What is Hepatitis? – Symptoms, Types, Causes & Treatment

Hepatitis refers to the inflammation of the liver, a condition that can stem from different sources, including viral infections, chemical exposure, alcohol consumption, genetic factors, or autoimmune reactions. In this case, the inflammation may manifest as either acute, marked by sudden onset and resolution, or chronic, characterized by constant symptoms and gradual liver deterioration over time. 

Symptoms 

Hepatitis often operates under the radar, initially presenting with subtle or unnoticeable symptoms. Some early indicators may include:

• Feeling of Discomfort or tenderness in the upper abdomen, mainly on the right side.
• Nausea or decreased appetite.
• Fatigue and a sense of overall unwellness.
• Fever, particularly if a viral infection is present.

As Hepatitis keeps progressing and finally disturbs the liver function, many other symptoms emerge, mainly in severe cases of acute Hepatitis or long-standing chronic Hepatitis. Therefore, when liver function is compromised, bile processing may be affected, leading to the following. 

• Jaundice is indicated by a yellowish tint to the skin and eyes.
• Changes in urine color to a darker shade and stool color to a lighter hue.
• Itchy skin (pruritus).
• Mental confusion, disorientation, or drowsiness is a condition known as hepatic encephalopathy.

Causes

Hepatitis has different origins, and its effects range from acute to chronic, mainly depending on the duration of liver exposure to the causative agents. Hepatologists categorize these diverse causes into distinct types of Hepatitis for clarity and effective treatment.

Viral Hepatitis

Viral Hepatitis occurs when viruses invade and harm liver cells, triggering an immune response that causes inflammation. Multiple viral infections can induce Hepatitis, including: 

Hepatitis A: This type of Hepatitis generally manifests as an acute infection, distinguished by temporary liver inflammation. Hepatitis A is commonly resolved within a few months; in rare cases, it can lead to severe acute liver failure.

Hepatitis B: Initially occurs as an acute infection; Hepatitis B can transform into a chronic condition in a minority of cases, resulting in ongoing liver inflammation.

Hepatitis C: Also begins as an acute infection, hepatitis C frequently progresses to a chronic state, making it a common cause of prolonged liver inflammation.

Hepatitis D: It is also majorly known as delta virus. It commonly affects people who are already infected with hepatitis B, ultimately leading to chronic Hepatitis. Co-infection with both viruses can exert major stress on the liver.

Hepatitis E: Predominantly occurs in Asia and is less common elsewhere; hepatitis E typically induces an acute infection accompanied by temporary liver inflammation.

(EBV): Known for triggering infectious mononucleosis, the Epstein-Barr virus can also lead to acute Hepatitis.

(CMV): In individuals with weakened immune systems, Cytomegalovirus infection has the potential to induce acute Hepatitis.

Autoimmune Hepatitis

In certain individuals, chronic Hepatitis arises because of an autoimmune disorder wherein their immune systems mistakenly target their liver tissues. Autoimmune diseases frequently pop up without clear triggers, with autoimmune Hepatitis directly inflaming the liver, while other autoimmune conditions may impact the bile ducts passing through the liver, such as primary biliary cholangitis or primary sclerosing cholangitis. 

Alcohol-Instigated Hepatitis

Alcohol-related Hepatitis can manifest as either chronic or acute, depending on the duration and intensity of alcohol consumption. Acute Hepatitis may occur after a brief episode of heavy drinking, while chronic Hepatitis is typically associated with long-term, excessive alcohol intake. Although alcohol poses a risk to liver health for everyone, individual tolerance levels are different. While excessive drinking usually leads to Hepatitis, sensitivity to alcohol differs among individuals.

Toxin-Induced Hepatitis

When your bloodstream consists of high levels of toxins, it can trigger toxic Hepatitis, mainly if your liver is already under strain due to many other factors. Your liver works tirelessly to filter toxins from your blood, but an excessive toxin load can overwhelm it, which can lead to slowed function or cellular damage. The seriousness and frequency of exposure confirm whether the damage is acute or chronic. Various factors contribute to toxic Hepatitis, such as: 

• Exposure to industrial-grade chemicals like vinyl chloride, carbon tetrachloride, and specific pesticides and herbicides. 
• OTC medications – Generally, when consumed in high doses, some common examples are Non-steroidal inflammatory drugs like acetaminophen (Tylenol®). 
• Prescription medications like certain antibiotics, and anti-seizure drugs. 
• Recreational drugs like ecstasy, cocaine, or misuse of anabolic steroids. 
• Certain herbs and supplements, especially when consumed in large or frequent quantities, particularly when the liver is already under stress from other factors.

MASH (Metabolic dysfunction-associated steatohepatitis)

Steatohepatitis, or liver inflammation due to fat accumulation, is an advanced stage of fatty liver disease, where the liver begins to store surplus fat within its tissues. While alcohol consumption is a common trigger for this fat deposition, in non-alcohol-related cases, it’s referred to as metabolic dysfunction-associated steatotic liver disease. Because of the excess fat accumulation, it can progress to metabolic dysfunction-associated steatohepatitis, associated with conditions like hyperlipidemia(excess fat in the blood), obesity, insulin resistance, type 2 diabetes, high blood pressure, and cardiovascular ailments.

Other Notable Causes of Hepatitis

Cholestasis, where bile flow stagnates within the biliary tract, hindering liver function. This can occur abruptly due to bile duct obstruction or gradually as a result of chronic conditions affecting bile flow. 

Inherited metabolic disorders are rare genetic conditions impacting metabolism that can lead to the accumulation of harmful substances in the liver. For instance, Wilson disease and hemochromatosis result in excessive metal levels in the liver, while Gaucher disease and glycogen storage disease cause the buildup of metabolic waste in the bloodstream, filtered by the liver. 

Ischemia is the sudden or gradual reduction of blood supply to an organ, which can provoke acute or chronic inflammation. Common causes include abrupt vasoconstriction, blockages like blood clots, or arterial diseases constricting arteries. In some cases, ischemia arises in response to severe infections or organ failure-induced shock.

Diagnosis 

Various diagnostic tests are considered to identify Hepatitis and its underlying causes, including:

Liver function tests: Multiple blood tests assess different substances produced by the liver. Elevated levels of liver enzymes, proteins, or byproducts in the blood can indicate liver function, stress, and potential causes of dysfunction.

Imaging tests: Imaging examinations of the liver can reveal inflammation due to Hepatitis and detect issues affecting the bile ducts or blood vessels within. Some tests combine radiological techniques with other technologies, such as nuclear liver and spleen scans or elastography, to gather comprehensive information.

Liver biopsy: This procedure involves extracting a small tissue sample from the liver for lab analysis. Normally performed using a hollow needle, the biopsy allows medical practitioners to identify diseases, infections, and toxins contributing to Hepatitis.

Treatment

Healthcare practitioners go ahead with the hepatitis treatment by minimizing liver stress factors, often through dietary and lifestyle adjustments. This may involve eliminating toxins and alcohol, as well as reducing dietary fat intake to alleviate liver strain. Also, few people may benefit from medications to regulate blood lipids or glucose levels.

Certain forms of chronic Hepatitis may require direct medication intervention. Chronic hepatitis C, for example, can be cured with antiviral medications, whereas chronic hepatitis B typically requires lifelong treatment. Inherited metabolic disorders and autoimmune Hepatitis are also lifelong conditions, but a combination of medications and lifestyle changes can help mitigate liver stress and lower down the severity of chronic hepatitis symptoms.

Addressing the root cause can lead to the resolution of specific hepatitis types. Toxic and alcohol-induced Hepatitis often show improvement once exposure to the toxin ceases. Dietary adjustments and lifestyle changes might help in alleviating metabolic dysfunction-associated steatohepatitis symptoms. While certain chronic hepatitis-causing conditions are not curable, treatment can mitigate inflammation and reduce associated damage to the liver.

As they say, prevention is better than cure. There are steps to take for preventing Hepatitis:

• Get Vaccinated – Viral Hepatitis A and B
• Drinking alcohol responsibly and adhering to medication guidelines are important steps. For those struggling with substance abuse disorders, seeking treatment is vital to prevent toxic Hepatitis. 
• Additionally, effectively managing metabolic factors like blood lipids and blood sugar levels is essential, with healthcare providers offering guidance and support in this regard.

To conclude the article, we suggest you consult a hepatologist or your family physician regularly for liver-related issues!