Nikolay Bondarenko

Gilbert syndrome (benign unconjugated hyperbilirubinemia) is an inherited disorder of pigment metabolism caused by a mutation in the UGT1A1 gene. The condition is characterized by intermittent elevations of unconjugated bilirubin while liver function remains normal. Despite its benign nature, Gilbert syndrome requires specific lifestyle modifications and careful use of certain medications. In this article, we examine the pathogenesis of the disorder and effective management strategies.

Proton pump inhibitors (PPIs) have revolutionized gastroenterology, becoming the gold standard for the treatment of acid-related disorders. However, growing evidence has raised concerns about their overprescription and unnecessary long-term use. Prolonged PPI therapy has been associated with a range of potentially serious adverse effects, including alterations in the gut microbiome, nutrient malabsorption, kidney injury, and increased cardiovascular risk. In this article, we review the current evidence on the safety of long-term PPI use and discuss modern deprescribing strategies designed to reduce the dose gradually while maintaining symptom control and restoring normal gastric physiology.