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Hepatitis and elevated liver enzymes explained

Last Modified: July 28, 2017

Diseases & Disorders

July 28 is World Hepatitis Day, an occasion to raise awareness about the World Health Organization’s goal to eliminate hepatitis. But first, we need to understand what triggers the condition. When a doctor uses the term “hepatitis,” it means that there is inflammation in the liver leading to an elevation in liver enzymes. Hepatitis ranges from limited, benign elevations to significant diseases that need to be evaluated and treated. Reshi Kanuru, MD, PPG – Gastroenterology, helps us better understand the disease and its causes.

alcohol and medications as the cause.
Most commonly, elevated liver enzymes are related to excessive alcohol use or the use of certain medications. While it’s likely that a few alcoholic drinks per week won’t cause an elevation in liver enzymes, the amount of alcohol that can cause liver damage varies from person to person. Alcohol consumption in any form can put a strain on the liver, and your doctor can help determine if it’s the cause of your hepatitis. Additionally, numerous medications, such as antibiotics, blood pressure medications, and cholesterol medications can also put a strain on the liver and cause elevations in the enzymes. The good news is that stopping the use of these medications, or stopping the consumption of alcohol, will allow the hepatitis to resolve over time and your enzymes will eventually return to normal.

viral hepatitis.
The next most common cause of liver enzyme elevations is viral hepatitis, such as hepatitis A, B, or C. Of these three types, hepatitis A, which is contracted through contaminated food, is the only one that does not cause long term liver injury. Hepatitis B and C can both lead to long term liver injury and eventually cirrhosis, which is severe scarring of the liver. Currently, hepatitis C is behind most needed liver transplants in the United States. Because hepatitis C is so common and can cause such severe damage, it’s recommended that anyone born between 1945 and 1965 be screened for the disease. It’s important to understand that both hepatitis B and C are treatable.

In the past, hepatitis C was difficult to treat and had poor cure rates partly because of medications that had many intolerable side effects. Recently, however, new medications for hepatitis C have been developed that have few side effects, and boast cure rates above 95 percent after a single course of treatment. Treating everyone for hepatitis C will prevent cirrhosis in millions of Americans and help to significantly reduce healthcare costs in the future.

fatty liver disease.
The epidemic of obesity and the availability of fried foods have led to dramatic health consequences.  Instances of both heart disease and fatty liver disease have been increasing over the last few decades, primarily because of our poor eating habits and overall weight gain.

Fatty liver disease is when fat deposits in the liver and leads to inflammation, which can cause an elevation in liver enzymes. Typically, fatty liver disease occurs in those dealing with obesity who may also have diabetes; however, the disease can also occur in thin individuals who may have genetics that predispose them to liver issues. It’s important to catch fatty liver disease as early as possible, not only because it will soon beat hepatitis C as the most common cause for liver transplantation in the United States, but also because fatty liver disease significantly increases the risk of death due to heart attack and stroke. It can lead to cirrhosis of the liver.

The treatment of fatty liver disease entails eating healthy and committing to 30 minutes of cardiovascular exercise every day with the goal of losing 10 percent of your body weight. Losing weight will cause the amount of fat deposited in the liver to significantly decrease and your risk of heart attack, stroke, and cirrhosis will greatly improve.

autoimmune hepatitis, PBC, PSC and other liver disorders.
Though most people will develop hepatitis related to alcohol, medications, fatty liver and viruses, there are many other diseases that cause elevations in liver enzymes.  Our immune system plays a large role in our health, but unfortunately, the immune system can also cause diseases.

Diseases like autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cholangitis are all autoimmune disorders that affect the liver. It is important to be evaluated for these diseases because they can cause severe liver injury. Beyond autoimmune issues, there are liver diseases that cause abnormal deposition of copper and iron in the liver.  These deposition diseases not only cause liver injury, but can cause damage to multiple organs throughout the body.




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