Hepatitis, in general terms, is an inflammation of the liver (hepatitis) caused by the disruption or damage of liver cells. This impairment of the liver by hepatitis pathogens is reportable. Hepatitis divides more specifically into hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E.
What is hepatitis?
Hepatitis is a form of liver disease. The liver is considered the largest of the organs in the human body and is one of the most important organs when it comes to detoxifying food as well as pollutants and other waste products. When the liver is inflamed, the disease is called hepatitis. The origin of the term hepatitis comes from the Greek and is composed of the compound partial terms hépan = liver and the word itis = inflammation. Hepatitis disease can cause damage to liver cells, disabling the liver’s most important function of filtering harmful substances.
Causes
Hepatitis disease can be attributed to several factors. Decisive for a hepatitis disease can be, for example, viruses, bacteria or but also different types of parasites. Also various diseases, such as sarcoidosis or autoimmune diseases can lead to hepatitis. Another factor that can lead to hepatitis is the excessive consumption of alcohol or drugs. Also various chemicals can lead to the outbreak of the disease. As a rule, most hepatitis diseases are caused by different types of viruses. Here, a distinction is made between five different types of viruses. These five virus types occur in most people who suffer from hepatitis. A distinction is made between the hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and the hepatitis E virus (HEV). This is also the origin of the different forms of hepatitis. In medicine, a distinction is made between hepatitis A, B, C, D or E. Another virus that belongs to the same virus group is the hepatitis G virus, which is not recognized as an independent viral disease, but rather as a secondary virus. Depending on which liver inflammation is present, different symptoms may occur.
Symptoms, complaints, and signs
Hepatitis can manifest itself through quite different symptoms. In some patients, the liver inflammation takes a severe course. Others, however, experience no symptoms, and the disease is diagnosed by chance. In acute hepatitis, different symptoms can occur in the individual phases. In the early phase, symptoms such as nausea and vomiting, loss of appetite and fever appear. There is also upper abdominal pain and joint or muscle pain. Patients usually complain of an altered or weakened sense of smell and taste. In the jaundice phase, which occurs after two to eight weeks, the typical yellowing of the skin or eyeball is added. In this phase, the stool is almost colorless and the patient experiences increasing itching in various parts of the body. In the recovery phase, symptoms such as fatigue, weakness and exhaustion appear. The recovery phase may last several weeks to months. Chronic hepatitis causes fatigue, loss of appetite, and decreased performance. Typical physical symptoms include pressure pain under the right costal arch, joint pain, and diarrhea. In men, testicular atrophy and enlargement of the mammary glands may occur. In women, menstrual cramps often present. In the chronic form, symptoms occur in episodes.
Course
As a rule, hepatitis always begins with somewhat harmless general symptoms. Frequently, affected individuals experience signs such as fatigue or nausea. Later, characteristic symptoms may also appear. For example, discoloration of the skin or discoloration within the eye (e.g. yellow) are typical of a hepatitis disease. In hepatitis, a distinction is made not only between the individual virus types, but also between the reasons for transmission. For hepatitis A and hepatitis E, for example, smear infections are responsible. These usually occur when pathogens are excreted and later reenter the patient’s own organism. The course of the disease usually subsides after a few weeks or months.In the case of chronic hepatitis, the disease often only subsides after six months. A hepatitis disease is always positive in most cases, however, if you have hepatitis, you must make notification, because hepatitis falls under the Infection Protection Act.
Complications
Hepatitis can take different courses. Depending on the type of hepatitis disease, there can be spontaneous healing, but also chronic courses. Hepatitis A and hepatitis E both tend to heal spontaneously without any sequelae, whereas in hepatitis B or especially hepatitis C, the course can become chronic. A chronic course leads to a strong impairment of the quality of life of the affected person. The latter can develop depression and a certain addictive behavior, which can aggravate the hepatitis. In the worst cases, cirrhosis of the liver develops. In this, the liver is remodeled in a nodular fashion, and the affected person usually complains of pain in the upper abdomen. Edema and coagulation disorders are also observed, as the liver is no longer able to synthesize the necessary proteins. The spleen is also usually enlarged at the same time due to cirrhosis of the liver, as blood is diverted there from the liver. This causes additional pain. Other bypasses are located on the veins in the stomach and esophagus. Varicose veins develop there, which can burst and thus lead to internal bleeding. Hemorrhoids also develop in the rectal area due to the detour. Additionally, there is a lack of detoxification of ammonia by the liver, which can accumulate in the blood and lead to encephalopathy.
When should you see a doctor?
If symptoms such as loss of appetite, abdominal pain, fatigue, or lassitude are noticed, a hepatitis infection may be present. A physician should be consulted if symptoms persist for more than a week or increase in intensity within a short period of time. If other symptoms occur, medical advice is also required. Liver complaints such as a change in the color of urine or stool, as well as signs of blood poisoning, should be clarified immediately. In the event of a severe fever that rises above 41.3 degrees Celsius, an emergency doctor must be alerted. The same applies to serious cardiovascular problems such as a heart attack or circulatory collapse. A hepatitis infection requires medical diagnosis and treatment in any case. For this reason, a visit to the family doctor should be made at the first suspicion. This is especially true if the symptoms are due to a specific cause. If the symptoms mentioned occur, for example, after unprotected sexual intercourse or contact with a possibly infected person, a doctor should be consulted immediately. In case of doubt, the emergency medical service can be contacted first.
Treatment and therapy
Treatment of hepatitis varies and depends greatly on the type of virus. In the case of hepatitis A, hepatitis D and hepatitis E, the main treatment is to try to combat the symptoms, as there is no effective medication against the different types of virus. As a rule, a low-fat and high-carbohydrate diet should be consumed for these types. For hepatitis B, on the other hand, interferon-alfa therapy is used in most cases, which is intended to prevent chronic progression. Treatment of hepatitis G, on the other hand, is not strictly necessary, since in most cases it disappears again without action.
Outlook and prognosis
The prognosis of hepatitis depends on the type of disease and whether medical care is sought. Without treatment, the virus usually continues to spread unchecked. Chronic disease progression may occur, and the risk of premature death is significantly increased. With hepatitis A disease, the patient has a good chance of recovery. With adequate rest and drug treatment, the patient is discharged from treatment as cured within a week. Consequential symptoms are not to be expected. In addition, the affected person becomes immune to the virus for life. In the case of hepatitis B, the chances of recovery are also good. However, the course of the disease can also be chronic. The patient is subject to the risk of late complications. With liver cirrhosis or liver cancer, a life-threatening condition is imminent. Organ failure resulting in death may occur.There is a cure for hepatitis C disease with early treatment. The sooner the patient seeks medical care, the better the prognosis. Hepatitis is responsible for liver cancer in over 50% of cases. If the affected person consumes alcohol or leads an unhealthy lifestyle, the prospects of a cure decrease immensely.
Follow-up
Those who want to prevent the recurrence of hepatitis should get vaccinated. Effective protection can be established against forms A and B. Because of the usually favorable prognosis and rapid progression of the disease, long-term follow-up is not necessary for an acute episode. Only in the case of renewed symptoms does an affected person consult a physician. Adequate hygiene, a balanced diet and a healthy weight prevent recurrence. A strong immune system is able to defend itself against infection. In hepatitis, the liver is particularly affected. If the course of the disease is chronic or if the patient has consumed alcohol to an excessive extent, long-term damage is not uncommon. Regular monitoring is then recommended. Blood tests, tissue samples and ultrasound images provide clarity about the progress of the disease. Medications often complement the therapy. All aftercare measures are aimed at making a patient’s daily life bearable in the case of a chronic course of hepatitis. To this end, the right dose must be found, depending on the extent of the symptoms. If necessary, monitoring serves to decide on liver transplantation. Chronic disease sometimes leads to liver cancer. This complication can be fatal and require further extensive treatment.
Here’s what you can do yourself
An existing hepatitis disease should be treated by a specialist, as failure to treat it or treating it yourself alone can result in a chronic course. There is also a risk of life-threatening complications. The treatment and also the measures that affected persons can take themselves depend on the cause of the disease. For example, hepatitis can develop as a result of medication or alcohol abuse. In this case, a new medication regimen should be discussed with the attending physician, or alcohol should be strictly avoided. If addiction is already present, medically supervised withdrawal therapy and self-help groups are treatment options. Since most hepatitis diseases are of viral origin, treatment focuses on symptom relief. Depending on the type of virus, the infections heal on their own or are accompanied by medication. Since in all cases the liver is severely stressed and damaged, sufferers should pay attention to a low-fat and high-carbohydrate diet. Equally beneficial is a high level of fluid intake – no alcoholic or sugary drinks – and sufficient sleep. Regular exercise in fresh air also strengthens the immune system and stimulates the metabolism. A strong defense is fundamental in fighting infectious diseases. The body can additionally be supported in detoxification: through the targeted supply of minerals and plenty of fresh vegetables. This balances the acid-base balance and helps the body to better eliminate harmful substances.
