Liver Inflammation - Symptoms, Causes, Treatments Liver Inflammation Treatments What is liver inflammation? Liver inflammation is a reaction that occurs when liver cells are attacked by a disease-causing microbe or substance. The liver is an organ in the digestive system that assists the digestive process and carries out many other essential functions. These functions include producing bile to help break down food into energy; creating essential substances, such as hormones; cleaning toxins from the blood, including those from medication, alcohol and drugs; and controlling fat storage and cholesterol production and release. The word hepatitis refers to liver inflammation. Most forms of hepatitis result from viral infection, although in some cases it is caused by an autoimmune disorder, in which the body’s immune system attacks liver cells because it cannot tell the difference between harmful invaders and healthy liver tissue. Damage to the liver from alcohol, toxins, and certain drugs can also result in inflammation. Some inherited diseases can cause inflammation and hepatitis, along with prolonged obstruction of bile flow. Some forms of liver inflammation produce mild symptoms, while others can be serious or life threatening. Looking for a Doctor?

Search Now Find a Gastroenterologist Near You Several types of viral hepatitis are known, the most common of which are designated as hepatitis A, B, C, D and E. Depending on the type, viral hepatitis can be spread through food or water contaminated by feces from an infected person; contact with infected blood through infected needles or contaminated blood transfusions; through sexual contact with an infected person; or passed from mother to child during childbirth. 8 Foods That Aid Digestion Here's what you can eat help keep your digestive tract healthy and happy. The severity, treatment and outcome of liver inflammation depend largely on the type of hepatitis you have. The initial symptoms of inflammation are similar to flu, but with the addition of jaundice, a yellowish discoloration of the skin and whites of the eyes. Left untreated, liver inflammation will begin to interfere with liver function and may progress to end-stage liver disease and liver failure. The liver damage caused by any inflammation is worsened by drinking alcohol. Fortunately, vaccines have been developed to protect against hepatitis A and B, two common causes of liver inflammation.

Seek immediate medical care (call 911) for serious symptoms associated with complications of liver inflammation, such as confusion, hallucinations, extreme fatigue, fainting, fever (especially if combined with a swollen abdomen), vomiting blood, or severe mood changes (especially agitation). Seek prompt medical care if you experience any of the following symptoms, including yellowing of the skin or whites of the eyes (jaundice); abdominal pain; nausea, vomiting or diarrhea; constant weakness or dizziness; difficulty thinking or understanding; and low-grade fever. Also seek prompt medical care if you are being treated for hepatitis but your symptoms persist or recur. SPONSORED Hepatitis: MedlinePlus Medical Encyclopedia 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 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. Images Liver anatomy 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 . 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 . Read More Hepatitis: Inflammation of the Liver Hepatitis: Inflammation of the Liver Text Size Photo: Getty Images When we hear that someone has hepatitis, we typically think they have a disease, like having heart disease or a lung infection. In actuality, hepatitis is swelling and inflammation of the liver. Hepatitis is not a condition -- it is the way the liver responds to something that is going wrong. The liver, which is the largest organ inside the body, is located in the abdomen overlapping the stomach.

The liver carries out many important functions including changing food into energy and cleaning poisons and alcohol from the blood. The liver also produces bile which is a liquid used by the stomach to help with digestion of food. This Article Vote Saved My Life Hepatitis or swelling of the liver causes the liver not to function the way it should. Hepatitis can also lead to scar tissue on the liver, which is known as cirrhosis. Because scar tissue cannot carry out the same functions as healthy liver tissue, cirrhosis can cause serious problems in other organs in the body because the liver is not doing its job effectively. Approximately 5 percent of people who have cirrhosis of the liver develop liver cancer. Hepatitis can be caused by a variety of things including viruses such as the hepatitis A, B, or C virus. But having hepatitis does not necessarily mean you have one of these viruses. Hepatitis can also be caused by one of the following: • Bacteria or parasites: These infections can cause swelling of the liver. • Toxins: Anything that is poisonous to the liver can cause damage leading to inflammation. • Autoimmune: Some disorders of the immune system can cause the body to attack its own organs including the liver.

• Blood supply: An injury or illness that restricts the blood supply to the liver can cause damage leading to inflammation and swelling. • Injury: An accident or trauma to the abdomen can damage the liver and cause inflammation. Some people with hepatitis have no symptoms and may have chronic inflammation of the liver without knowing it. Other people with hepatitis have one or more of the following symptoms: • Pain in the abdomen or stomach • Poor appetite • Upset stomach, nausea, or vomiting • Fatigue Hepatitis: Types, Symptoms, & Treatment Read This Next What Is Hepatitis? Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue. The liver is located on the right upper quadrant of your abdomen.

It performs many critical functions that affect metabolism throughout your body, including: bile production that’s essential to digestion filtering of toxins from the body excretion of bilirubin, cholesterol, hormones, and drugs metabolism of carbohydrates, fats, and proteins activation of enzymes, which are specialized proteins essential to metabolic functions storage of glycogen, minerals, and vitamins (A, D, E, and K) synthesis of plasma proteins, such as albumin synthesis of clotting factors According to the Centers for Disease Control and Prevention (CDC) , there are 4.4 million Americans currently living with chronic hepatitis. Many more people don’t even know that they have it . Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. Hepatitis A is a milder version of the disease, and hepatitis C and D are more severe. Treatment options vary depending on what form of hepatitis you have and what caused the infection. You can prevent some forms of hepatitis through immunizations or lifestyle precautions. The 5 Types of Viral Hepatitis Hepatitis A This type derives from an infection with the hepatitis A virus (HAV).

This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A. Hepatitis B This type derives from an infection with the hepatitis B virus (HBV). This type is transmitted through puncture wounds or contact with infectious body fluids, such as blood, saliva, or semen. Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B. It’s estimated by the CDC that 1.25 million people in the United States have chronic hepatitis B and 350 million people worldwide live with this chronic disease. Hepatitis C This type comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. HCV is among the most common blood-borne viral infections in the United States. Approximately 2.7 million Americans are currently living with a chronic form of this infection. Hepatitis D This is also called delta hepatitis. Hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through puncture wounds or contact with infected blood.

Hepatitis D is a rare form of hepatitis that occurs in conjunction with hepatitis B infection. It’s very uncommon in the United States. Hepatitis E Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and is typically caused by ingesting fecal matter. This disease is uncommon in the United States. However, cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, reports the CDC . Hepatitis A and E are normally contracted from eating contaminated food or drinking contaminated water. Hepatitis B, C, and D are contracted through contaminated blood. These forms of hepatitis can be either acute or chronic. Types B and C usually become chronic. Causes of Nonviral Hepatitis Alcohol Hepatitis can be caused by liver damage from excessive alcohol consumption. This is sometimes referred to as alcoholic hepatitis. The alcohol causes the liver to swell and become inflamed. Other toxic causes include overuse of medication or exposure to poisons. Autoimmune Disease The immune system may mistake the liver as a harmful object and begin to attack it, hindering liver function.

Common Symptoms of Hepatitis If you have forms of hepatitis that are usually chronic (hepatitis B and C), you may not have symptoms in the beginning. Symptoms may not occur until liver damage occurs. Signs and symptoms of acute hepatitis appear quickly. They include: fatigue yellow skin and eyes, which may be signs of jaundice Since chronic hepatitis develops slowly, these signs and symptoms may be too subtle to notice. How Is Hepatitis Diagnosed? Physical Exam During a physical examination, your doctor may press down gently on your abdomen to see if there’s pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam. Liver Biopsy A liver biopsy is an invasive procedure that involves the doctor taking a sample of tissue from your liver. This is a closed procedure. In other words, it can be done through the skin with a needle and doesn’t require surgery. This test allows your doctor to determine if an infection or inflammation is present or if liver damage has occurred. Liver Function Tests Liver function tests use blood samples to determine how efficiently the liver works. These tests check how the liver clears blood waste, protein, and enzymes.

High liver enzyme levels may indicate that the liver is stressed or damaged. Ultrasound An abdominal ultrasound uses ultrasound waves to create an image of the organs within the abdomen. This test will reveal fluid in the abdomen, an enlarged liver, or liver damage. Blood Tests Blood tests used to detect the presence of hepatitis virus antibodies and antigen in the blood will indicate or confirm which virus is the cause of the hepatitis. Viral Antibody Testing Further viral antibody testing may be needed to determine if a specific type of the hepatitis virus is present. How Is Hepatitis Treated? Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic. Hepatitis A Hepatitis A isn’t usually treated. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea, you will be put on a special diet created by your doctor to prevent malnutrition or dehydration. Vaccination can also prevent hepatitis A infections by helping your body produce the antibodies that fight this type of infection. Most children receive the vaccination between ages 12 and 18 months. Vaccination is also available for adults. Hepatitis B Acute hepatitis B doesn’t require specific treatment.

Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be followed for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is progressing. The CDC recommends hepatitis B vaccinations for all newborns. The vaccine is also recommended for all healthcare and medical personnel. Hepatitis C Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment. People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant. Hepatitis D Hepatitis D is treated with a medication called alpha interferon. According to the Public Health Agency of Canada , between 60 to 97 percent of people develop hepatitis D again even after treatment . Hepatitis E There are currently no specific medical therapies to treat hepatitis E. Because the infection is often acute, it typically resolves on its own.

People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol. Tips to Prevent Hepatitis Hygiene Practicing good hygiene is one key way to avoid contracting hepatitis. If you’re traveling to a developing country, you should avoid: drinking local water Viral Hepatitis and HIV - TheBody.com Viral Hepatitis and HIV About the Liver and Hepatitis The Liver and Its Many Functions The liver is the largest organ in the human body. Approximately the size of a football, it is located in the upper right part of the abdomen. We can't live without a functioning liver. It's the body's filter and warehouse. Almost all cells and tissues in the body depend on the liver. When something goes wrong with the liver, it can have a serious effect on almost every other organ in the body. A little over 1-1/2 quarts of blood pump through the liver every minute, allowing the liver to quickly and effectively remove toxins and waste products from the bloodstream. At the same time, the liver stores important nutrients such as vitamins , minerals, and iron.

The liver also plays a role in managing levels of certain substances in the body, such as cholesterol, hormones, and sugars, which are all necessary for survival and are potentially harmful when out of balance. The liver also has a key role in digesting food through the production of bile and controls blood-clotting factors, which prevent excessive bleeding. Advertisement What Is Hepatitis? Hepatitis is a general term that means inflammation of the liver. "Hepa" refers to the liver and "itis" means inflammation (as in arthritis, dermatitis, and pancreatitis). Inflammation of the liver -- hepatitis -- has several possible causes, including: Toxins and chemicals such as excessive amounts of alcohol; Autoimmune diseases that cause the immune system to attack healthy tissues in the body; and Microorganisms, including viruses. HAV, HBV , and HCV infect liver cells -- called hepatocytes -- that provide the best conditions for these viruses to reproduce. In response to the infection, the body's immune system targets the liver, causing inflammation (hepatitis).

If the hepatitis is severe (which can happen with HAV and HBV) or goes on for a long period of time (which can happen with HBV and HCV), hardened fibers can develop in the liver, a condition called fibrosis. Over time, more and more normal liver tissue can be replaced by hardened scar tissue, which can obstruct the normal flow of blood through the liver and seriously affect its structure and ability to function properly. This is called cirrhosis. If the liver is severely damaged, blood can back up into the spleen and the intestines, which can result in high pressure in these organs. Consequences of this condition -- called portal hypertension -- include bleeding (variceal bleeding) and fluid in the abdomen (ascites). Significant liver damage can also reduce the production of bile needed for proper digestion and decrease the liver's ability to store and process nutrients needed for survival. Other effects of a damaged liver include the inability to remove toxins from the bloodstream, which can eventually lead to mental confusion and even coma (encephalopathy).

There are five viruses known to affect the liver and cause hepatitis: HAV, HBV, HCV, the delta hepatitis virus (HDV, which only causes problems for people infected with HBV), and hepatitis E virus (HEV). There is no hepatitis F virus. The hepatitis G virus (HGV) was originally thought to cause liver damage, but has since been found to be an apparently harmless virus and has been renamed GB virus-C (GBV-C). Hepatitis | Causes, Symptoms, Treatment & Prevention Hepatitis D (HDV), a virus that only affects people with hepatitis B. Hepatitis E (HEV), which is similar to hepatitis A and rare in the United States. Causes and Risk Factors The hepatitis viruses are transmitted from person to person in different ways: Hepatitis A (HAV) is spread by ingesting even microscopic amounts of feces from an infected person. This can happen through close personal contact or infected food or water. Raw shellfish that has been contaminated by sewage is a common source of infection. Hepatitis B (HBV) is transmitted through contact with the body fluids of an infected person, including blood, vaginal fluid and semen.

In the United States, about two-thirds of new adult cases are sexually transmitted. The virus can also be passed from mother to baby during birth. Hepatitis C (HDV) is usually spread by contact with infected needles (either during IV drug use or accidental needle sticks) or during childbirth. It's also sometimes transmitted during sexual contact or by sharing personal hygiene products like shaving razors. Symptoms Not all people with hepatitis experience symptoms, and many people with the disease don't realize they're infected. When present, symptoms include: Fever Jaundice (yellowing of the skin and eyes) Diagnosis and Treatment If you think you've been exposed to viral hepatitis, seek immediate medical attention. In some cases, your doctor may recommend vaccination or injections of immune globulin (a product containing antibodies made from human blood plasma) to prevent or halt infection. Hepatitis is diagnosed based on your history and a blood test (or series of tests). Acute infection may last weeks to months. Some people with acute hepatitis need to be hospitalized, but many can remain at home. Self-care for hepatitis includes: Stay hydrated. Eat a balanced, nutritious diet. Choose high-calorie foods if your appetite is poor.

To protect the liver, avoid alcohol and check with a healthcare professional before taking medications or supplements. In addition, some people with acute hepatitis C and chronic hepatitis benefit from medications. People with chronic hepatitis should be monitored regularly by a healthcare provider who understands the condition. To protect the liver, patients should avoid alcohol and check with their provider before taking medications or supplements. Prognoses (long-term outcomes) vary depending on the form of hepatitis: Most people with hepatitis A recover fully within two to six months. Some people with hepatitis B develop chronic hepatitis. Risk ranges from about 90 percent in infants to 6–10 percent in older children and adults. About 15–25 percent of people with chronic hepatitis B go on to develop serious complications. About 75–85 percent of people with hepatitis C develop chronic hepatitis. Of these, 60-70 percent develop chronic liver disease; 5–20 percent eventually develop cirrhosis; and 1–5 percent die from cirrhosis or liver cancer. In addition, people with hepatitis C are at risk for serious illness if they later develop hepatitis A or B.

Prevention There are many steps you can take to reduce the risk of viral hepatitis: Consider getting vaccinated against hepatitis A and B if you weren't vaccinated as a child. This is the number one way to prevent these illnesses. Wash your hands with soap and water after using the bathroom or changing a baby's diaper and before handling food. When traveling in developing countries, avoid unpeeled or raw foods. Drink only bottled, boiled or chemically treated water. Practice safe sex. Hepatitis B is about 50–100 times more transmissible during sex than HIV . Condoms and other barrier methods greatly reduce the risk. Never share syringes, shaving razors, toothbrushes or tattooing or piercing supplies. Wear gloves when performing first aid. Disinfect blood spills (including dried ones) with diluted bleach and wear gloves during cleanup. Follow all occupational safety precautions in your workplace. If you are pregnant, seek early and regular prenatal care. To reduce the risk of non-viral hepatitis, avoid excessive alcohol consumption and consult with a healthcare professional about medications and supplements. Sources WHO | What is hepatitis? What is hepatitis? Reviewed July 2016 Q: What is hepatitis?

A: Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. Q: What are the different hepatitis viruses? A: Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways. Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV. Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood.

Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV. Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV. Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection. Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

Hepatitis A Background - Hepatitis A Health Information - NY Times Health Hepatitis C In-Depth From A.D.A.M. Background Hepatitis means "inflammation of the liver." It is a disorder in which viruses or other mechanisms produce inflammation in liver cells, resulting in their injury or destruction. The liver is the largest internal organ in the body, occupying the entire upper right quadrant of the abdomen. It performs over 500 vital functions. Some key roles are: The liver processes all of the nutrients the body requires, including proteins, glucose, vitamins, and fats. The liver manufactures bile, the greenish fluid stored in the gallbladder that helps digest fats. One of the liver's major contributions is to render harmless potentially toxic substances, including alcohol, ammonia, nicotine, drugs, and harmful by-products of digestion. The esophagus, stomach, large and small intestine -- aided by the liver, gallbladder, and pancreas -- convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted. Damage to the liver can impair these and many other processes.

Hepatitis varies in severity from a self-limited condition with total recovery to a life-threatening or life-long disease. It can occur from many different causes: In the most common hepatitis cases (viral hepatitis), specific viruses injure liver cells and activate the immune system to fight off the infection. Certain immune factors that cause injury become overproduced. Hepatitis can also result from an autoimmune condition, in which abnormally targeted immune factors attack the body's own liver cells. Inflammation of the liver can also occur from medical problems, drugs, alcoholism, chemicals, and environmental toxins. All hepatitis viruses can cause an acute (short term) form of liver disease. Some specific hepatitis viruses (B, C, and D), and some non-viral forms of hepatitis, can cause chronic (long term) liver disease. (Hepatitis A and E viruses do not cause chronic disease.) In some cases, acute hepatitis develops into a chronic condition, but chronic hepatitis can also occur on its own. Although chronic hepatitis is generally the more serious condition, patients with either condition can have varying degrees of severity. Acute Hepatitis.

Acute hepatitis can begin suddenly or gradually, but it has a limited course and rarely lasts beyond 1 or 2 months, although it may last up to 6 months. Usually, there is only minimal liver cell damage and evidence of immune system activity. Rarely, acute hepatitis due to hepatitis B can cause severe, even life-threatening, liver damage. Chronic Hepatitis. If hepatitis does not resolve after 6 months, it is considered chronic. The chronic forms of hepatitis last for prolonged periods. Doctors usually categorize chronic hepatitis by indications of severity: Chronic persistent hepatitis is usually mild and does not progress or progresses slowly, causing limited damage to the liver. Chronic active hepatitis involves progressive and often extensive liver damage and cell injury. Click the icon to see an image of aggressive hepatitis. Viral Hepatitis Most cases of hepatitis are caused by viruses that infect liver cells and begin replicating. They are identified by the letters A through G: Hepatitis A, B, and C are the most common viral forms of hepatitis and are the primary focus of this report. Other hepatitis viruses include hepatitis D and E. Hepatitis D is a serious and uncommon form of hepatitis that can be chronic.

It is associated with hepatitis B, as the D virus relies on the B virus to replicate. (Therefore, hepatitis D cannot exist without the B virus also being present.) Hepatitis E, like hepatitis A, is an acute form of hepatitis that is transmitted by contact with contaminated food or water. Researchers are investigating additional viruses that may be implicated in hepatitis unexplained by the currently known viruses. The name of each type of viral hepatitis condition corresponds to the virus that causes it. For example, hepatitis A is caused by hepatitis A virus (HAV), hepatitis B is caused by hepatitis B virus (HBV), and hepatitis C is caused by hepatitis C virus (HCV). Scientists do not know exactly how these viruses actually cause hepatitis (inflammation in the liver). As the virus reproduces in the liver, several proteins and enzymes, including many that attach to the surface of the viral protein, are also produced. Some of these may be directly responsible for liver damage. Researchers are investigating elevated levels of specific immune factors, including T cell sub-types, which are found in the livers of patients with hepatitis C or B.

T cells are important infection fighters in the immune system that can release powerful inflammatory substances (tumor necrosis factor and interferon gamma) that may be involved in the damage associated with hepatitis B and C. Non-Viral Forms of Hepatitis Autoimmune Hepatitis . Autoimmunehepatitis is a rare form of chronic hepatitis. Like other autoimmune disorders, its exact cause is unknown. Autoimmune hepatitis may develop on its own or may be associated with other autoimmune disorders, such as systemic lupus erythematosus. In autoimmune disorders, a misdirected immune system attacks the body's own cells and organs (in this case the liver. Alcoholic Hepatitis. About 20% of heavy drinkers develop alcoholic hepatitis, usually between the ages of 40 - 60 years. In the body, alcohol breaks down into various chemicals, some of which are very toxic to the liver. After years of drinking, liver damage can be very severe, leading to cirrhosis. Although heavy drinking itself is the major risk factor for alcoholic hepatitis, genetic factors may play a role in increasing a person's risk for alcoholic hepatitis. Women who abuse alcohol are at higher risk for alcoholic hepatitis and cirrhosis than are men who drink heavily.

Nonalcoholic fatty liver disease (NAFLD) affects 10 - 24% of the population. It covers several conditions, including nonalcoholic steatohepatitis (NASH). NAFLD has features similar to alcoholic hepatitis, particularly a fatty liver, but it occurs in individuals who drink little or no alcohol. Severe obesity and diabetes are the major risk factors for NAFLD as well as complications from NAFLD. NAFLD is usually benign and very slowly progressive. In certain patients, however, it can lead to cirrhosis, liver failure, or liver cancer. Drug-Induced Hepatitis. Because the liver plays such a major role in metabolizing drugs, hundreds of medications can cause reactions that are similar to those of acute viral hepatitis. Symptoms can appear anytime after starting drug treatment. In most cases, they disappear when the drug is withdrawn, but in rare circumstances they may progress to serious liver disease. Drugs most noted for liver interactions include halothane, isoniazid, methyldopa, phenytoin, valproic acid, and the sulfonamide drugs.

Very high doses of acetaminophen (Tylenol) have been known to cause severe liver damage and even death, particularly when used with alcohol. Toxin-Induced Hepatitis . Certain types of plant and chemical toxins can cause hepatitis. These include toxins found in poisonous mushrooms, and industrial chemicals such as vinyl chloride. Metabolic-Disorder Associated Hepatitis . Hereditary metabolic disorders, such as hemochromatosis (accumulation of iron in the body) and Wilson’s disease (accumulation of copper in the body) can cause liver inflammation and damage. More Information on This Topic Background Chronic Hepatitis Guide: Causes, Symptoms and Treatment Options Chronic Hepatitis What Is It? Hepatitis is an inflammation of the liver. In chronic hepatitis, liver inflammation continues for at least six months. This condition may be mild, causing relatively little damage, or more serious, causing many liver cells to be destroyed. Some cases lead to cirrhosis and liver failure. Chronic hepatitis from infection is most often caused by these viruses: Hepatitis B and C. Often the person infected is unaware of any initial symptoms. Or the symptoms were so mild that the person did not seek medical attention. This is especially true for chronic hepatitis C.

Over time, perhaps a decade or more, both types may lead to the serious complication of cirrhosis due to ongoing destruction of liver cells and resultant scarring. A minority of patients with cirrhosis develop liver cancer over time. Hepatitis D. Hepatitis D infects only patients already infected with hepatitis B, and it generally results in a flare of active hepatitis. The three more commonly diagnosed causes of non-infectious chronic hepatitis include: Alcohol. Alcohol can cause a chronic hepatitis, especially if associated with inadequate nutrition. Also, even moderate intake of alcohol can make chronic hepatitis from any other cause (especially hepatitis C) worse, with an increased risk of advancing to cirrhosis. Non-alcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis or NASH has become a relatively common cause of persistent liver inflammation. "Steato" means fat and the hallmark of NASH is fat in the liver AND active on-going liver damage. Most people have no symptoms. They are usually discovered when a routine blood test is performed and the level of liver enzymes are found to be above normal. Autoimmune hepatitis. In this form of chronic hepatitis, the immune system mistakenly destroys the body's own liver cells.

What triggers autoimmune chronic hepatitis is unknown. If left untreated, it's a progressive disease that can lead to cirrhosis. It may appear with other autoimmune diseases, such as Sjögren's syndrome and autoimmune hemolytic anemia. Autoimmune hepatitis most often is found in young women, but it can affect women and men of all ages. Some medications also can lead to chronic hepatitis. These medications include: Phenytoin ( Dilantin ) for seizure disorders Macrodantin for urinary tract infections However, chronic hepatitis caused by medications is relatively uncommon. Periodic blood tests are warranted when patients are placed on drugs known to cause hepatitis. Discontinuing the medication usually reverses early liver inflammation. Some rare, inherited metabolic disorders also can lead to chronic hepatitis. They include: Wilson's disease, a condition in which the body has difficulty metabolizing copper Hemochromatosis, a condition of excessive iron deposits in the liver and many other parts of the body Symptoms At first, chronic hepatitis often does not cause any symptoms. People with symptoms most commonly complain of fatigue. Fatigue worsens throughout the day and may even be debilitating.

Other common symptoms include: Mild upper abdomen discomfort Easy bruisability and spontaneous bleeding Confusion that may progress to coma Diagnosis Because chronic hepatitis often does not cause any early symptoms, the disorder frequently is discovered during a routine blood test. If your doctor suspects you may have chronic hepatitis, he or she may examine you for jaundice, tenderness in the abdomen (especially the right upper corner where the liver is located) and signs of fluid that fills the abdomen during liver failure. Blood tests may be done to measure: Liver enzymes, which are released when liver cells become inflamed or damaged Bile duct enzymes Levels of bilirubin, a pigment produced by the breakdown of red blood cells. High levels of bilirubin cause jaundice. Protein levels and clotting factors to assess how the liver is functioning If these tests show signs of liver inflammation or liver failure, you will undergo tests for hepatitis B and C and for antibodies that signal autoimmune hepatitis. Your doctor will review medications you take now or have taken recently to determine if they could be causing your chronic hepatitis. If the cause still is not known, further blood tests will be ordered to check for uncommon causes.

An ultrasound or computed tomography (CT) test may be done to assess the size of the liver. A small liver that appears scarred suggests cirrhosis. A liver biopsy may be recommended. In a biopsy, a small piece of tissue will be removed from your liver and will be examined under a microscope to help determine: The cause of chronic hepatitis The severity of inflammation The amount of scarring The extent and type of liver damage This information helps to determine the best treatment and to assess your risk of developing cirrhosis and liver failure. A liver biopsy also can help to check for other disorders, such as alcoholic liver injury or fatty liver. Expected Duration By definition, chronic hepatitis is inflammation that continues for more than six months. With mild or nonexistent symptoms, you may have chronic hepatitis for some time before it is discovered. Treatment for some types of viral chronic hepatitis can eliminate active infection. However, the virus can remain dormant in cells, so the condition can return. Prevention Usually, chronic hepatitis is caused by infection with the hepatitis B or C virus. These viruses primarily are passed from person to person through sexual contact or through contact with blood or other bodily fluids when needles are shared or during blood transfusions.

The reason some cases of viral hepatitis become chronic hepatitis and others do not remains unknown. The best way to protect against chronic hepatitis is to protect yourself against the hepatitis B and C viruses. Vaccinations for hepatitis B are recommended for health care workers and people traveling to certain countries. Infants are now routinely vaccinated against hepatitis B. Condoms always should be used during sexual contact to help prevent infection. Needles should never be shared. When getting a tattoo or any body piercing done, make sure to choose an establishment where all equipment is sterilized adequately. Non-alcoholic steatohepatitis (NASH) is seen most often in people who are overweight, especially if they accumulate excessive fat around the midsection. Women with waist size 35 inches or greater and men with waist size 40 inches or greater are at highest risk of developing this type of chronic hepatitis. Maintaining a healthy weight and exercising regularly give you the best chance of preventing NASH. There is no way to prevent autoimmune chronic hepatitis because the cause is unknown. If you are taking a medication that could affect your liver, make sure to have your blood tested regularly to avoid the development of chronic hepatitis or liver damage.

Treatment The goals of treatment for chronic hepatitis are to prevent the disease from getting worse and to prevent cirrhosis and liver failure. Chronic hepatitis B and C are treated with antiviral medications. The newest drugs have incredibly high success rates. If you have hepatitis C, you should receive the vaccine for hepatitis A and B unless blood tests show that you are already immune to these viruses. You can develop more severe symptoms from hepatitis A or B than someone who does not have hepatitis C. Treatment of alcoholic hepatitis is complete abstinence from alcohol. People with NASH usually need to lose weight and always need to exercise more. In addition, many people with NASH have elevated blood sugars and frequently progress to type 2 diabetes. Good control of blood sugar can help to decrease the fatty accumulation and inflammation in the liver. If you already have evidence of cirrhosis, you should have a test called endoscopy to look for esophageal varices, enlarged veins in the esophagus that can cause life-threatening bleeding. In an endoscopy, a flexible viewing tube is inserted through your mouth into your esophagus. You also should be screened periodically with a blood test (alpha fetoprotein) and an ultrasound study to search for an early liver cancer.

Corticosteroids and other medications such as azathioprine to suppress the immune system are the main treatment of autoimmune chronic hepatitis. These drugs usually decrease symptoms, reduce liver inflammation and prolong survival. Treatment for the less common forms of chronic hepatitis focuses on the disease that is causing the condition. Medication-related chronic hepatitis requires stopping or changing the drug. If cirrhosis or liver failure develops, a liver transplant may be needed. If you have chronic hepatitis, you must avoid further liver damage from alcohol or acetaminophen ( Tylenol ). Discuss with your doctor how much acetaminophen you can take, if any. Remember that certain cold formulations and pain medications also contain acetaminophen. A healthy lifestyle is so important for people with chronic hepatitis. A well-balanced diet and good physical fitness can help you battle fatigue and improve overall health. You may need to limit your salt intake if you tend to accumulate fluid as a consequence of cirrhosis. Also, always talk to your physician before taking any additional drugs, including prescription, nonprescription and alternative medications. Your injured liver may not be able to detoxify these.

When To Call a Professional If you experience persistent fatigue, the most common symptom of chronic hepatitis, make an appointment to see your doctor. If you show signs that could come from chronic hepatitis or liver failure, such as jaundice, abdominal swelling or weight loss, you should call your doctor for an evaluation. Prognosis The prognosis for chronic hepatitis has improved dramatically over the last few years. In fact, for hepatitis C, many people can now be cured. Despite treatment, some people will progress to cirrhosis. Advanced cirrhosis can lead to liver failure and death unless a liver transplant can be done. The likelihood of developing cirrhosis depends on the severity of the disease and the response to treatment. When a biopsy shows more severe damage, treatment can be important to help decrease the risk of developing cirrhosis even if you do not have symptoms. Other factors that affect the prognosis include age, other medical illnesses, the subtype of virus and alcohol use. Cirrhosis increases the risk of developing liver cancer. Periodic screening with a blood test and ultrasound examination of the liver improves the chance of early detection. Learn more about Chronic Hepatitis Symptoms and treatment for:

Question: Hepatitis is the inflammation of which organ?
Answer: Liver