Liver Diseases


Hepatitis


There are 2 types of hepatitis:

  1. Acute Hepatitis – inflammation of the liver that lasts less than 6 months
  2. Chronic Hepatitis – inflammation of the liver that lasts more than 6 months

What is Acute Hepatitis?


Acute hepatitis is a hepatic inflammation resulting in damaged and destroyed liver cells. Acute hepatitis is very common: Acute hepatitis occurs in one of 4000 persons in developed countries each year whereas this may be 5 times more in developing countries.

Common Causes

  1. Viral infections (viral hepatitis A, B, C, D or E)
  2. Drug overdose (e.g. acetaminophen, paracetamol)
  3. Being exposed to chemical substances (dry cleaning chemical and some wild mushrooms)

Symptoms

Acute hepatitis often present with flue-like symptoms. The most common symptoms of acute hepatitis are listed below. However, each individual may suffer from different symptoms including jaundice, nausea, vomiting, loss of appetite, fever, sensitivity of right upper portion of abdomen, muscular pain, arthralgia, and itchy rash.

Symptoms of acute hepatitis may resemble other diseases or medical problems. Consult a physician for diagnosis on the right time.

Diagnosis

In addition to complete medical history and medical tests, diagnostic procedures of acute hepatitis include followings,

  1. Specific laboratory tests to identify viruses,
  2. Function tests of the liver.

Treatment

Treatment of acute hepatitis will be planned by your physician based on the cause and severity of the disease; your condition and a medical history of any liver diseases.

Many people usually recover without receiving any treatments. Severe acute hepatitis may require hospitalization. Those who have suffered from acute viral hepatitis may become a chronic carrier of the disease in case of Hepatitis B or C infection.


What Is Chronic Hepatitis?


Some people may not be able to completely recover from acute hepatitis and develop chronic hepatitis because the liver is further damaged and infected. In case the symptoms last more than six months, the hepatitis is considered chronic. Chronic hepatitis may last years. There are different types of chronic hepatitis:

  1. Alcoholic hepatitis – permanent liver damage caused by heavy alcohol intake.
  2. Chronic active hepatitis – aggressive inflammation of liver cells to produce cirrhosis
  3. Chronic persistent hepatitis – milder chronic inflammation of the liver usually not leading to cirrhosis

Causes

Certain viruses and drugs may cause chronic hepatitis in some people but may not in others.

Common Causes

  1. Viral hepatitis
  2. Heavy alcohol intake
  3. Autoimmune disorders (the body attacks its tissues)
  4. Reaction to certain medications particularly to those for tuberculosis.
  5. Metabolic disorders (e.g. hemochromatosis or Wilson disease)

Symptoms

Symptoms of chronic hepatitis are often mild. Although the liver damage progresses, the progression is usually slow. Some individuals do not present symptoms while the others present followings: feeling ill, loss of appetite, fatigue, tiredness, low fever, upper abdominal pain, jaundice, and symptoms of chronic liver disease (splenomegaly, spider angiomata, and ascites).

Symptoms of chronic hepatitis may resemble other diseases or medical problems. Consult a physician for diagnosis.

Diagnosis

In addition to complete medical history and medical tests, diagnostic procedures of hepatitis include the followings:
A) Specific laboratory tests to identify viruses,
B) Function tests of the liver, or
C) Liver biopsy to determine inflammation, scarring, cirrhosis, and severity of underlying cause.

Treatment

Treatment of chronic hepatitis will be planned by your physician based on the cause and severity of the disease; your condition and a medical history of any liver diseases. The goal of the treatment is to terminate liver damage and relieve the symptoms.

The treatment may involve one or more of the followings:

Antiviral Agents – If hepatic inflammation is caused by Hepatitis B or C, it can be ceased by interferon-alpha which is an injectable antiviral drug. Also, oral intiviral agents, e.g. lamivudine or adefovir, can be used in Hepatitis B, and ribavirin can be used in Hepatitis C.

Corticosteroids – Corticosteroids can be used in the treatment of chronic liver disease caused by autoimmune disorder. Inflammation is suppressed but the fibrosis of the liver (scarring) may continue.

Cessation of certain drugs – When chronic hepatitis is caused by certain drugs, cessation of these drugs usually remove the symptoms.

Cessation of alcohol – This is essential in alcohol-related chronic liver disease, and highly recommended in Hepatitis C and other chronic diseases of the liver.

Prevention of spread of Viral hepatitis:

Appropriate hygiene is essential to prevent many diseases including hepatitis from spreading. Other precautionary measures include the followings:

Immunization – Hepatitis B vaccine is routinely administrated as part of immunization program in toddlers. Hepatitis A vaccine is administrated in those who are at risk of catching the disease during a journey. (There is currently no vaccine for hepatitis C, D or E.)

Blood transfusion – The blood products are routinely screened for Hepatitis, B, C, and HIV to reduce the risk of infection during transfusion.

Preparation of Antibodies – In case of being exposed to Hepatitis B, an antibody preparate can be administrated to prevent one from catching the disease.

Particularly, the followings further increase the risk of transmitting Hepatitis B and C:

a) Unsafe blood transfusion,
b) Family history of Hepatitis B and Hepatitis C,
c) Surgical procedures or dental manipulations,
d) Administration of intravenous drugs,
e) Unprotected intercourse,
f)  Dialysis,
g) Medical staff or paramedical staff


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