Q: I am a 31 years old male weighing 87 kg and 175 cm tall. I had a mild jaundice 4.5 months back when I was also experiencing little loss of balance, shortness of breath especially after meals and after eating oily or sweet things or at night. My general physician told me that it is Gilbert's syndrome and would go away on its own. I used to have breathlessness and a choking feeling in the throat even with little exertion. Then the problems subsided slowly and a LFT about 2.5 months back showed no signs of jaundice any more. But then I had a very strong attack of cough, cold, chest tightness, nasal blockage and headache - that went away with medicines after 2 weeks but I still used to have one-sided neck and ear-pain every now and then. Now, I have returned to normal life, but still feel discomfort and mild pain in left shoulder and shortness of breath when I lift heavy weight with my arm and carry it. I also have regular constipation and occasional abdominal cramps that, at times, are very painful. Frequent belching and burping is also present. Besides, I feel tired in my head after talking for a long time and around 3 PM almost everyday. I have also noticed shortness of breath and weakness, which goes away after taking food. I have a deviated nasal septum from birth and had a painless, rubbery, swollen lymph node from the last 5 months in my right neck just below the jaw. I keep getting cold and neck/ear pains occasionally, but the most concerning problem for me now is the shortness of breath. The blood-count showed no irregularity, though a pulmonary function test showed hypersensitive airway passage. The general physician's advice is to reduce weight, regularly exercise and eat right. Could you please give me some advice on how to proceed further about this ? Should I consult a gastroenterologist or consider cancer as a possible cause? I am emotionally under stress because of this and my quality of life is getting affected severely. Please help.

A:Gilbert's syndrome is a congenital abnormality of the bile pigment metabolism in the liver and is a condition, which does not lead to liver disease but jaundice can be noted with malaise due to any other cause. The diagnosis is relevant in as much to exclude other causes of chronic liver disease and I advise you to consult a gastro-enterologist for investigations to obtain a definitive diagnosis.