The primary goals for managing viral hepatitis are to provide adequate nutrition, to prevent additional damage to the liver, and to prevent transmission to others. For mild cases of acute viral hepatitis, no drug therapy or other treatment is either available or necessary. Hospitalization is needed only for people at high risk for complications, such as pregnant women, elderly people, patients with other serious conditions, or those who have severe nausea and vomiting and need to have fluids administered intravenously.
The following tips may be useful:
- In some cases, the physician may prescribe drugs that have minimal impact on the liver to alleviate the symptoms of hepatitis, such as nausea or severe itching.
- All patients should abstain from alcohol and sexual contact during the acute phase.
- Although most patients with hepatitis experience fatigue and require more rest than usual, they can be as physically active as they want without affecting recovery. In fact, patients should be encouraged to be as active as they can.
- Depression is common, particularly in people used to an active life. Patients should be reassured that in the great a majority of hepatitis cases, recovery is complete.
- The liver processes many types of medications, so as soon as hepatitis is diagnosed, the patient should stop taking all drugs, including over-the-counter medications, except those a physician specifically prescribes or recommends. Of special note, ibuprofen (Advil, Motrin) apparently increases liver enzymes in hepatitis C patients and therefore should be avoided. Ibuprofen is one the common painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDs). Other NSAIDs include aspirin and naproxen. The usual alternative to an NSAID is acetaminophen (Tylenol). It should be noted that acetaminophen also can be toxic in the liver, particularly when drinking alcohol.
After the onset of acute hepatitis, periodic visits to the physician for repeat blood tests are necessary, the frequency of which depends on how well the patient feels. If symptoms still occur after three months and laboratory tests still indicate active presence of the virus, the patient should be evaluated every month. If symptoms persist beyond six months, a liver biopsy may be required to determine any liver damage.
Dietary Factors to Protect the Liver. In general, no vitamins or special diets have been proven to be particularly beneficial. The following may be helpful however:
- Eating many small snacks during the day, with larger ones in the morning, may help prevent weight loss while reducing the severity of nausea. Patients might be able to tolerate high-caloric drinks to supplement their regular diet.
- One small Japanese study suggested that vitamin E might help protect against liver damage in patients with hepatitis C.
- Thiamine binds to iron and helps reduce iron load in the liver. One small study suggested it may be helpful for patients with chronic hepatitis B. Pork is high in the vitamin, but more healthful sources include dried fortified cereals, oatmeal, corn, nuts, cauliflower, sunflower seeds and vitamin pills.
- Some research suggests that supplements of omega-3 fatty acids (found in fish oil and evening primrose oil) may help protect the diseased liver.
- In one Norwegian study, higher coffee intake was associated with a lower risk for cirrhosis.