Hepatitis could be clinically presented with many symptoms that may be tricky and overlap with gastroenteritis or respiratory infection symptoms. Hepatitis has two main types of manifestation upon which we are going to discuss separately:
– Acute symptoms of hepatitis are associated with infection with HAV, HEV, and exposure to a high dose of hepatotoxic substances as alcohol. The parasitic liver infection causes acute hepatitis yet it is predominantly present in rural regions or developing countries. Fortunately, most of these symptoms are often reversible leaving no marked residual effect on the liver. Acute hepatitis is characterized by fast onset and regressive course of symptoms.
Constant right upper abdominal pain is usually the chief complaint of patients with hepatitis. This pain may radiate to the right shoulder, middle abdomen, or diffuse in the back, but fortunately, it responds to analgesics. Fever is also a common symptom, especially during infection. Frequent vomiting accompanied by nausea and headache. Patients with acute hepatic infection may be pale or even slightly yellowish due to malnutrition and disturbed metabolism of bilirubin that cause jaundice. Fatigue and malaise are frequently reported with the hepatic viral infection. Anorexia (loss of appetite) is usually present due to frequent vomiting.
– Although chronic hepatitis may be asymptomatic with no apparent affection, its symptoms are usually accompanied by other systemic manifestations. Keeping in mind that the liver is the main route of detoxification and synthesis of essential proteins so chronic liver inflammation will definitely interfere and obstacle its functions. Chronic hepatitis is usually caused by HBV, HCV infection, malignancy, and alcoholism. Symptoms of chronic hepatitis may take a longer period to resolve than acute hepatitis.
Frequent epistaxis (bleeding from the nose) or purpura (bleeding under the skin) may be the only complaint of patients with chronic hepatitis. Accumulation of fluids in the abdomen is commonly seen in chronic hepatitis which for some level helps in assessing the degree of liver affection. The liver may be enlarged or shrunken according to the cause and the course of inflammation while the spleen is usually enlarged because it shares with the liver the same blood drainage system. Patients with chronic viral hepatitis often get fatigued with minimal effort. Patients with chronic hepatitis may have hepatocellular jaundice making their skin and sclera yellowish-orange.