How Does Hepatitis Manifest?

Q: Hello, since 1 week my brother has severe diarrhea, loss of appetite, abdominal pain, backache and vomiting. He is pale in color. Stool are sometimes green. Sometimes he has dark urine. He has been diagnosed with hepatitis. His lab investigations were- raised bilirubin 1.5 and hepatitis viruses were negative. He has raised LDL and low HDL. He got some treatment but he is not getting better. It’s already about 1 week now and he is very tired and fatigued. He is having normal blood pressure. What is his true diagnosis?
-By Bana

Reply:

The picture does look like hepatitis. Let us explain this in more detail.

What Is Hepatitis?

The term implies an inflammation (or irritation) of the liver tissue (cells). This could be due to any agent- a virus, bacteria, some chemical, alcohol or any other.

Your brother’s liver appears inflamed. This is evident from the following:

• His symptoms
• Increased bilirubin
• High LDL and low HDL

Let’s talk about the symptoms first. Liver is an important organ. It carries out many important functions of the body like-

• Detoxifying our body.
• Producing hormones and enzymes for the body.
• Produces urea, the main waste product excreted by kidneys.
• Managing metabolism of fat, protein and glucose.
• Decomposing old blood cells. Thereby, the liver produces bilirubin which is processed by it.

Symptoms of Hepatitis

So, when the liver cells are affected, all these functions of the body are affected.

1. Due to improper secretion of enzymes, the food is not digested well. Patient has diarrhea and vomiting. Stools are sometimes fatty.
2. Slight abdominal pain can be left in the region where liver is present.
3. Fever is there if the causative agent of hepatitis is a bug (bacteria/ virus).
4. Weight loss
5. Lot of fatigue is felt as food intake is reduced. Further, whatever is being taken is not digested well.
6. Muscle or joint aches
7. Jaundice or pale color of the skin. This occurs because the inflamed liver is unable to do its regular job of processing bilirubin. This chemical therefore accumulates leaking into the blood from the liver. Bilirubin in blood gives the skin a yellowish color.
8. Itchy skin may be there due to toxins in blood
9. Dark urine

Confirming the Diagnosis

Your brother’s bilirubin is high, indicating some liver problem. You may opt for certain other specific test of hepatitis to confirm the diagnosis. These include:

• Levels of liver enzymes (ALT, AST) in blood- They increase whenever there is any liver damage.
• His body must have made antibodies against the infective agent. His blood can be tested for them.

Antibody screening tests are very specific. They include antibody test for Hepatitis A, B, C and D.

You may go for these tests to make sure of the diagnosis.

Hepatitis takes time to recover. It may take a month or so for the acute phase to be over. What medication is he taking?

Supportive treatment is necessary. He needs a diet good in carbohydrates and proteins. You also need to keep him well hydrated.

Take Care,

Buddy M.D.