Toxic hepatitis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 30, 2016
StartDiseasesToxic hepatitis

Most ingested food, drink, medication and chemicals are processed by the liver. When a person ingests something harmful, it can lead to toxic hepatitis.

Contents

Definition & Facts

Toxic hepatitis is a condition in which the liver becomes inflamed as a result of exposure to toxins. In some cases, symptoms of the inflammation are reduced once the person is no longer exposed to the harmful substance.

However, in a small percentage of cases toxic hepatitis can lead to permanent liver damage. Occasionally, the patient experiences liver failure, which can be life-threatening. Symptoms of toxic hepatitis may appear immediately after ingestion of the toxin, or they may appear after several months of ingesting the substance.

Symptoms & Complaints

In the mildest of cases, patients do not experience any symptoms; however, the condition can still be detected via blood tests. For patients who do complain of symptoms, the symptoms vary widely depending on the type of ingested toxin.

The most common symptoms of the condition are fatigue, itching, rash, headache, loss of appetite, nausea, and vomiting. Many patients also complain of dark urine, diarrhea, and stool that is white or light-colored.

Some patients also develop jaundice, a condition in which the whites of the eyes (sclera), and the skin turn yellow. Abdominal pain in the upper right part of the abdomen is also common. Patients who experience a severe form of any of the aforementioned symptoms should see a doctor.

Depending on the severity of the case, toxic hepatitis can also cause the patient to lapse into a comatose state. For this reason, symptoms of toxic hepatitis should not be ignored. Over time, the damage done to a patient's liver can cause the liver to scar. This scarring is also called cirrhosis. When this condition develops, the liver is no longer able to function properly. 

Causes

The human liver is generally able to break down most of the chemicals and drugs that enter the body. The liver is also able to regenerate itself. However, constant exposure to harmful substances can sometimes cause irreversible liver damage. For instance, drinking heavily for years can cause the liver to become inflamed; this condition is also called alcoholic hepatitis.

Another common cause of toxic hepatitis is over-the-counter pain pills. Taking too much acetaminophen, ibuprofen, and/or naproxen can damage the liver, especially when these drugs are combined with alcohol. Prescription drugs can also be harmful, particularly when they are not taken as directed by a doctor. Such drugs include statins, amoxicillin-clavulanate, azathioprine, phenytoin, and some anabolic steroids, among many others.

Digesting large doses of certain herbs and supplements is considered dangerous to the liver, such as black cohosh, aloe vera, comfrey, and ephedra, to name a few. In some cases, children may accidentally overdose on vitamin supplements, which can also lead to liver damage.

Some workers are at a higher risk of developing liver damage. This is because some places of employment expose workers to industrial chemicals, such as carbon tetrachloride, a dry-cleaning solvent, and vinyl chloride, a material used in plastics production. 

Diagnosis & Tests

To diagnose toxic hepatitis, a physician will give the patient a thorough physical examination. The physician will also ask extensive questions about the patient's medical history and family history. The questions will allow the physician to assess the level of the patient's alcohol consumption, the names and dosages of any medicines taken by the patient and the names and amounts of herbs ingested.

The physician might also order an ultrasound to get detailed pictures of the patient's liver. Liver functions tests are sometimes required. These tests are a series of blood tests to assess liver functioning. The tests can also reveal the type of liver damage and the severity of it.

The physician may also recommend a computed tomography (CT) scan, which can show a 3D image of the liver and a more detailed view overall of the patient's internal organs than what is produced using a traditional X-ray unit. Once the patient has been diagnosed with toxic hepatitis, the physician will attempt to determine the cause of the symptoms.

Treatment & Therapy

In many cases, if the toxin can be exposed and the patient's exposure to it can be stopped, then the patient's symptoms will lessen in severity. Intravenous fluids and medications to relieve nausea and vomiting are the most common treatments used for patients with toxic hepatitis.

If the patient's symptoms are caused by an overdose of acetaminophen, the healthcare provider might administer medicine that reverses the effects of acetaminophen overdose. This medicine, called acetylcysteine, works best if given within 16 hours of overdose.

Another treatment for toxic hepatitis is a liver transplant. This is done in cases where extreme damage to the liver is seen. In many cases the donor is deceased, but in some cases living donors give a portion of their liver.

Prevention & Prophylaxis

Sometimes people do not know a substance will cause an adverse reaction in his or her body. For this reason, toxic hepatitis cannot always be prevented by avoiding toxic substances.

However, there are a few measures people can take to reduce their risk of developing toxic hepatitis. Patients should be sure to follow prescription label instructions and always take medicine exactly as the doctor instructs. All medicines should be kept away from children, and people should never take alcohol with medicine.

One mistake people make is to assume natural products, such as herbs, are not harmful. However, before taking any herbs or supplements, patients should consult a physician first.

Furthermore, people who work with hazardous chemicals should follow all safety measures. If exposed to a harmful substance in the workplace, the worker should follow the employer's protocol as well as any government regulations. A person should consult a physician when any worrisome signs of toxic hepatitis appear.