With mild viral hepatitis, slight fatigue may be the only symptom. When hepatitis is severe, the patient loses the taste for food and cigarettes, develops a heaviness in the right-upper abdomen and, especially with acute B hepatitis, may have diarrhea and arthritis. The liver and even the spleen can enlarge. The eyes and skin turn yellow, the urine dark, and the stool a putty-white color. Jaundice results when the yellow bile pigment, which normally flows through the bile ducts to the intestine, backs up and spills into the blood.
Acute hepatitis can last from two weeks to several months.
The patient often needs to be hospitalized in the early, acute phase of the illness. The physician often suspects hepatitis based on the patient's medical history and physical exam. Certain blood tests, however, are the best indicators of hepatitis, its causes, and its severity. Blood tests are used to follow the course of the infection through to recovery. Occasionally a liver biopsy may be needed to provide information to the physician.