VIRAL HEPATITIS- THE HEPATOCYTES’ NEMESIS


Liver is the largest glandular organ in human body. It is multi-functional and is the body’s chemical workshop. It is the most metabolically active, working in close association with the liver, gallbladder, and pancreas.


Viral hepatitis is also known as infective hepatitis. It is a major healthcare burden worldwide, characterized by mediated liver inflammation. Inflammation is the swelling of body tissues that happens when they are infected or injured. It damages the hepatocytes and affects their normal functioning.


Hepatitis can be a short-termed (acute) or long-termed (chronic) infection. Some types of viruses cause only acute infection while others can cause both acute and chronic. Viruses of type A, B, C, D, E, and G can cause hepatitis.


Hepatitis A and E are self-limiting. Recovery from these strains is complete and not followed by cirrhosis and fibrosis of the liver. Other types are more dangerous. Acute hepatitis B, C, D, and G can be a cause of chronic hepatitis.


SPREAD:


Hepatitis A and E viruses are excreted in stools and therefore can be spread by the fecal-oral route. Hepatitis E can also be caused by the consumption of raw, uncooked pork, deer, or shellfish. In this, the patient can suffer from jaundice along with liver enlargement and tenderness.

Hepatitis B, C, D, and G are caused after the transfusion of blood or blood products from an infected person. The most common being improperly sterilized needles. Type B and D cause extreme jaundice.


SYMPTOMS OF VIRAL HEPATITIS:


The symptoms of infective hepatitis include:

· Anorexia

· Headache

· Rapid weight loss

· Fever

· Vomiting

· Nausea

· Abdominal discomfort

· Urine color changes to red from dark yellow

· Whitish stools


These symptoms continue for 1-2 months. Neglected viral hepatitis leads to liver cirrhosis.


WHAT CAN HEPATITIS LEAD TO:


Chronic hepatitis infection can lead to severe complications including scarring of the liver- cirrhosis, fibrosis of the liver, liver failure, and liver cancer.

These stages are preventable if diagnosed early and treated properly.


DIETARY MODIFICATIONS IN HEPATITIS:


The recommended diet for infective hepatitis includes:

· High protein

· High calorie

· High carbohydrate

· Moderate fat

Small and attractive meals at regular intervals are preferred to large meals. Overfeeding should be avoided.


High Protein: an adequate supply of good quality protein is necessary for the liver cells to regenerate.


Fats: they make the food more palatable and also increase the calorie count hence moderate amount is recommended


High carbs: a high carbohydrate diet is needed so that enough calories are supplied and proteins are not broken for providing energy to the body. Intravenous glucose is suggested in case of fever, nausea, or vomiting.


Vitamin: vitamin C, vitamin K, and supplements of B complex vitamins are essential on daily basis.


Minerals: monitoring and maintenance of serum sodium and potassium levels are necessary. Often added salt is recommended when oral feeds such as fruit juice, vegetable, and meat soups are given.


FOODS PREFERRED

Ø Cereal porridge

Ø Soft chapatis

Ø Rice

Ø Skimmed milk

Ø Potato

Ø Tapioca

Ø Sugar, jaggery, honey

Ø Fruits and fruit juices

Ø Custard without buttercream

Ø Non-stimulating beverages


FOODS AVOIDED:

Ø Pulses, Beans

Ø Meat, fish, chicken, egg, meat soups

Ø Sweet preparations devoid of ghee, butter, or oil

Ø Bakery products

Ø Dried fruits and nuts

Ø Spices

Ø Alcoholic beverages

Ø Papads

Ø Chutney

Ø Whole milk and cream

Ø Fried preparations.


The infected person should be encouraged to be hydrated and have enough fluids. Fluid balance has to be maintained so that water load is prevented.

Annually, World Hepatitis Day is celebrated on the 28th of July, the birthday of Dr. Baruch Blumberg who discovered the chronic hepatitis B virus in 1967. Two years later, he won the Nobel prize for developing the first hepatitis B vaccine.


Vaccination for hepatitis B is now a part of a routine immunization program. Type A and B vaccinations are available.







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