Toxic hepatitis is caused by certain chemicals, medicines and excessive consumption of giloy and triphala without the advice of an ayurvedic doctor. This can lead to liver failure. Dr Arvinder Singh Soin, Chairman, Institute of Liver Transplantation and Regenerative Medicine, Medanta Hospital, Gurgaon, demystifies the jargon for World Hepatitis Day
How can we differentiate between acute and chronic hepatitis?
Acute hepatitis occurs in a few days and 95 percent of these cases are completely cured. Two common manifestations of acute hepatitis are hepatitis A and E – both of which are spread through infected water and food. Now if someone has yellow eyes, urine becomes very yellow and reports Liver Function Test (LFT), they may be suffering from Hepatitis A or E. You do not need to panic – with supportive treatment, the condition will get better. Resolve in two to three weeks and the patient will recover. Liver will be completely fine.
However, chronic hepatitis is more serious. There are four causes of chronic hepatitis in India. One is related to alcohol. Then there is non-alcoholic fatty liver disease (NAFLD) which can lead to hepatitis B and C. Alcoholic hepatitis develops when a person consumes excessive amounts of alcohol for more than seven to eight years, meaning more than 14 units a week for men and more than ten units a week for women. Each unit of alcohol can be measured as a glass of wine, a mug of beer or 30 ml of whiskey. Initially, alcoholic hepatitis presents itself as fatty liver. When that fatty liver becomes inflamed, it is called hepatitis. If excessive alcohol is still consumed, it can further develop into fibrosis, cirrhosis, liver failure, and liver cancer. So to avoid this, reduce the consumption of alcohol.
The other type of hepatitis resulting from NAFLD is found in people with obesity, diabetes, poor lipid profiles and high cholesterol. NAFLD is present in about 35 percent of adults. But 20 percent of these patients will eventually develop liver inflammation and half of them will also progress to an early grade of scarring and fibrosis. Then half of people with fibrosis will progress to cirrhosis and, if left unchecked and uncontrolled, can lead to liver failure as well.
The obvious way to prevent hepatitis caused by NALFD is to control diabetes, cholesterol and weight. Don’t lead a sedentary lifestyle, ensure to exercise 30 minutes a day, eat a healthy diet and make sure there is no movement.
Hepatitis B and C are two viral infections that can be transmitted through blood or bodily fluids, much like AIDS. In fact, it can be transmitted through needles, syringes, dialysis machines, infected blood, and sexual intercourse. It can be prevented by vaccination. But there is no vaccination for hepatitis C, so precautions must be taken to prevent its spread through body fluids and blood. Both these viruses are much better controlled now than they were ten years ago and this is because there are effective drugs available for hepatitis B and C along with hepatitis B vaccination. Hence their prevalence has decreased.
What is toxic hepatitis?
Toxic hepatitis is an injury to the liver caused by the use of certain chemicals, drugs or drugs. It is one of the most common causes of acute liver failure. Sometimes it can be a reaction caused by drugs that damage the liver, sometimes it can also be caused by an overdose. Consumption of toxic substances can lead to liver injury, inflammation and liver failure. About 15-20 percent of liver poisoning patients suffer from liver failure and the rest recover easily when the toxic substance is stopped. A person suffering from toxic hepatitis should always consult a liver specialist.
What are the symptoms?
All hepatitis strains have similar symptoms, such as jaundice and body itching. However, if liver failure progresses, blood in the vomit, urine or stool may be seen along with water accumulated in the body – the abdomen, legs and abdomen of the person become swollen due to water retention. In very advanced cases, people may suffer from encephalopathy, which means that the effects of a badly swollen and damaged liver can be seen in the brain leading to drowsiness, confusion, and aggression. Some people can be pre comatose or comatose. Some early symptoms of toxic hepatitis are fatigue and fatigue. After that, jaundice begins to develop.
Who is more sensitive to it? What Are the Risk Factors?
Toxic hepatitis can happen to anyone at any age as its occurrence mainly depends on the consumption of a toxic substance. It can be any person, a child between the ages of 10-15 years, a young adult or an elderly person. So, first and foremost, the important thing to understand is the reason. In India, the primary cause, which is known in most cases, is an overdose of anti-TB drugs/drugs. About 18 percent of liver transplants are caused by excessive doses of anti-TB drugs. Additionally, over-consumption of complementary and alternative (CAM) medicines such as herbal and Ayurvedic concoctions, giloy and triphala herbs can also lead to liver failure. During the pandemic, we reported several cases of liver damage due to over-consumption of Giloy without the advice of Ayurvedic experts or doctors. This has occurred in people with healthy livers, and especially in people who did not have autoimmune liver disease. In addition, people who take body-building supplements and anabolic steroids are at risk of liver damage.
How can toxic hepatitis be managed?
Toxic hepatitis can be managed by early detection of symptoms such as fatigue and jaundice in people who consume stimulants. Such people should see a liver doctor and get tested for timely diagnosis. Treatment includes specialized liver treatments, which include stopping the toxic drugs. In extreme cases, the patient may require hospitalization and a liver transplant. About 80-90 percent of patients recover with adjuvant treatment but a small percentage may come down with severe liver disease and may even undergo liver transplantation due to late diagnosis and treatment. Is. The protocol mainly includes stopping drugs that cause liver damage, management of jaundice and liver damage, in specialized liver units following standards for liver protocols, including counteractive drugs, hepatic encephalopathy and antibiotics If they have a superedged infection. The doctor may prescribe medications to lower bilirubin and in some cases prostaglandins are given. A liver dialysis may be required.
How can we prevent serious liver conditions?
The first and most important prevention is early diagnosis. This means being regular with your liver function tests. Follow this up with identification of prothrombin time and an ultrasound. If any chronic chronic liver disease is suspected, an endoscopy, CT scan and a liver biopsy are performed. Preventive measures may also include understanding the drugs and anabolic steroids that can damage the liver and stopping their intake.
People should ensure that they take medicines as prescribed by the doctor and in restricted quantity. Similarly, herbal and ayurvedic medicines should also be taken within the safe limits prescribed by ayurvedic qualified doctors. People should avoid taking over the counter medicines without a doctor’s prescription and advice. Take proper dosage without exceeding the limit. And if someone is taking anti-tuberculosis drugs, they should follow a regular protocol, including liver function tests every two weeks.
What is the prevalence of Hepatitis in India? What are the challenges in treating and diagnosing it?
In rural areas, the expertise and facilities for the diagnosis and treatment of hepatitis may not be available. In that case people travel to big cities or now they seek help online – 70 percent of India is now connected to online facilities via internet in most of the major hospitals in the country. Hence, patients can do tele-consultation and seek help online. Usually, when hepatitis is suspected, the doctor will ask you to perform a liver function test, an abdominal ultrasound, sometimes a fibrosis scan, in addition to giving you medications to treat early cases of hepatitis. But once hepatitis has turned into severe liver damage, scarring and cirrhosis, it may not be completely reversible.
The world is currently facing a new outbreak of unexplained acute hepatitis infection affecting children. What are the possible reasons? What according to you are the chances of such an outbreak in India?
Worldwide, several unexplained cases of hepatitis in children have been reported and linked to COVID infection. Even India is seeing that these cases occur with children two months after being exposed to COVID. About a third of these children usually have a history of being infected with COVID before two to three months, while other children may have been exposed to COVID infection through their parents and family members, but they have never been exposed to it. Infection did not occur. Typically, what happens is that these babies become jaundiced, have nausea, loss of appetite, report high levels in liver function tests (LFTs) and, in extreme cases, severe liver disease and liver failure. development takes place. But usually it is not serious. In only 10 to 15 percent of cases, patients develop complete liver failure and cannot survive other than being in the ICU or liver transplant unit. Associated hepatitis can usually be treated with special care by a liver specialist and the child will usually respond to medications.
What are preventive measures for non-fatty liver?
Non-alcoholic fatty liver disease can be prevented by living a healthy lifestyle – a good diet, controlling sugar, maintaining weight, lipid profile and cholesterol. Make sure you get enough exercise and drink enough water. Eat a balanced nutritious diet with olive oil, whole grains and pulses, fish. Stay away from processed food, red meat, sugary food and excessive alcohol. Hepatitis B can be prevented by getting vaccinated against it. Hepatitis C can be prevented by ensuring that all medical facilities test blood in blood banks, use disposable needles and syringes, and deploy cleaning protocols for dialysis machines. If someone is diagnosed with hepatitis B and C infection, they can transmit their infection sexually. So, the sexual partner must use a barrier method of contraception.