Hepatitis is an inflammation of the liver, it can be acute or chronic. The liver is a unique organ and is the only organ that can regenerate and in some cases we can talk about complete regeneration. For other organs like the heart, damaged tissues are replaced with scars, like those we all have on the skin. The liver has the capacity to replace dameged or diseased cells with new and healthy ones.
Long-term complications of liver diseases usually occur when the regeneration is either incomplete, or prevented by the appearance of scar tissues. It is the case of aggressive agents such as viruses, drugs and alcohol abuse that continue to attack the liver and preventing therefore the complete regeneration process. Once the scar tissue is formed reversibility of this process is very difficult to obtain.
A disease characterized by the appearance in large amounts of scar tissues is the liver cirrhosis. End-stage liver cirrhosis is the final stage of the liver disease, usually followed by life threatening complications.
Types of hepatitis
– Acute hepatitis that evolves in less than 3 months
– Viral hepatitis
- Viral hepatitis A
- Viral hepatits B
- Viral hepatitis C
- Viral hepatitis D and E (quite rare)
– Chronic hepatitis
- B viral chronic hepatitis
- C viral chronic hepatits
– Toxic hepatitis and drug induced hepatites
- Toxic hepatitis
- Alcoholic hepatitis
– Autoimunne hepatitis
Symptoms and signs
They are inconstant and variable in intensity. Some are common for all types of hepatitis: jaundice, dark collored urine, pale stools, nausea, liver sensitive to palpation, or liver pain. Others depend on the cause of hepatitis: flu-like syndrome in cases of viral hepatitis (fatigue, intense headaches, joint pains) enlarged and “rocky” liver with signs of alcoholic impregnation (vulnerable skin, leg pain, tremors) in the case of alcoholic hepatitis.
Diagnosis is confirmed by blood sampling and tests, which often show a significant increase in transaminases (liver enzymes) levels, and a transitory evidence of acute destruction of the liver cells, abnormality of conjugated bilirubin and alkaline phosphatase, biological evidence of jaundice. Also tests search abnormalitys in blood clotting factors which are synthesized in the liver, signs of hepatocellular failure in order to assess the hepatitis impact on the liver. Blood tests also orientate doctors towards the cause of hepatitis.
There are small variations in treatments depending on the cause, but the main purpose is targeting symptoms (analgesics, transfusions in case of digestive bleeding, portocaval anastomosis in case of portal hypertension) and rebalancing nutrition (intake of vitamins and trace elements) and removing the cause of course.
The severity of chronic hepatitis is related to the possibility of irreversible liver failure in the near future (blood clotting disorders, hepatic encephalopathy, metabolic acidosis) and portal hypertension. This kind of evolution is caused by cirrhosis. Cirrhosis may also evolve into hepatocellular carcinoma (liver cancer).