Q. What is hepatitis?

A. Hepatitis refers to any inflammation of the liver and is divided into two categories, acute and chronic. Fulminant hepatitis, which could be considered a third type, is a serious form of acute hepatitis. Viruses, autoimmune liver disease, obesity, alcohol and some medications or herbs cause hepatitis. Five different hepatitis viruses that attack the liver, each with distinct characteristics, are known by alphabetical names Hepatitis A-E. The most common are A, B and C.

Symptoms of hepatitis vary significantly. Most people with hepatitis don't have any symptoms. Other people have vague nonspecific symptoms like mild fatigue or loss of appetite. Diagnosis occurs in many different ways. Most of the time people are found to have hepatitis during a routine checkup, being rejected for a life insurance policy due to abnormal liver tests or blood bank findings. The only way to find out the amount of damage is through a combination of liver tests.

Treatment depends on whether it is acute or chronic. Treatment of acute hepatitis is more supportive. Most patients are advised to take naps during the day and take a few days off work. Alcohol and recreational drugs should be avoided and a low-fat diet and plenty of water are recommended. No specific medications or shots are necessary.

The treatment for chronic hepatitis is more complicated and is specific for each problem. Treatment of fulminant hepatitis, again, depends upon the cause, and close monitoring in intensive care may be required. If the person does not improve, a liver transplant may be considered.

Most people think once symptoms of viral hepatitis resolve, the disease is gone. While the majority of people totally recover from viral hepatitis like Hepatitis A, and some from Hepatitis B, Hepatitis C develops into chronic liver disease, cirrhosis or liver cancer without causing any symptoms along the way. Vaccinations are available for Hepatitis A and B, but not Hepatitis C. Most people with Hepatitis C develop chronic hepatitis that should be treated.

Rad M. Agrawal, M.D.
Gastroenterology