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Hepatitis

  • Definition
    • Hepatitis is swelling and inflammation of the liver.

  • Causes
    • Hepatitis can be caused by:

      • Immune cells in the body attacking the liver
      • Infections from viruses (such as hepatitis A, hepatitis B, or hepatitis C), bacteria, or parasites
      • Liver damage from alcohol or poison
      • Medicines, such as an overdose of acetaminophen
      • Fatty liver

      Liver disease can also be caused by inherited disorders such as cystic fibrosis or hemochromatosis, a condition that involves having too much iron in your body.

      Other causes include Wilson's disease, a disorder in which the body retains too much copper.

  • Symptoms
    • Hepatitis may start and get better quickly. It may also become a long-term condition. In some cases, hepatitis may lead to liver damage, liver failure, or even liver cancer.

      There are several factors that can affect how severe the condition is. . These may include the cause of the liver damage and any illnesses you have. Hepatitis A, for example, is most often short-term and does not lead to chronic liver problems.

      The symptoms of hepatitis include:

      • Pain or bloating in the belly area
      • Dark urine and pale or clay-colored stools
      • Fatigue
      • Low fever
      • Itching
      • Jaundice (yellowing of the skin or eyes)
      • Loss of appetite
      • Nausea and vomiting
      • Weight loss

      You may not have symptoms when first infected with hepatitis B or C. You can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested often.

  • Exams and Tests
    • You will have a physical exam to look for:

      • Enlarged and tender liver
      • Fluid in the abdomen (ascites)
      • Yellowing of the skin

      You may have lab tests to diagnose and monitor your condition, including:

      • Ultrasound of the abdomen
      • Autoimmune blood markers
      • Blood tests to diagnose Hepatitis A, B, or C
      • Liver function tests
      • Liver biopsy to check for liver damage
      • Paracentesis (if fluid is in your abdomen)
  • Treatment
    • Your health care provider will talk to you about treatment options. Treatments will vary, depending on the cause of your liver disease. You may need to eat a high-calorie diet if you are losing weight.

  • Support Groups
    • There are support groups for people with all types of hepatitis. These groups can help you learn about the latest treatments and how to cope with having the disease.

  • Outlook (Prognosis)
    • The outlook for hepatitis will depend on what is causing the liver damage.

  • Possible Complications
    • Complications may include:

      • Permanent liver damage, called cirrhosis
      • Liver failure
      • Liver cancer
  • When to Contact a Medical Professional
    • Seek care immediately if you:

      • Have symptoms from too much acetaminophen or other medicines. You may need to have your stomach pumped
      • Vomit blood
      • Have bloody or tarry stools
      • Are confused or delirious

      Call your health care provider if:

      • You have any symptoms of hepatitis or believe that you have been exposed to hepatitis A, B, or C.
      • You cannot keep food down due to excessive vomiting. You may need to receive nutrition through a vein (intravenously).
      • You feel sick and have travelled to Asia, Africa, South America, or Central America.
  • Prevention
    • Talk to your provider about having a vaccine to prevent hepatitis A and hepatitis B.

      Steps for preventing the spread of hepatitis B and C from one person to another include:

      • Avoid sharing personal items, such as razors or toothbrushes.
      • DO NOT share drug needles or other drug equipment (such as straws for snorting drugs).
      • Clean blood spills with a mixture of 1 part household bleach to 9 parts water.
      • DO NOT get tattoos or body piercings with instruments that have not been cleaned properly.

      To reduce your risk of spreading or catching hepatitis A:

      • Always wash your hands well after using the restroom, and when you come in contact with an infected person's blood, stools, or other bodily fluid.
      • Avoid unclean food and water.
  • References
    • Czaja AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 90.

      Pawlotsky J-M. Chronic viral and autoimmune hepatitis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 149.

      Sjogren MH, Bassett JT. Hepatitis A. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 78.

      Sorrell MF, Belongia EA, Costa J, et al. National Institutes of Health Consensus Development Conference Statement: management of hepatitis B. Ann Intern Med. 2009;150(2):104-110. Epub 2009 Jan 5. PMID: 19124811 www.ncbi.nlm.nih.gov/pubmed/19124811.

      Wedemeyer H. Hepatitis C. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 80.

      Wells JT, Perrillo R. Hepatitis B. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.

      Yee HS, Chang MF, Pocha C, et al. Update on the management and treatment of hepatitis C virus infection: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program Office. Am J Gastroenterol. 2012;107(5):669-689. PMID: 22525303 www.ncbi.nlm.nih.gov/pubmed/22525303.