Hepatitis Symptoms: First Signs, External Manifestations, and Types

Hepatitis is inflammation of the liver, most often caused by a virus or by many years of alcohol consumption. Many people have no symptoms at all, and in some they appear weeks, months, or years after infection. Below is what is known about the signs of the disease, how its types differ, and when a doctor is needed.

What hepatitis is and what types exist

Hepatitis is inflammation of the liver: the tissue swells and is damaged, and the organ's function suffers. The course can be acute, short-lived, or chronic, long-lasting. Five main viruses cause viral hepatitis — A, B, C, D, and E; this is the most common type of the disease. Non-viral forms: alcoholic (many years of alcohol abuse or regular binge drinking), toxic (poisons, chemicals, certain medications and supplements), and autoimmune — the immune system attacks its own liver, which is more common in women and in people with other autoimmune diseases; it cannot be contracted.

First symptoms of hepatitis: how the disease begins

Most people who fall ill have no early "warning sign": the disease develops unnoticed. When signs do appear, the onset often resembles the flu — fever, headache, body aches. For 5–7 days before the main symptoms there may be nausea, vomiting, diarrhea, and abdominal pain. Then comes severe fatigue, appetite is lost, fever rises, and pain in the upper abdomen, usually under the right ribs, is bothersome. The typical set: fever, fatigue, loss of appetite, nausea and vomiting, abdominal pain, dark urine, pale stool, joint pain, jaundice. They usually last 1–3 weeks but can drag on and return. In acute hepatitis, symptoms may begin 2 weeks to 6 months after infection; the incubation of hepatitis A averages 15–30 days (from 7 to 50), and of hepatitis B — 50–180 days.

External signs of hepatitis: skin, eyes, urine, and stool

• Jaundice — yellowing of the skin and whites of the eyes: bilirubin that the liver has not processed enters the blood. On tanned and dark skin the yellowness is less noticeable.
• Itching of the skin, sometimes itchy rashes.
• Discolored stool: it becomes pale, "clay-like."
• Urine darker than usual.

Jaundice is the most noticeable sign of liver inflammation, but it does not always occur: anicteric forms are common. A normal color of the skin and eyes does not rule out other signs — fatigue, nausea, pain under the right ribs.

Does the liver hurt with hepatitis

Pain in the right hypochondrium is a frequent complaint, but its source is not always the liver tissue itself. It is usually explained by stretching of the liver capsule when the organ enlarges; sometimes it is related to the gallbladder and pancreas. Its character varies: dull, aching, prolonged — or paroxysmal and intense, radiating to the right shoulder and right shoulder blade. In chronic hepatitis, persistent enlargement of the liver, dull pain under the ribs, and intolerance of fatty foods are typical. The absence of pain rules nothing out: the disease often runs without symptoms.

How the symptoms of different types of hepatitis differ

Hepatitis A is transmitted through water and food that has come into contact with the stool of an infected person. Hepatitis B is transmitted through blood and biological fluids — a negligible amount of blood is enough for infection; the incubation is 50–180 days, and the icteric form with digestive upset, joint pain, weakness, and itchy rashes develops more often, and in 10% of adults the disease becomes chronic. Hepatitis C is also transmitted through blood, but symptoms often appear months or years after infection. Hepatitis D is possible only in people with hepatitis B. Hepatitis E is associated with raw meat and shellfish: most people recover, but in pregnant women and with weakened immunity it is severe. The alcoholic and autoimmune forms are not contagious. There are vaccines against hepatitis A and B.

When to see a doctor

Suspicion of hepatitis is a reason not to wait but to see a doctor. The doctor asks about symptoms and medical history, performs an examination, orders blood tests, including tests for hepatitis viruses, and if necessary ultrasound, CT or MRI, and a liver biopsy. The reason for urgency is complications: chronic hepatitis without monitoring leads to cirrhosis, liver failure, and liver cancer.

Hepatitis in itself is not a reason to call an ambulance. 103 or 112 — for a life-threatening condition; in other cases, a doctor's consultation is needed.

This material is for reference: it helps to recognize the signs but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer