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Hepatitis

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

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 to 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.

How severe hepatitis is depends on many factors, including the cause of the liver damage and any illnesses you have. Hepatitis A, for example, is usually 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

Your doctor may order lab tests to diagnose and monitor your condition, including:

  • Ultrasound of the abdomen
  • Autoimmune blood markers
  • 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 doctor 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

  • 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 doctor 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 doctor about receiving 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

Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486-1500.

Jou JH, Muir AJ. In the clinic. Hepatitis C. Ann Intern Med. 2008;148:iTC6-1-ITC6-16.

Sjogren MH, Cheatham JG. Hepatitis A. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa:Saunders Elsevier; 2010:chap 77.

Pawlotsky JM, Mchutchison J. Chronic viral and autoimmune hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 151.

Updated: 10/14/2013

George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team


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