Hepatitis

What is hepatitis?

Hepatitis is an inflammation of the liver caused by various viruses. Liver inflammation and the formation of antibodies are the body's normal responses when confronted with viruses. Often the organism succeeds in achieving a cure with lifelong immunity. If the human body's defences are not sufficient to destroy the virus, a chronic infection develops.

In this case, in addition to the antibodies, viruses (which could not be destroyed) are still detectable in the blood and more or less pronounced signs of inflammation may be present. The body is therefore in a permanent struggle as healing is not achieved. You could call it a case of "stuck" inflammation, so to speak.

In general, we should only speak of a chronic infection if the liver inflammation has not healed after 6 months. Chronic cases occur primarily with hepatitis C, but also with hepatitis B.

What are the different forms of hepatitis?

There are various forms of hepatitis which differ in terms of their symptoms, course and treatment.

Hepatitis A
Hepatitis A is caused by the hepatitis A virus. The infection is transmitted via contaminated drinking water and food, but also sexually. The incubation period (time from contact with the virus to the first symptoms of the disease) is 2 to 6 weeks.  As a rule, the disease resolves completely. There is no such thing as chronic hepatitis A.

Hepatitis B
Hepatitis B is caused by the hepatitis B virus. It is transmitted via blood or sexual contact. The incubation period is 30 to 180 days. It occurs acutely in up to 90% of cases (of which about 2/3 are asymptomatic) and turns into a chronic infection in around 10%.

Hepatitis C
Hepatitis C is caused by the hepatitis C virus. It very often goes unnoticed (in 80 % of all cases) and at least 60 % of those infected develop chronic hepatitis C.

Hepatitis D
Hepatitis D only occurs with concurrent hepatitis B infection.

Symptoms and course of hepatitis

Many hepatitis infections run their course without symptoms or with non-specific symptoms such as slightly increased temperature, loss of appetite or pressure pain in the upper abdomen, so that those affected do not even notice the disease. In some cases, patients develop jaundice (icterus). The skin, mucous membranes and the whites of the eyes turn yellow.

Unlike hepatitis A, hepatitis B and hepatitis C can become chronic. The diseases often progress insidiously and are only discovered when they are already chronic. The problem with such chronic inflammation is not so much the inflammation itself, with its certainly debilitating impairments. The main problem is the increasing destruction of the liver to the point of cirrhosis.

Cirrhosis of the liver is the scarring of the entire liver, i.e. previously healthy tissue is replaced by scarred, non-functional tissue (connective tissue). This then massively impairs the entire blood circulation and the function of the liver, resulting in serious consequences for the entire body.

Depending on the detectable virus (six different types are now distinguished in hepatitis C), the risks of developing cirrhosis vary between 10% and 60%. Cirrhosis can develop after a few years or even decades.

How is hepatitis diagnosed?

The most important examination method for a hepatitis diagnosis is the determination of the so-called "liver enzymes" in the blood. In the acute phase of inflammation, liver cells perish. The enzymes actually contained in the liver cell (GOT, GPT) enter the circulation and are significantly elevated in the blood. Other laboratory values may also be altered (e.g. "inflammatory markers").

As a result of infection with hepatitis viruses, the body produces antibodies to destroy the pathogens. These antibodies circulate in the blood and can be detected there for the rest of the patient's life. They prove that an infection has occurred.

An ultrasound examination (sonography) can also be used to assess the structure and size of the liver. In cases of chronic hepatitis, tissue samples can also be taken from the liver (biopsies) to determine the extent of the liver damage. This examination is usually done under a short period of drug-induced sleep (sedation).  

What are the treatment options for hepatitis?

For most acute liver inflammations, no specific therapy is usually necessary, as they heal by themselves and do not have any consequences. However, bed rest, physical rest and alcohol prohibition are important.

By contrast, chronic hepatitis must always be treated.

Hepatitis B is treated with two classes of drugs: interferons (which are injected once a week) and nucleoside or nucleotide analogues, which are taken daily as tablets. These active substances prevent the virus from reproducing. However, these therapies are often not curative, so complete elimination of the virus is often not to be expected. The therapeutic goal is rather to mitigate the course of chronic hepatitis B and to reduce the risk of late complications.

Hepatitis C, on the other hand, has been curable for a few years now, in very many cases by means of virus-inhibiting combination therapy. However, since the success of the therapy is strongly dependent on the specific type of virus and the virus concentration in the blood, some rather elaborate blood tests are necessary before initiating the therapy. As a rule, a liver biopsy is necessary too.

Anthroposophic medicine can contribute much to the treatment of a weakened and infected/inflamed liver. Milk thistle preparations, constitutional remedies for the liver made from vine and strawberry leaves (Hepatodoron®), medicines made from green tomatoes, external applications with wraps and rubs, art and exercise therapies are all helpful, for example.

What does the diagnosis of "chronic hepatitis" mean for my life?

In daily life, the impairment varies greatly from person to person and mostly depends on the symptoms as they subjectively perceive them. Some people with chronic inflammation feel permanently weak and unwell and will certainly cut back a little and avoid extreme physical exertion for that reason alone. However, most patients feel well despite the inflammation, so the disease is certainly not a constant worry for them either.

However, a healthy lifestyle should still be observed, especially in these cases. Particularly worth mentioning are a regular daily routine with sufficient sleep at night, a regular, balanced and high-quality diet (there is no need to follow a special diet) as well as sufficient physical activity (however, weight training or competitive sports are not recommended).

With all forms of hepatitis infection, it is important that patients abstain completely from alcohol, as this puts a strain on the liver and can cause additional damage.

Unfortunately, there is no "miracle pill" to strengthen and invigorate the liver, and one should also advise against taking vitamin tablets or so-called "boosters", which are often thought to be healthy. Vitamins are only necessary if there really is a deficiency (which is extremely rare).