Journal of Medical Sciences

Hepatitis: Symptoms, Treatment and Prevention


Hepatitis is a highly contagious infectious disease. Insidious onset, sinister progress, symptoms that are far from attractive, it can keep you from your work for weeks or months. How to recognize and treat the monster “Hepatitis” is outlined here.

Beware of the disease that turns white people yellow! Right now it’s cutting a stealthy track throughout the world. It goes by a variety of names. Its official one is infectious hepatitis, but viral hepatitis or simply jaundice all tell the same story.

The unlucky victims haven’t much doubt about the diagnosis. In fully fledged cases, the whites of the eyes turn a tell-tale brownish-yellow. The skin also turns yellowish, or jaundiced.

Not too much is known about hepatitis. But we do know it’s caused by a tiny virus. This gains access to the system, often (it’s believed) through infected food, milk, or water. Flies are claimed to be a common carrier.

Once inside the system, it has a special liking for the liver. Here is the spot where most of the trouble is caused. The cells become infected, and swell in inflammation. Indeed, the whole organ enlarges.

That’s why the side of the abdomen just under the ribs on the right-hand side becomes tender and uncomfortable. If the doctor presses this part even gently when examining you, it can cause considerable discomfort.

Usually the liver cannot be felt, but when it swells, it can frequently be felt as it juts from under the rib margin. It’s due to the blocking up of the liver canals that jaundice occurs.

Increasing amounts of certain products normally excreted by the bowel churn into the blood-stream, and are circulated through the whole system. Soon after the infection becomes well-established, the tell-tale yellowing starts to put in appearance.

Often this gives an intense itch to the skin. The maddening desire to scratch is very common (and it’s always worse when in a nice warm bed or on a hot day, as every hepatitis person knows so well.)

Key symptoms of hepatitis

EARLY:

  • Feeling off-color. Tired, achy all over, flu symptoms, fevers with chills and shivers.
  • Often followed by severe headaches, back aches. Nausea, vomiting, off food, diarrhea, or constipation. Often mild pain in abdomen.

LATER:

  • Jaundice after 5 – 10 days. First seen in eyes, later spreads to skin. Skin may itch. (Many do not become jaundiced, though.) Urine very dark.
  • Tenderness of liver (under lower right rib margin), and spleen (similar position opposite side), and lymph glands, under neck under arm and groin.
  • Pathology tests if ordered by doctor diagnostic.

How hepatitis starts

The hepatitis picture varies enormously. It may take anything from a few days up to a month (and maybe even more) for the viruses to set up symptoms after they’ve gained a toe-hold in the system.

There is often a general vague sort of “ill-feeling” for several days.

This may be followed by sensations of fatigue, or even downright exhaustion. Aches all over are common, and sometimes intense headaches or back aches. Shivers, feeling cold (even though there may be an elevated temperature) is common.

In the more severe cases, there is a sudden loss of interest in food. Nausea, vomiting, abdominal pains, diarrhea, constipation have all been recorded, and vary from person to person. Sometimes there are symptoms of oncoming flu.

Very often the whites of the eyes are the first part to show the tell-tale yellow tint. To check for this, it’s essential that daylight be used. Trying to see it under ordinary electric light (which in itself has a yellow tinge) is often impossible. But in daylight it is often very easy to pick up, even in the early stages.

A little later (maybe a day or two, perhaps more), the yellow tinge spreads to the skin of the body. Sometimes the color becomes very deep and quite obvious.

The urine turns a characteristic dark color. “Very strong tea” is the apt way doctors describe its clinical appearance. (Doesn’t sound too appetizing, but what medical terms do?). Indeed, the severity of the disease is often reflected by the intensity of the jaundice and the depth of color of the urine.

Conversely, the stools are often very light in color, for they become progressively devoid of their usual coloring matter. Often there is swelling and discomfort of various organs of the system. The liver often swells to considerable proportions.

It becomes tender to the ouch as well. Sometimes the spleen, the large organ on the left-hand side of the upper part of the stomach area may swell as well, and similarly become tender. Also, the lymph glands (the protective guardians of the system) swell and also become infected.

Quite a few tests are available to the physician to make sure his diagnosis is correct. However, for practical purposes, many of these are seldom carried out in general practice, for the diagnosis is often pretty obvious.

However, if there is doubt, the physician talks on about liver function tests, about Bromsulphalein (BSP), Liver transaminases (AST or SGOT and ALT or SGPT), and cephalin-cholesterol flocculation test, and thymol turbidity, and all manner of other gruesome names that are a national secret between him and the pathologist down the road.

Guidelines for treatment of hepatitis

What’s the best line of attack if hepatitis strikes you or your household? It’s very wise to enlist medical assistance right from the start. For sure, like so many other viral-induced diseases, there is no specific tablet that will cure hepatitis over-night.

But much may be done to help the patient, and just as important, to prevent others in the home from getting it too. This is very important, for once smitten, it may take many weeks for full recovery. Even then, the patient may be feeling off-color for anything up to 12 months.

Go to bed: This is the best bet by far. You should stay there until you’re feeling better. Wait until the acute symptoms have subsided, then start to amble round the house, doing it gradually, bit by bit.

Fluids: Plenty of fluids is a good idea. It replaces what is lost from perspiration (usually increased), vomiting, etc. Fluids help rid the system of toxins and dead viruses. It’s a simple effective way to better health.

Additives: Often if you’re feeling off food, adding powdered glucose D to the fluid makes it more palatable, helps a little in checking vomiting, and in itself provides nourishment. (Much of the food we eat is broken down by the system into glucose before being absorbed.)

Food: A low-fat diet was once recommended, but today there is no real restriction on food intake. It’s largely governed by the patient’s desires. A nice, attractive meal well prepared and suitably served will often tempt a patient who is not really hungry.

Avoid physical exertion: Unnecessary travelling should also be curtailed. All medication should be stopped, unless specifically okayed by the doctor. Sleeping tablets (especially barbiturates, sedatives, sulfas) are broken down by the liver and throw extra work onto an already damaged organ, and are best avoided.

Alcohol is definitely out in all forms. (A strange observation is often a gross dislike for alcoholic drinks even for many months or even years after recovery. This is either a happy or devastating side effect, depending on your point of view.) Cut down (or preferably give away) smoking.

Don’t despair if you’re a victim. In the overwhelming number of cases, complete cure is the rule. However, this may take anything from three to 16 weeks. It all depends on the luck of the draw, it seems.

Sometimes it can race ahead and get out of control and lead to sinister consequences. But the records indicate only about one in a 100 suffers this. It is usually older people, and women who are beyond menopause who seem to have an above-average risk in this direction.

Prevention of viral hepatitis

Supposing your best friend (or close relative or neighbor) contacts it, what then?

Fortunately, the doctor may give an injection of a product called gamma globulin which will give quite high protection against hepatitis. This lasts for at least a month, but there is some beneficial protection for several months afterwards.

Sorry to say it, but the injection is a big one. For this reason it’s usually given in the buttocks. Kind doctors often add another chemical (like procaine) to lessen the uncomfortable effect of the injection. Children have a smaller dose of the same material.

The earlier the injection is administered, the more effective is the protection. If the virus is well entrenched in the system when the injection is given, it’s quite possible it will be ineffective.

NOTE: In simple terms, the earlier it’s given after you’ve made a hepatitis contact, the greater chances you have of avoiding it too!

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