Hepatitis means inflammation of the liver, and one of the most common (and potentially serious) causes of liver inflammation is the infectious form of hepatitis, which is caused by one of five viruses, called hepatitis A, B, C, D and E.
Some forms of hepatitis are benign, but others can become chronic. This may result in chronic inflammation and scarring, and cause the infected person to become a permanent carrier, remaining infectious long after all symptoms have disappeared.
Hepatitis disturbs the ability of the liver to carry out its normal functionssecretion of bile, conversion of sugar to stored carbohydrate (and back again), and excretion of waste productsand may cause mild to severe flu-like symptoms as well as jaundice and serious life-threatening ailments such as liver cancer and cirrhosis. There is also a noninfectious form of hepatitis that is caused by toxic substances—particularly alcohol, but also certain toxic chemicalsand by the excessive use of certain medications, especially if they are taken with alcohol.
Symptoms of Hepatitis
During its acute phase, viral hepatitis is often mistaken for the flu and therefore often goes undetected. The most common symptoms include:
- General discomfort, aching muscles and joints
- Loss of appetite
- Weight loss
- Nausea, diarrhea and vomiting
- Abdominal discomfort or pain
- Dark urine and pale stools
- Enlarged liver, liver tenderness
- Jaundice (indicated by a yellow tinge to the skin, the whites of the eyes, and in body fluids; occurs in about 50 percent of hepatitis cases)
- Whole-body itching (called pruritus)
Note: Sometimes there are no symptoms.
What Causes Hepatitis?
Viral hepatitis is contagious and is passed through human contact and contaminated water and food, as well as by unprotected sex and injection drug use. There are a variety of routes by which the different viral forms of hepatitis spread, and accordingly, certain groups are at greater risk for contracting each type of virus.
- Hepatitis A. A common form of the disease is hepatitis A, which can cause severe flu-like symptoms but usually leaves no lasting effects and confers lifelong immunity. It is highly infectious and is most easily transmitted when an infected person handles food. An estimated 125,000 to 200,000 people are infected each year in the United States. Typically, the infection is passed through contaminated foods, water, and human feces. About 25 percent of all people infected with hepatitis A will experience no symptoms; those who do will have a fever of about 100°F, will feel exhausted, and will develop jaundice (yellow eyes and skin). Some people with hepatitis A become seriously ill and require hospitalization. The infection can also cause liver damage. But people usually recover completely from hepatitis A.
- Hepatitis B. About 200,000 to 300,000 Americans, typically adults, are diagnosed with hepatitis B each year, and almost 6,000 die from the infection annually. Hepatitis B is spread by direct blood contact, sexual intercourse, the sharing of contaminated needles, and through blood transfusions in which the virus is present—much like HIV, the AIDS virus. The virus may also pass through cuts or scrapes in the skin, and it can be transmitted via saliva on a shared toothbrush. Many pregnant women with acute or chronic hepatitis B pass the infection to their babies, generally during delivery, potentially leaving them as chronic carriers of the disease. Employment in the health-care field (doctors, nurses, laboratory technicians) increases the risk of infection, as does injection drug use and sexual contact. Although symptoms are generally mild—about half of those who become infected develop jaundice—a small number of patients for unknown reasons go on to develop a chronic carrier state with the potential to infect others. It’s estimated that there are one million such carriers currently in the United States. Chronic carriers are at risk for developing cirrhosis and/or liver cancer.
- Hepatitis C. This variant was known as non-A, non-B hepatitis until 1988. It's estimated that nearly 3.2 million Americans are chronically infected with hepatitis C, with about 36,000 new cases occurring each year. The majority of those infected have no symptoms, but many do develop symptoms, which can include nausea, extreme fatigue, fever, headaches, diarrhea, jaundice, loss of appetite, and abdominal pain. About 85 percent of acute infections become chronic, which may lead to cirrhosis or liver cancer and which appears to be irreversible and ultimately kills thousands each year—more than types A and B combined. Hepatitis C is the leading reason for liver transplants in the United States. As with hepatitis B, transmission is primarily by direct blood contact—usually via contaminated needles. Hepatitis C can also be sexually transmitted, but this is rare. While blood transfusions once posed a leading risk, the risk of getting either the B or C virus through transfusions is minuscule (less than 1 in 3,300 units of blood), thanks to screening tests used by blood banks.
- Hepatitis D. Hepatitis D only occurs as a co-infection with hepatitis B, intensifying the severity of the hepatitis. In the United States most cases are contracted through frequent blood transfusions or from injection drug users who share needles.
- Hepatitis E. This infection only occurs in developing countries and is not considered a problem in industrialized nations. The virus causes an acute illness, but does not develop into a chronic carrier state.
Hepatitis Prevention for Infants
The U.S. Public Health Service, the American Academy of Pediatrics, and other physician groups have advocated that all infants be immunized routinely against hepatitis B. Like some other immunizations, hepatitis B requires three injections and confers long-term immunity. The cost can be as much as $100 for the three shots—though the cost would decline if the vaccine were more widely used. If you have children in your care or are expecting a baby, it’s worth asking your doctor about the vaccine.
What If You Do Nothing?
Most cases of infectious hepatitis resolve on their own within two to four weeks, though some may take two to three months. But a number of people with hepatitis B or C become chronic carriers who face potentially fatal complications, notably cirrhosis and liver cancer. If symptoms or laboratory tests indicate the possibility of chronic infection, drug therapy can be considered.
Home Remedies for Hepatitis
Though drugs are being used to treat hepatitis, no known pharmaceuticals or other specific treatments provide a cure for the illness, so therapy focuses on prevention and on relieving symptoms until the infection has run its course. Major objectives include getting appropriate rest, eating a proper diet, and controlling the spread of the virus.
- Eat a hearty breakfast. Hepatitis symptoms of nausea and vomiting typically get worse as the day goes on. Eating a substantial breakfast will help ensure that you maintain an adequate daily intake of calories. Eating several small meals during the course of the day, rather than a large lunch and dinner, may also help you cope with nausea.
- Wash up. If you have hepatitis A, it’s important to wash your hands thoroughly after going to the bathroom.
- Don’t drink alcohol. Alcohol can’t be effectively metabolized by the damaged liver, so refrain from drinking during the course of the disease and for a month after all laboratory tests show normal results.
- Do not smoke. If you do smoke, quit.
- Check with your physician about over-the-counter and prescription drugs. Acetaminophen, aspirin, birth control pills, and certain antibiotics are potentially toxic to the liver.
- Wash your hands. Always wash with soap and water after using the toilet, after changing diapers, before preparing foods, and before eating. This helps stop the spread of many diseases, including hepatitis A.
- Cook your foods. You are at risk of contracting hepatitis A if you eat certain foods, such as shellfish, in a raw or undercooked state.
- Practice safer sex. Using condoms and avoiding multiple sex partners will significantly reduce your risk of hepatitis B and C.
- Get inoculated against hepatitis A. A vaccine is available for use against this virus. Formerly, the closest thing to a vaccine was gamma globulin for those who had been exposed or were likely to be, but it offers limited and short-term protection (lasting only about five months). The new vaccine provides protection for at least 10 years. You do need a booster shot after 6 to 12 months. The vaccine is safe and has few side effects. These are the people who need protection against infection from hepatitis A:
- Anybody over age two who will be traveling in Mexico and Latin America, Africa, Eastern Europe, the countries of the former Soviet Union, or in other areas where hepatitis A is common.
- Anyone who has oral-genital sex.
- People with chronic liver disease, for whom hepatitis can be very dangerous.
- Injection drug users who share needles.
- Children living in states or communities with a high rate of hepatitis A (twice the national average or higher).
- Get inoculated against hepatitis B. There is an effective vaccine with minimal side effects. Newborns should be routinely vaccinated, just as they are immunized against polio and other diseases. Recently, an increasing number of state health departments have taken steps to require hepatitis B vaccinations for all adolescents, who are viewed as a high-risk group. Unfortunately, parents and physicians have been slow to accept the idea of immunization—perhaps because of the high cost and an unwillingness to believe that the disease is a real danger to people not designated as high risk. Other high-risk groups include sexually active gay men, heterosexuals with multiple partners, health-care workers, injection drug users, children of immigrants from regions where hepatitis is common, such as Southeast Asia, and people who travel frequently to high-risk areas. The three-dose vaccine usually provides immunity for seven or more years.
- If you are pregnant, have a hepatitis B blood test. If it’s positive, a physician can help protect the newborn with an injection at birth of a special type of gamma globulin. The infant should also be vaccinated against hepatitis B.
- If you had a blood transfusion before July, 1992, get tested for hepatitis C. Though it is very rare for hepatitis C to be acquired through a transfusion, methods used to screen donated blood were less accurate before July, 1992, so the risk of acquiring the virus from a transfusion was greater.
- Be careful with any needles. If you are getting your body pierced or tattooed, or receiving acupuncture, make sure the needles are brand new or have been properly sterilized in an autoclave.
- Don’t use an injection street drug. If you do use such drugs, never share needles.
Beyond Home Remedies: When To Call Your Doctor
Contact a physician if you develop symptoms of viral hepatitis or if you already have hepatitis and symptoms persist despite treatment. Also contact your physician if you have been exposed to someone known to have acute viral hepatitis.
What Your Doctor Will Do
Along with taking a complete medical history, your doctor may feel the right side of the abdomen to check for any tenderness or enlargement of the liver and then take blood tests to look for the virus or antibodies to the virus.
Most people with hepatitis don’t need extensive medical treatment. In more serious cases or if a diagnosis is still uncertain, a liver biopsy may be recommended to determine the extent of liver damage. Some people with progressive hepatitis may require prolonged treatment.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media