Oh My Liver!

"Oh, my liver hurts!"

In a perfect world, a patient would be saying that to the doctor during a consultation when he/she is suffering from Hepatitis.  Furthermore, the doctor would ask, which Hepatitis? A, B, C, D or E?   "Probably Hepa A".

Wow, that would be very nice!  It would save me a whole lot of thinking.   But this isn't a perfect world, so before I can diagnose Hepatitis, I need to know the patient's symptoms and run some blood tests.  This disease can kill, so the earlier the diagnosis the better will be the outcome.   Let me give you an idea what is Hepatitis, how you can get it and how long will the symptoms show after being exposed to the causative agent.

This condition is caused by a virus, but not the same virus causing flu or HIV.  There are so many kinds of viruses around.  That being said, antibiotics are not effective because they only target bacteria.   This virus affects the liver predominantly, that is why a patient would complain of pain at the upper part of the abdomen, just under the ribs.  Symptoms include body weakness, nausea, vomiting, diarrhea and low grade fever.  In some cases, the patient's skin will turn yellow and the urine will be dark, because the liver is damaged and it cannot do its job properly.  The clinical manifestations will appear around 2-3 weeks from exposure to the virus to as long as 24 weeks.

There are 5 types of this disease and they are conveniently named after the first 5 letters of the alphabet (so that medical students won't have a difficulty in memorizing them.)  Don't worry, only a few of these types are harmful.  For starters, HAV (Hepatitis A Virus), HCV and HEV only causes mild symptoms.  However, a large number of Hepa B and C can lead to chronic infection.   Only 1% of Hepa B cases will progress to a severe disease.

How can you get this virus?  To be specific, A and E are transmitted through contaminated water and food. The rest are transmitted through sexual activity and needle injuries or needle sharing with infected individuals.

On a positive note, you can be protected with a vaccine.  So check your vaccination cards and go to your doctor for a shot.

Finally, the cure.  The milder forms are only given supportive treatment, medicines are given to alleviate the symptoms.  For example, if you are dehydrated because of too much vomiting then you will be inserted with an IV (intravenous) line in order to start rehydration. If you have itchiness, an oral medication (cholestyramine) will be given to you.  However, for severe HBV infection, an antiviral therapy is indicated, which is lamivudine along with the supportive treatments.

Well, that's about it.  Feel free to ask me if you don't understand some of the "very" medical terms.

So, if you are planning to eat street food, think again.  :)



-Dr. A