Acute hepatitis is very different from chronic hepatitis in terms of disease development and treatment. Patients with acute hepatitis may recover on their own without treatment;

Chronic hepatitis means that the liver function is in an abnormal state for a long time, and regular follow-up and treatment are required to avoid the process of liver cirrhosis and liver cancer. Only by understanding the causes and prevention of acute and chronic hepatitis can you protect yourself and stay away from liver disease.

Ms. Liu never knew that she was infected with hepatitis C. Two years before her death from liver cancer, she had a dull pain in her right upper abdomen, but she did not seek medical examination; month of life. The doctor also reminded Ms. Liu’s family to follow up and check, and found that her children were also chronic hepatitis C patients, and advised them to receive treatment, which has now been completely cured.

Why does acute hepatitis occur?

Clinically, there are two types of hepatitis, one is acute hepatitis and the other is chronic hepatitis. Acute hepatitis refers to the fact that the liver is in a state of acute inflammation. The liver function indexes of aspartate aminotransferase (AST or GOT) and alanine aminotransferase (ALT or GPT) exceed the upper limit of the normal value, and the inflammation state generally disappears within 6 months.

There are many causes of acute hepatitis. The acute hepatitis caused by viruses is mainly hepatitis A, B, D, and E (distinguished by ABCDE in foreign countries). Among them, types A and E are transmitted through fecal-oral infection, and viruses such as A, B, B, and D are transmitted through blood or Bodily fluid infection. It is worth mentioning that the hepatitis D virus is a defective virus. It must have the hepatitis B virus to infect the human body.

In addition to acute hepatitis caused by viral infection, in recent years, with the change of living habits, acute hepatitis caused by drugs and health food has also increased. Some oral drugs such as antifungal drugs and some anti-tuberculosis drugs, antibiotics, certain Some antispasmodics, drugs for the treatment of arrhythmia, etc., may cause drug-induced acute hepatitis.

An overdose of the pain-relieving and fever-reducing drug acetaminophen (also known as paracetamol, or Acetaminophen in English) is also one of the causes of acute hepatitis. Therefore, you must follow the instructions of your doctor and pharmacist when taking such drugs. In addition, taking Chinese herbal medicines and health food from unknown sources may also cause acute hepatitis.

Acute liver injury can also occur in some congenital metabolic diseases such as Wilson’s disease or septic shock caused by the disease. Some blood diseases, patients need long-term blood transfusion, iron accumulation in the liver, can also cause acute hepatitis.

Treatment and prevention of acute hepatitis

Acute hepatitis caused by viral hepatitis is mostly supported and symptomatic treatment; for acute hepatitis B, if the condition rapidly deteriorates into fulminant hepatitis, in addition to oral anti-HBV drugs, the possibility of liver transplantation must be evaluated at the same time. Patients with acute hepatitis C can consider using the powerful full oral anti-hepatitis C virus drugs developed in recent years. Hepatitis virus can be cleared naturally.

As for acute hepatitis caused by drugs or other reasons such as alcoholism and congenital diseases, the cause of liver inflammation must be found first. If it is a drug, the patient is advised to stop the drug he is taking and take supportive and symptomatic treatment at the same time.

There is a corresponding antidote for acute liver inflammation caused by taking a large amount of the pain-relieving and antipyretic drug acetaminophen. However, there is no antidote for liver damage caused by most drugs, and the only way is to stop or change the drug. For example, taking anti-tuberculosis drugs for pulmonary tuberculosis, some patients will cause acute hepatitis. The current treatment method is to stop or change the drug first. medicine, and take symptomatic treatment.

In fact, most patients with acute hepatitis can recover on their own without treatment, but a small number of patients will develop chronic hepatitis or even fulminant hepatitis with a high fatality rate. Attention must be paid to the development of the disease.

How is chronic hepatitis treated?

Clinically, it is generally considered that the hepatitis problem occurs for more than 6 months, the transaminase is higher than the upper limit of the normal value, and the situation cannot be recovered for a long time. The chronic hepatitis patients in China are mainly those with hepatitis B and C. Hepatitis D can also cause chronic hepatitis, but it cannot be infected alone. Only people with hepatitis B can be infected. As for hepatitis A and E, it generally does not turn into chronic hepatitis.

In addition to chronic hepatitis caused by viruses, autoimmune diseases, taking Chinese herbal medicines with unknown effects, health food, or long-term alcoholism may also cause chronic hepatitis. In addition, fatty liver caused by improper diet is a civilization disease of modern people, and it can also lead to chronic inflammation of the liver and develop into steatohepatitis, liver cirrhosis, etc.

Regarding the treatment of chronic hepatitis, doctors will give different treatment plans according to the patient’s etiology and clinical conditions, such as prescribing antiviral drugs, immunosuppressants, etc. If the patient’s condition is stable, as long as the doctor’s orders are followed, regular follow-up examinations are enough; if the liver does not have severe inflammation or fibrosis, even just observation and examination may not require treatment.

Both acute and chronic hepatitis have few obvious symptoms

After understanding the possible causes and treatment methods of acute and chronic hepatitis, what most people want to know is how to know that their liver is inflamed? What are the obvious symptoms?

The answer is no. Regardless of acute or chronic hepatitis, it is difficult for patients to detect that the liver is in a state of inflammation from the symptoms. Even acute hepatitis is only manifested by fatigue, poor appetite, nausea, and vomiting. In severe cases, jaundice, right upper quadrant pain, Symptoms such as brown urine.

Patients with chronic hepatitis may not have obvious symptoms, and symptoms often depend on the degree of liver inflammation. Some people with severe liver inflammation have relatively high liver function values ​​such as alanine aminotransferase and aspartate aminotransferase, which may even be several times higher than the standard value. Clinically, it has been found that many hepatitis B and C patients only know that they are virus carriers only after physical examinations.

Patients must be followed up regularly

If you have chronic hepatitis, you should not ignore it. You should find out the cause of liver inflammation, and improve or treat them one by one, so that the liver will not continue to be injured. For example, the best way for alcoholic hepatitis is to quit drinking; chronic hepatitis B and C patients, as long as they receive drug treatment to suppress or eradicate the virus in the body, they will have the opportunity to improve liver fibrosis and restore normal liver function. .

A brief comparison of acute hepatitis and chronic hepatitis

Clinical diagnosis

Acute hepatitis: The liver is in a state of acute inflammation, with alanine aminotransferase and aspartate aminotransferase exceeding the upper limit of normal, and the state of inflammation does not exceed 6 months.

Chronic hepatitis: The inflammatory state is more than 6 months, and the liver function index is still higher than the upper limit of normal value.

Cause

Acute hepatitis: All kinds of hepatitis viruses may cause it; in addition, alcohol, drugs, health food, Chinese herbal medicine, etc. may also cause it.

Chronic hepatitis: Most are caused by fatty liver, hepatitis B or C virus. Chronic hepatitis may also be caused by autoimmune diseases, taking unexplained Chinese herbal medicines, health food or long-term alcoholism.

Symptoms

Acute Hepatitis: Fatigue, poor appetite, nausea, vomiting, jaundice, right upper quadrant pain, brown urine and other symptoms in severe cases.

Chronic hepatitis: Most patients have no symptoms. Some patients have symptoms such as fatigue, poor appetite, nausea, vomiting, jaundice, right upper quadrant pain, and brown urine.

treat

Acute hepatitis: Treat according to the cause, eg, antiviral drugs and supportive care if the condition is due to the hepatitis virus. It is recommended to quit drinking, stop eating health food, Chinese herbal medicine and unnecessary drugs.

Chronic hepatitis: Treat according to the cause. For example, if it is caused by hepatitis virus, it may be necessary to give antiviral drugs. If it is caused by fatty liver, it is usually recommended to lose weight, increase physical activity, and reduce the intake of alcohol, fat, and fructose. Alcohol, health food, Chinese herbal medicine and unnecessary drugs must be stopped.

During the physical examination, it was found that the hepatitis B surface antibody was positive, but he had not had the hepatitis B vaccine. The doctor said that he may have been infected with hepatitis B as a child but recovered. However, in the impression of the patient, he was not hospitalized because of hepatitis. Does infection with hepatitis B necessarily cause hepatitis? And will it heal on its own without knowing it?

In fact, this situation is not uncommon. Many people have been infected with acute hepatitis B. At that time, the body’s immunity was good and the virus was cleared. Because hepatitis B infection does not necessarily have symptoms, it often heals without knowing it, especially in childhood.

Abnormal liver function index transaminase, is the liver inflammation?

uncertain.

At present, the commonly used liver function index, aspartate transaminase, etc., although most of them come from the damage of liver cells, a few cases such as rhabdomyolysis may also cause abnormalities. It is recommended to follow up and observe, and ask clinicians to assist in further judgment and disposal.