Najjar type II syndrome, phenobarbital has been shown to decrease bilirubin production. The prognosis is excellent. I, no medications are effective. Combined phototherapy and exchange transfusions are beneficial in infants to prevent kernicterus.
Liver transplantation is the treatment of choice.
For Crigler-Najjar type II, phenobarbital produces a fall in plasma bilirubin levels. Therapy only benefits patients cosmetically. For Gilbert syndrome, no medical therapy is needed. As with Crigler-Najjar type II syndrome, phenobarbital has been shown to decrease bilirubin production. Although the mechanism of action is uncertain, enzyme induction is probably the major action.