Hepatitis

What is Hepatitis?

Hepatitis is a general term that means inflammation of the liver.

What Causes Hepatitis?

Viral infection, drugs, and other toxins can all cause hepatitis.

Viral Infections

Hepatitis A Virus: People can get hepatitis A after they eat food or drink water contaminated with the virus or if they touch something that has the virus on it and then touch their food or put their hands in their mouth.

Hepatitis B Virus: Hepatitis B virus spreads from person to person through bodily fluids and can be contracted in the following ways:

  • Having sex with someone who is infected
  • Sharing drug needles with someone who is infected
  • Using infected needles for tattooing, acupuncture, or piercings
  • Sharing toothbrushes, razors, or other personal items with someone who is infected
  • Hepatitis B infection can also be passed directly from an infected pregnant woman to her baby.

Chronic hepatitis B also increases the risk of getting liver cancer.

Hepatitis C Virus: Hepatitis C virus is acquired from contact with the blood of someone who is infected. This can happen if you:

  • Share drug needles or cocaine straws
  • Have sex with someone who is infected
  • Use infected needles for tattooing, acupuncture, or piercings
  • Share toothbrushes, razors, or other personal hygiene items that could have blood on them
  • Got a blood transfusion before 1990 (when the way blood was handled changed)
  • Hepatitis C infection can also be passed directly from an infected pregnant woman to her baby.

Drugs

The following prescription and over-the-counter medicines can cause toxic hepatitis:

  • Acetaminophen (Tylenol®)
  • Non Steroidal Anti-Inflammatory Drugs (NSAIDs), including ibuprofen (Advil®, Motrin®) and naproxen (Aleve®, Naprosyn®)
  • Certain antibiotics
  • Some herbal and diet supplements

Toxins

  • Alcohol

What are the Symptoms of Hepatitis?

When an individual first get viral hepatitis, they can feel like they have the flu or experience the following symptoms:

  • Feeling tired or weak
  • Muscle or joint pain
  • Nausea and vomiting
  • Not feeling hungry
  • Fever (in viral hepatitis)
  • Pain under the ribs on the right side of the belly

Many individuals with hepatitis, however, will have no symptoms and only find out they have it after their doctor does routine blood tests or blood tests for another reason that reveal elevated liver enzymes.

Later on, symptoms may include:

  • Jaundice (yellowing of the skin or white part of the eye)
  • Dark-colored urine
  • Light-colored bowel movements
  • Itchy skin

Symptoms of hepatitis A: In children, hepatitis A does not usually cause any symptoms at first. Adults often experience a flu-like illness that starts suddenly about a month after an individual is infected.

Symptoms of hepatitis B:  When people first get hepatitis B, they can feel like they have the flu. Some people’s eyes or skin turn yellow (called jaundice). These symptoms usually get better, but it can take weeks to months.

About 1 out of every 20 adults who gets hepatitis B develops “chronic” hepatitis B. Most people with chronic hepatitis B have no symptoms. But, over time, the infection can lead to a liver condition called “cirrhosis.”

Symptoms of hepatitis C: Most individuals with hepatitis C experience no symptoms and only become aware of the infection on routine lab evaluation or many years after the infection when they develop cirrhosis.

How is Hepatitis Diagnosed?

Simple blood tests can detect liver inflammation in individuals with hepatitis.  These tests measure liver “liver enzymes”; when these enzymes are elevated in the blood, they can suggest a diagnosis of hepatitis. However, they do not tell the doctor the specific cause of the hepatitis.

More specific tests are required to help determine the specific cause of hepatitis.  Your doctor can order specific blood tests to determine if you have been exposed to hepatitis virus.

Other tests may be required in order to make a definitive diagnosis and make sure there isn’t another reason for the elevated liver enzymes. These may include:

  • CT or MRI Imaging tests that create pictures of the inside of the body.
  • A liver biopsy in which the doctor uses a needle to remove a small sample of tissue from your liver so it can be evaluated under a microscope.

How is Hepatitis Treated?

The main treatment for acute viral and toxic hepatitis is to avoid the drug, supplement, or toxin that inflamed your liver and avoid exposing your liver to other substances that could cause additional damage.

  • Avoid drinking alcohol.
  • Avoid certain medicines.  Check with your doctor before you take any medicines or supplements.
  • Get plenty of rest. Do not return to work or school until your fever is gone, your appetite is back, and your skin and eyes are no longer yellow.

Most individuals will not need any additional specific treatment, because the liver will heal on its own. It can take weeks to months for the liver to heal; during this time your doctor will monitor your situation and check your liver enzymes.

Complications of Hepatitis

Liver Failure: Individuals with hepatitis B or C and those with toxic hepatitis after taking a medicine or supplement for a long time can sometimes get scarring of the liver, called cirrhosis. Severe cirrhosis can lead to liver failure, and in this case patients may need a liver transplant.  Severe liver damage and liver failure happens most often when people overdose on acetaminophen.  In rare cases, hepatitis A can cause liver damage that can lead to death.

Chronic Hepatitis: Individuals with hepatitis B or C can develop chronic hepatitis that can lead to cirrhosis and liver failure over many years.   In order to prevent this from occurring, doctors recommend the following:

  • Avoid alcohol.
  • Get vaccinated for hepatitis A, B, and other diseases, including the flu and pneumonia.
  • Ask your doctor or nurse before taking any over-the-counter pain medicines. (These medicines can sometimes damage the liver.)
  • Ask your doctor about several medicines now available to treat chronic hepatitis.

Liver Cancer: Individuals exposed to hepatitis B have an increased risk of developing liver cancer. Having an ultrasound test every 6 months to evaluate the liver is recommended.

CONDITIONS OF THE GI TRACT