Hepatitis And Jaundice: Difference Between The Liver Diseases

The liver is the largest internal organ in the human body and the hub for metabolism. Anything that enters the body gets through to the liver, where it’s metabolized and the waste products are excreted. The liver helps to keep the body going. With all this hard work, and the regular exposure to various toxins and pathogens, sometimes the liver itself needs help.

Other than fatty liver disease, which is the build-up of excess fat in the liver, two common ailments associated with the liver are hepatitis and jaundice. The difference between hepatitis and jaundice is that while the former is a full-blown disease in itself, causing inflammation of the liver, the latter is more an outward symptom of an internal issue, which is the rising level of bilirubin because of liver dysfunction.

Main liver functions, common diseases, symptoms

Liver functions

1. Bile secretion

The most important function of the liver is the secretion of bile juice. This bile juice is secreted by the liver and stored in the gallbladder. Bile is a fluid that helps with digestion. It breaks down the fatty acids that can be taken into the body by the digestive tract. It consists of cholesterol, bilirubin, and bile acid (bile salts). It also contains water, body salts (such as sodium salt and potassium salt), copper, other metals, etc.

After the metabolism, the bile byproducts go through the intestine and leave the body in the form of feces. The blood byproducts are passed to the kidneys, where they are filtered and the waste is eliminated in the form of urine.

2. Metabolizing medication

The liver is also known for its first-pass metabolism. This means that when a person takes any oral tablet or any other oral medication, it goes through the liver, where it’s metabolized and only some amount of the drug gets into the bloodstream. For the drug to show its therapeutic effect, it should reach a particular level in the bloodstream that’s called “a therapeutic range”. Above this range, the drug is toxic and below this range, the drug does not show any therapeutic effect.

So, when we take oral medication, it undergoes first-pass metabolism and then the drug reaches the therapeutic levels in the bloodstream. Also, some of the drugs are prodrugs. These prodrugs need to be metabolized by the liver and the metabolite produced is the actual drug. Hence, the liver plays an important role in drug metabolism.

3. Blood purification

Everything we eat and drink passes through the liver via the bloodstream, and the liver filters the blood of toxins. This includes the undesirable compounds in alcohol. Filtering these toxins damages liver tissues, and this unique organ constantly regenerates its tissues. Without the liver performing this task, our body would be full of toxins.

Liver diseases

• Fatty liver disease — alcoholic and non-alcoholic (fat deposit in the liver)
• Hepatitis — viral and non-viral (inflammation of the liver)
• Cirrhosis (permanent and excessive scarring of the liver)
• Jaundice (rise in bilirubin levels in the blood when the liver is sick)
• Liver cancer (tumors that started in the liver or have spread to the liver)
• Hemochromatosis (excessive iron in the liver and other organs)
• Wilson’s disease (excessive copper in the liver and other organs)

Liver disease symptoms

Liver disease doesn’t always cause noticeable signs and symptoms. If signs and symptoms of liver disease do appear, they may include:

• Skin and eyes that appear yellowish
• Abdominal pain and swelling
• Swelling in the legs and ankles
• Itchy skin
• Dark urine color
• Pale stool color
• Chronic fatigue
• Nausea or vomiting
• Loss of appetite
• Tendency to bruise easily

Also, as discussed earlier, the oral drugs that are taken may not be perfectly metabolized by the damaged liver, and hence, the therapeutic range of the drug can change to either toxic levels or ineffectual levels. Again, prodrugs might not be effective when the liver is damaged.

What is the difference between hepatitis and jaundice?

The outward symptoms of all liver disorders are very similar to each other, so you might mistake one liver problem for another. But there are very clear medical distinctions between hepatitis (viral or non-viral) and jaundice. In viral hepatitis, the virus strain that’s causing it would be identified through tests.

1. Hepatitis

This is an inflammation of the liver. Viral hepatitis is mainly categorized as Hepatitis A, Hepatitis B, and Hepatitis C, each caused by a virus of the same name. There are two other known viral types, D and E, but they’re rare.

Non-viral hepatitis may be the result of years of heavy drinking, and the alcoholic fatty liver leading to alcoholic hepatitis. Non-viral hepatitis can also be the result of an autoimmune condition.

Hepatitis A often clears on its own without any treatment. Inflammation caused by Hepatitis B or C may become chronic and lead to liver damage and other complications.

When a hepatitis virus gets into the bloodstream and attacks liver cells, the body’s immune system responds to fight it. Temporary inflammation is part of this response. But if inflammation persists for months or years, it can damage or even destroy liver cells.

Liver damage can prevent the body from processing essential nutrients and from ridding the body of toxins. Without treatment, viral hepatitis can lead to scarring of the liver, also called cirrhosis, which further interferes with liver function. Untreated Hepatitis B or C can also lead to liver cancer.

All the common hepatitis viruses are infectious. Hepatitis A can be spread through contaminated food, water, or personal contact with an infected person. Hepatitis B and C spread through contact with bodily fluids such as blood or semen. These viruses can affect people of any age, including newborn babies if the mother passes the virus to her child during birth.

2. Hepatitis A

Hepatitis A symptoms may not appear for weeks after infection, and some people have no symptoms at all.

• This disease can be spread from one person to another even before symptoms develop and up to one week after symptoms become evident.
• Hepatitis A can be spread through water and food that has been contaminated by microscopic amounts of stool containing the virus. This is more common in areas that have poor sanitation.
• Hepatitis A can also pass from person to person during unprotected sex.

Symptoms of Hepatitis A include flu-like symptoms, such as fever, nausea, loss of appetite, and diarrhea. Hepatitis A may also cause jaundice.

Hepatitis A is a short-lived, or acute, disease. When symptoms develop, they may cause severe illness requiring hospitalization and intravenous fluids.

In most people, the body overcomes the virus on its own after a few weeks or months. Occasionally, a person feels ill again a few months later and then gets better, usually for good after this second flare-up.

To protect yourself from Hepatitis A, vaccination is recommended, especially before traveling to a country where Hepatitis A is common, and also by avoiding easily contaminated food items. These include fresh vegetables or fruits (unless they can be peeled), raw shellfish, tap water, and ice cubes.

3. Hepatitis B

People infected with the Hepatitis B virus may or may not have symptoms but can still transmit the virus to others. Symptoms include jaundice, loss of appetite, nausea, vomiting, diarrhea, and muscle aches.

The infection may be acute, meaning short-lived, or chronic, which means it persists for a long time, even if symptoms never appear. Hepatitis is considered chronic if it lasts longer than six months.

In most people, the body fights the Hepatitis B virus within a few months without any permanent liver damage. In some, though, Hepatitis B becomes a long-term illness and can lead to liver damage or liver cancer.

Hepatitis B is spread through contact with bodily fluids, such as saliva, blood, and semen, or with a contaminated object, such as a toothbrush or razor, where the virus can live for days.

Certain factors increase the risk of infection. These include sharing needles when injecting drugs, having unprotected sex, having a tattoo or body piercing is done by someone who doesn’t use clean needles, men having sex with other men, traveling to countries where Hepatitis B is common, being on long-term dialysis, and sharing items such as a toothbrush or razor with someone infected.

4. Hepatitis C

Often, Hepatitis C doesn’t have symptoms, and a person may live with Hepatitis C for years or decades without knowing it.

Hepatitis C is infectious and can cause serious liver damage even if a person never has symptoms. Without treatment, Hepatitis C may lead to cirrhosis, which is scarring of the liver, and liver cancer. If symptoms develop, they include fatigue, joint pain, muscle weakness, and jaundice.

Hepatitis C is spread from person to person, primarily through contact with contaminated blood. Other risk factors include having unprotected sex with multiple partners, sharing devices such as straws when snorting a drug through the nose, and having a tattoo or piercing done by someone who uses unclean equipment.

5. Jaundice

Jaundice is a condition in which the skin, sclera (whites of the eyes), and mucous membranes turn yellow. This yellow color is caused by a high level of bilirubin, a yellow-orange bile pigment. Bile is fluid secreted by the liver. Bilirubin is formed by the breakdown of red blood cells.

Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down in a natural process, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow. This makes jaundice a symptom of the bilirubin problem, rather than a disease by itself.

Causes of jaundice

Jaundice can be caused by a problem in any of the three phases of bilirubin production.

1. Phase 1

Before the production of bilirubin, you may have what’s called unconjugated jaundice due to increased levels of bilirubin caused by:

• Reabsorption of a large hematoma(a collection of clotted or partially clotted blood under the skin)
• Hemolytic anemia (blood cells are destroyed and removed from the bloodstream before their normal lifespan is over)

2. Phase 2

During the production of bilirubin, jaundice can be caused by:

• Viruses, including Hepatitis A, chronic Hepatitis B and C, and Epstein-Barr virus infection
• Alcohol
• Autoimmune disorders
• Rare genetic metabolic defects
• Medicines, including acetaminophen toxicity, penicillins, oral contraceptives, chlorpromazine (Thorazine), and estrogenic or anabolic steroids

3. Phase 3

After bilirubin is produced, jaundice may be caused by obstruction (blockage) of the bile ducts from:

• Gallstones
• Inflammation (swelling) of the gallbladder
• Gallbladder cancer
• Pancreatic tumor

Symptoms of jaundice

Sometimes, a person may not have symptoms of jaundice, and the condition may be found accidentally. The severity of symptoms depends on the underlying causes and how quickly or slowly the bilirubin level rises.

If you have a short-term case of jaundice (usually caused by infection), you may have the following symptoms and signs:

• Fever
• Chills
• Abdominal pain
• Flu-like symptoms
• Change in skin color
• Dark-colored urine and/or clay-colored stool

If jaundice isn’t caused by an infection, you may have symptoms such as weight loss or itchy skin. If the jaundice is caused by pancreatic or biliary tract cancers, the most common symptom is abdominal pain. Sometimes, you may have jaundice occurring with liver disease, if you have:

• Chronic hepatitis or inflammation of the liver
• Pyoderma gangrenosum (a type of skin disease)
• Acute Hepatitis A, B, or C
• Polyarthralgia (inflammation of the joints)

Jaundice diagnosis and tests

Doctors diagnose jaundice by checking for signs of liver disease such as:

• Bruising of the skin
• Spider angiomas (abnormal collection of blood vessels near the surface of the skin)
• Palmar erythema (red coloration of the palms and fingertips)
• Urinalysis (urine testing) that’s positive for bilirubin, showing that the patient has conjugated jaundice
• Serum testing to reconfirm urinalysis results. The serum testing will include a complete blood count (CBC) and bilirubin level test
• An exam to determine the size and tenderness of your liver
• Imaging (ultrasonography and CT scan) and liver biopsy (taking a liver sample) to further confirm the diagnosis

Conclusion

There are many differences between hepatitis and jaundice. Jaundice is a symptom that can occur due to various liver diseases like cirrhosis, hepatitis, etc. Jaundice is the yellowing of the skin and excessive levels of bilirubin cause this yellowing of the skin. Hepatitis is inflammation of the liver. This can be caused by viruses or other factors, and a long period of inflammation can cause permanent liver damage. Hepatitis can often lead to cirrhosis or liver cancer and, hence, one must take great care once diagnosed with hepatitis. Jaundice usually requires rest and recuperation, along with medication.