Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis E

Hepatitis E is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. The hepatitis E virus has different types that spread in different ways.

• Some types are spread by drinking contaminated water. These types are more common in developing countries, including parts of Africa, Asia, Central America, and the Middle East.
• Other types are spread by eating undercooked pork or wild game, such as deer. These types are more common in developed countries, such as the United States, Australia, Japan, and parts of Europe and East Asia.

Hepatitis E typically causes acute, or short-term, infection.

Acute hepatitis E

Acute hepatitis E is a short-term infection. In most cases, people’s bodies are able to recover and fight off the infection and the virus goes away. People usually get better without treatment after several weeks.

Chronic hepatitis E

Chronic hepatitis E is a long-lasting infection that occurs when your body isn’t able to fight off the virus and the virus does not go away. Chronic hepatitis E is rare and only occurs in people with weakened immune systems. For example, hepatitis E may become chronic in people taking medicines that weaken their immune system after an organ transplant, or in people who have HIV or AIDS.

How common is hepatitis E?

Hepatitis E is more common in developing countries, where sanitation is poor and access to clean water is limited.

Although experts used to think hepatitis E was rare in the United States, recent research suggests that about 20 percent of the population has had hepatitis E.

How serious is hepatitis E?

The types of hepatitis E that are common in developing countries are likely to cause severe infections, especially in pregnant women.

The types of hepatitis E that are common in developed countries are often mild and cause no symptoms. Many people don’t know they’ve had these types of hepatitis E.

Who is more likely to get hepatitis E?

Different types of hepatitis E are more likely to affect different groups of people. The types of hepatitis E that are more common in developing countries are more likely to affect adolescents and young adults.²⁶

In contrast, the types of hepatitis E that are more common in developed countries most often affect older men.²⁶

What are the complications of hepatitis E?

Acute hepatitis E complications

Most people recover from acute hepatitis E without complications. In some cases, acute hepatitis E may cause acute liver failure, a condition in which the liver fails suddenly. Acute liver failure due to hepatitis E is more common in

• pregnant women
• people who have other liver diseases

In pregnant women, hepatitis E can cause other complications for the mother and baby, such as stillbirth, premature birth, or low birthweight.

Chronic hepatitis E complications

Chronic hepatitis E—which is rare and only occurs in people with weakened immune systems—may lead to complications such as cirrhosis or liver failure.

What are the symptoms of hepatitis E?

Many people infected with hepatitis E have no symptoms. Some people have symptoms 15 to 60 days after they become infected with the virus.²⁷ These symptoms may include

• feeling tired
• nausea and vomiting
• poor appetite
• pain over the liver, in the upper part of the abdomen
• darkening of the color of urine
• lightening of color of stool
• yellowish tint to the whites of the eyes and skin, called jaundice

People with hepatitis E typically get better without treatment after several weeks.

What causes hepatitis E?

The hepatitis E virus causes hepatitis E. In developing countries, hepatitis E typically spreads through drinking contaminated water. In developed countries, such as the United States, hepatitis E typically spreads from animals to people, when people eat undercooked pork or wild game, such as deer.

Research suggests that hepatitis E can also spread through blood transfusion, but this is very rare.

How do doctors diagnose hepatitis E?

Doctors diagnose hepatitis E based on symptoms and blood tests. A health care professional will take a blood sample from you and send the sample to a lab. Blood tests can detect antibodies to the hepatitis E virus and show whether you have hepatitis E. The virus can also be detected in blood and in stool samples taken during acute hepatitis E infection.

How do doctors treat hepatitis E?

Treatment for acute hepatitis E includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis E.

See your doctor regularly to make sure your body has fully recovered.

Doctors may treat chronic hepatitis E with ribavirin or peginterferon alfa-2a (Pegasys).

How can I protect myself from hepatitis E infection?

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Also, make sure any pork or deer you eat is thoroughly cooked, both in developing countries and in developed countries such as the United States.

How can I prevent spreading hepatitis E to others?

Research suggests that it is uncommon for people to spread hepatitis E directly to other people. If you have hepatitis E, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before preparing food. Talk with a blood donation center before you donate blood.

Is a hepatitis E vaccine available?

No vaccine for hepatitis E is available in the United States. Vaccines have been developed and are used in China.

What should I eat and drink if I have hepatitis E?

If you have hepatitis E, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis E appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

SomSome forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis C

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.

Hepatitis C can cause an acute or chronic infection.

Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.

Acute hepatitis C

Acute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis C

Chronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn’t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.

Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer.

How common is hepatitis C in the United States?

In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.

Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they have this infection.

Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.

New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.

Who is more likely to get hepatitis C?

People more likely to get hepatitis C are those who

• have injected drugs
• had a blood transfusion or organ transplant before July 1992
• have hemophilia and received clotting factor before 1987
• have been on kidney dialysis
• have been in contact with blood or infected needles at work
• have had tattoos or body piercings
• have worked or lived in a prison
• were born to a mother with hepatitis C
• are infected with HIV
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.

Should I be screened for hepatitis C?

Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

What are the complications of hepatitis C?

Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.

Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis C increases your chance of developing liver cancer. If chronic hepatitis C causes severe liver damage or cirrhosis before you receive hepatitis C treatment, you will continue to have an increased chance of liver cancer even after treatment. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis C?

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

• dark yellow urine
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in your abdomen
• vomiting
• yellowish eyes and skin, called jaundice

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by

• sharing drug needles or other drug materials with an infected person
• getting an accidental stick with a needle that was used on an infected person
• being tattooed or pierced with tools or inks that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person before they were used on you 
• having contact with the blood or open sores of an infected person
• using an infected person’s razor, toothbrush, or nail clippers
• being born to a mother with hepatitis C
• having unprotected sex with an infected person

You can’t get hepatitis C from

• being coughed or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

A baby can’t get hepatitis C from breast milk.

How do doctors diagnose hepatitis C?

Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.

Medical history

Your doctor will ask about your symptoms and whether you have any history of blood transfusions or injected drug use.

Physical exam

During a physical exam, your doctor will typically examine your body to check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis C?

Doctors use blood tests to diagnose hepatitis C. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.

Blood tests for hepatitis C include the following:

• Screening test for antibodies to the hepatitis C virus. A screening blood test will show whether you have developed antibodies to the hepatitis C virus. A positive antibody test means you were exposed to the hepatitis C virus at some point. However, the virus may no longer be present in your blood if your body fought off the infection on its own or if you received treatment that cured the infection.
• Hepatitis C RNA test. If your antibody test is positive, your doctor will use a hepatitis C RNA test to detect RNA—a type of genetic material—from the hepatitis C virus. The hepatitis C RNA test can show whether you still have the hepatitis C virus and how much virus is in your blood. This information can help your doctor treat the infection. To see if you are responding to treatment, your doctor may order this test while you are undergoing treatment to find out if the amount of virus in your blood is changing.
• Genotype test. Your doctor can use this test to find out what strain, or form, of hepatitis C virus you have. At least six specific strains—called genotypes—of hepatitis C exist. Genotype 1 is the most common hepatitis C genotype in the United States. Your doctor will recommend treatment based on which hepatitis C genotype you have.

Additional tests

If you’ve had chronic hepatitis C for a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may include

• blood tests
• transient elastography, a special ultrasound of your liver
• liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver

Doctors typically use liver biopsy only if other tests don’t provide enough information about a person’s liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis C?

Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.

Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.

Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:

• daclatasvir (Daklinza)
• elbasvir/grazoprevir (Zepatier)
• glecaprevir and pibrentasvir (Mavyret)
• ledipasvir/sofosbuvir (Harvoni)
• ombitasvir/paritaprevir/ritonavir (Technivie)
• ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak, Viekira XR)
• simeprevir (Olysio)
• sofosbuvir (Sovaldi)
• sofosbuvir/velpatasvir (Epclusa)
• sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

Newer medicines are sometimes used along with these older hepatitis C medicines:

• ribavirin
• peginterferon alfa-2a (Pegasys) or peginterferon alfa-2b (PEG-Intron)

You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on

• which hepatitis C genotype you have
• how much liver damage you have
• whether you have been treated for hepatitis C in the past

Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.

Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, talk with your doctor before using dietary, such as vitamins, or any complementary or alternative medicines or medical practices.

Cost of hepatitis C medicines

The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.

Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. .

How do doctors treat the complications of hepatitis C?

If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound  test to check for liver cancer.

If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis C infection?

If you don’t have hepatitis C, you can help protect yourself from hepatitis C infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools and unopened ink
• not sharing personal items such toothbrushes, razors, or nail clippers

Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C. 

If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection. 

If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.

How can I prevent spreading hepatitis C to others?

If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Don’t donate blood or blood products, semen, organs, or tissue.

Is a hepatitis C vaccine available?

Researchers are still working on a vaccine for hepatitis C. If you have hepatitis C, talk with your doctor about vaccines for hepatitis A and hepatitis B. These vaccines can protect you from hepatitis A and hepatitis B infections, which could further damage your liver.

What should I eat and drink if I have hepatitis C?

If you have hepatitis C, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis C appeared first on Medika Life.

VirViruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis D

Hepatitis D is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can spread from person to person.

The hepatitis D virus is unusual because it can only infect you when you also have a hepatitis B virus infection. In this way, hepatitis D is a double infection. You can protect yourself from hepatitis D by protecting yourself from hepatitis B by getting the hepatitis B vaccine.

Hepatitis D spreads the same way that hepatitis B spreads, through contact with an infected person’s blood or other body fluids. The hepatitis D virus can cause an acute or chronic infection, or both. 

Acute hepatitis D

Acute hepatitis D is a short-term infection. The symptoms of acute hepatitis D are the same as the symptoms of any type of hepatitis and are often more severe. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis D

Chronic hepatitis D is a long-lasting infection. Chronic hepatitis D occurs when your body is not able to fight off the virus and the virus does not go away. People who have chronic hepatitis B and D develop complications more often and more quickly than people who have chronic hepatitis B alone.

How do hepatitis D and hepatitis B infections occur together?

Hepatitis D and hepatitis B infections may occur together as a coinfection or a superinfection. People can only become infected with hepatitis D when they also have hepatitis B.

Coinfection

A coinfection occurs when you get both hepatitis D and hepatitis B infections at the same time. Coinfections usually cause acute, or short-term, hepatitis D and B infections. Coinfections may cause severe acute hepatitis.

In most cases, people are able to recover from and fight off the acute hepatitis D and B infections and the viruses go away. However, in less than 5 percent of people with a coinfection, both infections become chronic and do not go away,

Superinfection

A superinfection occurs if you already have chronic hepatitis B and then become infected with hepatitis D. When you get a superinfection, you may have severe acute hepatitis symptoms.

Up to 90 percent of people with a superinfection are not able to fight off the hepatitis D virus, and develop chronic hepatitis D. As a result, these people will have both chronic hepatitis D and chronic hepatitis B.

How common is hepatitis D?

Hepatitis D is not common in the United States. Hepatitis D is more common in other parts of the world, including Eastern and Southern Europe; the Mediterranean region and Middle East; parts of Asia, including Mongolia; Central Africa; and the Amazon River basin in South America.

Who is more likely to have hepatitis D?

Hepatitis D infection occurs only in people who have hepatitis B. People are more likely to have hepatitis D in addition to hepatitis B if they

• are injection-drug users
• have lived with or had sex with someone who has hepatitis D
• are from an area of the world where hepatitis D is more common

What are the complications of acute hepatitis D?

In rare cases, acute hepatitis D can lead to acute liver failure, a condition in which the liver fails suddenly. Although acute liver failure is uncommon, hepatitis D and B infections are more likely to lead to acute liver failure than hepatitis B infection alone.

What are the complications of chronic hepatitis D?

Chronic hepatitis D may lead to cirrhosis, liver failure, and liver cancer. People who have chronic hepatitis B and D are more likely to develop these complications than people who have chronic hepatitis B alone. Early diagnosis and treatment of chronic hepatitis B and D can lower your chances of developing serious health problems.

Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to work normally. Scar tissue replaces healthy liver tissue, partly blocking the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to work. As cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months or years. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis B and chronic hepatitis D increases your chance of developing liver cancer. Your doctor may suggest blood tests and an ultrasound or other type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis D?

Most people with acute hepatitis D have symptoms, which may include

• feeling tired
• nausea and vomiting
• poor appetite
• pain over the liver, in the upper part of the abdomen
• darkening of the color of urine
• lightening of the color of stool
• yellowish tint to the whites of the eyes and skin, called jaundice

In contrast, most people with chronic hepatitis D have few symptoms until complications develop, which could be several years after they were infected. Some symptoms of cirrhosis include

• weakness and feeling tired
• weight loss
• swelling of the abdomen
• swelling of the ankles, called edema
• itching skin
• jaundice

What causes hepatitis D?

The hepatitis D virus causes hepatitis D. The hepatitis D virus spreads through contact with an infected person’s blood or other body fluids. Contact can occur by

• sharing drug needles or other drug materials with an infected person
• having unprotected sex with an infected person
• getting an accidental stick with a needle that was used on an infected person

The hepatitis D virus rarely spreads from mother to child during birth.

You can’t get hepatitis D from

• being coughed on or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

How do doctors diagnose hepatitis D?

Doctors diagnose hepatitis D based on your medical history, a physical exam, and blood tests. If you have hepatitis D, your doctor may perform tests to check your liver.

Medical history

Your doctor will ask about your symptoms and about factors that may make you more likely to get hepatitis D.

Physical exam

During a physical exam, your doctor will check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis D?

Doctors use blood tests to diagnose hepatitis D. Your doctor may order tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood test

Your doctor may order one or more blood tests to diagnose hepatitis D. A health care professional will take a blood sample from you and send the sample to a lab.

Additional tests

If you have chronic hepatitis D and hepatitis B, you could have liver damage. Your doctor may recommend tests to find out whether you have liver damage or how much liver damage you have—or to rule out other causes of liver disease. These tests may include

• blood tests.
• elastography, a special ultrasound that measures the stiffness of your liver.
• a liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver. A pathologist will examine the tissue under a microscope to look for signs of damage or disease.

Doctors typically use liver biopsy only if other tests don’t provide enough information about the liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis D?

Doctors may treat chronic hepatitis D with medicines called interferons, such as peginterferon alfa-2a (Pegasys). Researchers are studying new treatments for hepatitis D. In addition, medicines for hepatitis B may be needed. These are usually medicines taken once daily by mouth.

How do doctors treat the complications of hepatitis D?

If chronic hepatitis D leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have a greater chance of developing liver cancer. Your doctor may order an ultrasound or other type of imaging test to check for liver cancer.

If acute hepatitis D leads to acute liver failure, or if chronic hepatitis D leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis D infection?

If you do not have hepatitis B, you can prevent hepatitis D infection by taking steps to prevent hepatitis B infection, such as getting the hepatitis B vaccine. If you do not get hepatitis B, you cannot get hepatitis D.

If you already have hepatitis B, you can take steps to prevent hepatitis D infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• not sharing personal items such as toothbrushes, razors, or nail clippers

How can I prevent spreading hepatitis D to others?

If you have hepatitis D, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they aren’t infected, get the hepatitis B vaccine. Preventing hepatitis B will also prevent hepatitis D.

You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis D. Don’t donate blood or blood products, semen, organs, or tissue.

Is a hepatitis D vaccine available?

No vaccine for hepatitis D is currently available. The hepatitis B vaccine can prevent hepatitis D by preventing hepatitis B.

Eating, diet, and nutrition for hepatitis D

If you have hepatitis D, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis D appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis B

Hepatitis B is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids.

The hepatitis B virus can cause acute or chronic infection.

You can take steps to protect yourself from hepatitis B, including getting the hepatitis B vaccine. If you have hepatitis B, you can take steps to prevent spreading hepatitis B to others.

Acute hepatitis B

Acute hepatitis B is a short-term infection. If you have symptoms, they may last several weeks. In some cases, symptoms last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away. Most healthy adults and children older than 5 years old who have hepatitis B get better without treatment.⁵

Chronic hepatitis B

Chronic hepatitis B is a long-lasting infection. Chronic hepatitis B occurs when your body isn’t able to fight off the virus and the virus does not go away.

Your chances of developing chronic hepatitis B are greater if you are infected with the virus as a young child. About 90 percent of infants infected with hepatitis B develop a chronic infection. About 25 to 50 percent of children infected between the ages of 1 and 5 years develop chronic infections. However, among people infected during adulthood, only about 5 percent develop chronic hepatitis B.

How common is hepatitis B?

Researchers estimate that about 850,000 to 2.2 million people in the United States have chronic hepatitis B. In 1991, doctors began recommending that children in the United States receive the hepatitis B vaccine. Since then, the rate of new hepatitis B infections has gone down 82 percent. Asian Americans and African Americans have higher rates of chronic hepatitis B. Many people in the United States who have chronic hepatitis B were infected before the vaccine became available.

Chronic hepatitis B is more common in Africa, Asia, and parts of the Middle East, Eastern Europe, and South and Central America than it is in the United States. Chronic hepatitis B infection has been especially common in some parts of the world, including sub-Saharan Africa, parts of Asia, and the Pacific Islands. Use of the hepatitis B vaccine has helped lower infection rates in some of these areas.

Who is more likely to get hepatitis B?

People are more likely to get hepatitis B if they are born to a mother who has hepatitis B. The virus can spread from mother to child during birth. For this reason, people are more likely to have hepatitis B if they

• were born in a part of the world where hepatitis B is more common
• were born in the United States, didn’t receive the hepatitis B vaccine as an infant, and have parents who were born in an area where hepatitis B was especially common

In the United States, 47 to 95 percent of people with chronic hepatitis B were born outside the United States, in parts of the world where hepatitis B is more common.

People are also more likely to have hepatitis B if they

• are infected with HIV, because hepatitis B and HIV spread in similar ways
• have lived with or had sex with someone who has hepatitis B
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have sex with men
• are injection drug users
• work in a field, such as health care, in which they have contact with blood, needles, or body fluids at work
• have lived in or travel often to parts of the world where hepatitis B is common 
• have been on kidney dialysis
• are taking medicines that weaken the immune system, such as steroids or chemotherapy medicines
• have worked or lived in a prison
• had a blood transfusion or organ transplant before the mid-1980s

In the United States, sexual contact is the most common way that hepatitis B spreads among adults. Injection drug use is another important way that hepatitis B spreads. Since 2009, the number of acute hepatitis B infections has risen in some Appalachian states, especially among adults who inject drugs.

Should I be screened for hepatitis B?

Your doctor may recommend screening for hepatitis B if you

• are pregnant
• were born in an area of the world where chronic hepatitis B is more common
• didn’t receive the hepatitis B vaccine as an infant and have parents who were born in an area where chronic hepatitis B was especially common, such as sub-Saharan Africa, parts of Asia, or the Pacific Islands
• are HIV positive
• have injected drugs
• are a man who has sex with men
• have lived with or had sex with a person who has hepatitis B
• have an increased chance of infection due to other factors

Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B don’t have symptoms and don’t know they have hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.

What are the complications of hepatitis B?

Chronic hepatitis B may lead to complications, including cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of chronic hepatitis B can lower your chances of developing these complications.

Cirrhosis

Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. As cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis B increases your chance of developing liver cancer. Your doctor may suggest an ultrasound test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis B?

Some people infected with hepatitis B have no symptoms. Some people have symptoms of acute hepatitis B within 2 to 5 months after they come in contact with the virus. These symptoms may include

• dark yellow urine
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in your abdomen
• vomiting
• yellowish eyes and skin, called jaundice

Infants and children younger than age 5 typically don’t have symptoms of acute hepatitis B. Older children and adults are more likely to have symptoms.

If you have chronic hepatitis B, you may not have symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms.

If you have ever had hepatitis B, certain medicines may cause the hepatitis B virus to begin damaging your liver and causing symptoms. These medicines include

• immunosuppressants—medicines that weaken your immune system—which doctors prescribe to treat many diseases, including cancer, rheumatoid arthritis, and inflammatory bowel disease
• hepatitis C medicines

Your doctor may test you for hepatitis B before you begin taking these medicines, even if you have no hepatitis B symptoms.

What causes hepatitis B?

The hepatitis B virus causes hepatitis B. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids. Contact can occur by

• being born to a mother with hepatitis B
• having unprotected sex with an infected person
• sharing drug needles or other drug materials with an infected person
• getting an accidental stick with a needle that was used on an infected person
• being tattooed or pierced with tools that were used on an infected person and weren’t properly sterilized, or cleaned in a way that destroys all viruses and other microbes
• having contact with the blood or open sores of an infected person
• using an infected person’s razor, toothbrush, or nail clippers

You can’t get hepatitis B from

• being coughed on or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

A baby can’t get hepatitis B from breast milk.

How do doctors diagnose hepatitis B?

Doctors diagnose hepatitis B based on your medical and family history, a physical exam, and blood tests. If you have hepatitis B, your doctor may perform additional tests to check your liver.

Medical and family history

Your doctor will ask about your symptoms and about factors that may make you more likely to get hepatitis B. Your doctor may ask whether you have a family history of hepatitis B or liver cancer. Your doctor may also ask about other factors that could damage your liver, such as drinking alcohol

Physical exam

During a physical exam, your doctor will check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis B?

Doctors use blood tests to diagnose hepatitis B. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis B. A health care professional will take a blood sample from you and send the sample to a lab.

Certain blood tests can show whether you are infected with hepatitis B. If you are infected, your doctor may use other blood tests to find out

• if the infection is acute or chronic
• whether you have an increased chance of liver damage
• whether you need treatment

If you have chronic hepatitis B, your doctor will recommend testing your blood regularly because chronic hepatitis B can change over time. Even if the infection is not damaging your liver when you are first diagnosed, it may damage your liver in the future. Your doctor will use regular blood tests to check for signs of liver damage, find out if you need treatment, or see how you are responding to treatment.

Blood tests can also show whether you are immune to hepatitis B, meaning you can’t get hepatitis B. You may be immune if you got a vaccine or if you had an acute hepatitis B infection in the past and your body fought off the infection.

Additional tests

If you’ve had chronic hepatitis B a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may include

• blood tests
• transient elastography, a special ultrasound of your liver
• liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver

Doctors typically use liver biopsy only if other tests don’t provide enough information about a person’s liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis B?

Doctors typically don’t treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus. Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging your liver, your doctor may prescribe antiviral medicines to lower your chances of liver damage and complications.

Medicines that you take by mouth include

• entecavir (Baraclude)
• telbivudine  (Tyzeka)
• tenofovir alafenamide (Vemlidy)
• tenofovir disoproxil fumarate (Viread)

Medicines that doctors can give as shots include

• interferon alfa-2b  (Intron A)
• peginterferon alfa-2a  (Pegasys)

The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, you also should talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

How do doctors treat the complications of hepatitis B?

If chronic hepatitis B leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.

If chronic hepatitis B leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis B infection?

You can protect yourself from hepatitis B by getting the hepatitis B vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

Hepatitis B vaccine

The hepatitis B vaccine has been available since the 1980s and should be given to newborns, children, and teens in the United States. Adults who are more likely to be infected with hepatitis B should also get the vaccine. The hepatitis B vaccine is safe for pregnant women.

Doctors most often give the hepatitis B vaccine in three shots over 6 months. You must get all three shots to be fully protected.

If you are traveling to countries where hepatitis B is common and you haven’t received the hepatitis B vaccine, try to get all the shots before you go. If you don’t have time to get all the shots before you travel, get as many as you can. Even one shot may give you some protection against the virus.

Reduce your chance of infection

You can reduce your chance of hepatitis B infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools
• not sharing personal items such as toothbrushes, razors, or nail clippers
• using a latex or polyurethane condom during sex

Prevent infection after contact with the virus

If you think you have been in contact with the hepatitis B virus, see your doctor right away. A dose of the hepatitis B vaccine and, in some cases, a medicine called hepatitis B immune globulin (HBIG), may protect you from getting sick. You must get the vaccine dose and HBIG shortly after coming into contact with the virus, preferably within 24 hours.

How can I prevent spreading hepatitis B to others?

If you have hepatitis B, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they aren’t infected, get the hepatitis B vaccine. You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis B. Don’t donate blood or blood products, semen, organs, or tissue.

Prevent hepatitis B infections in newborns

If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.

Eating, diet, and nutrition for hepatitis B

If you have hepatitis B, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis B appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis A

Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.

Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. In rare cases, hepatitis A can be severe and lead to liver failure and the need for an emergency liver transplant to survive. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.

You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.

How common is hepatitis A?

In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked. However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness. Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.

Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.

Who is more likely to get hepatitis A?

People more likely to get hepatitis A are those who

• travel to developing countries
• have sex with an infected person
• are men who have sex with men
• use illegal drugs, including drugs that are not injected
• experience unstable housing or homelessness
• live with or care for someone who has hepatitis A
• live with or care for a child recently adopted from a country where hepatitis A is common

What are the complications of hepatitis A?

People typically recover from hepatitis A without complications. In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults older than age 50 and in people who have another liver disease.³

What are the symptoms of hepatitis A?

Some people have symptoms 2 to 7 weeks after they come in contact with the virus. People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include

• dark yellow urine
• diarrhea
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in the abdomen
• vomiting
• yellowish eyes and skin, called jaundice

Some people infected with hepatitis A have no symptoms, including many children younger than age 6. Older children and adults are more likely to have symptoms.

What causes hepatitis A?

The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by

• eating food made by an infected person who did not wash his or her hands after using the bathroom
• drinking untreated water or eating food washed in untreated water
• placing a finger or an object in your mouth that came into contact with an infected person’s stool
• having close personal contact with an infected person, such as through sex or caring for someone who is ill

You cannot get hepatitis A from

• being coughed on or sneezed on by an infected person
• sitting next to an infected person
• hugging an infected person

A baby cannot get hepatitis A from breast milk

How do doctors diagnose hepatitis A?

Doctors diagnose hepatitis A based on symptoms and a blood test. A health care professional will take a blood sample from you and send the sample to a lab. A blood test will detect antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies and show whether you have acute hepatitis A. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you are immune to hepatitis A, due to either past hepatitis A infection or hepatitis A vaccination.

How do doctors treat hepatitis A?

Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.

See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.

How can I protect myself from hepatitis A infection?

You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.

Hepatitis A vaccine

All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.

Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.

If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, talk with your doctor about how to prevent getting hepatitis A. If possible, try to get both shots of the hepatitis A vaccine before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.

Reduce your chance of infection

You can reduce your chance of getting hepatitis A by washing your hands thoroughly with soap and warm water for 15 to 30 seconds

• after using the toilet
• after changing diapers
• before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Prevent infection after contact with the virus

If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if

• you live with, have had sex with, or have had close contact with someone who has hepatitis A
• you shared illegal drugs with someone who had hepatitis A
• you ate food or drank water possibly containing the hepatitis A virus

You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.

How can I prevent spreading hepatitis A to others?

If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and don’t prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.

Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.

You are most contagious—able to spread the virus to others—during the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.

What should I eat and drink if I have hepatitis A?

If you have hepatitis A, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis A appeared first on Medika Life.

• Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts.
• Having colitis or certain liver diseases can increase the risk of bile duct cancer.
• Signs of bile duct cancer include jaundice and pain in the abdomen.
• Tests that examine the bile ducts and nearby organs are used to detect (find), diagnose, and stage bile duct cancer.
• Different procedures may be used to obtain a sample of tissue and diagnose bile duct cancer.
• Certain factors affect prognosis (chance of recovery) and treatment options.

Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts.

A network of tubes, called ducts, connects the liver, gallbladder, and small intestine. This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats during digestion). The small ducts come together to form the right and left hepatic ducts, which lead out of the liver.

The two ducts join outside the liver and form the common hepatic duct. The cystic duct connects the gallbladder to the common hepatic duct. Bile from the liver passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder.

When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine.Bile duct cancer is also called cholangiocarcinoma.

There are two types of bile duct cancer:

• Intrahepatic bile duct cancer: This type of cancer forms in the bile ducts inside the liver. Only a small number of bile duct cancers are intrahepatic. Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas.

Extrahepatic bile duct cancer: The extrahepatic bile duct is made up of the hilum region and the distal region. Cancer can form in either region:

• Perihilar bile duct cancer: This type of cancer is found in the hilum region, the area where the right and left bile ducts exit the liver and join to form the common hepatic duct. Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma.
• Distal extrahepatic bile duct cancer: This type of cancer is found in the distal region. The distal region is made up of the common bile duct which passes through the pancreas and ends in the small intestine. Distal extrahepatic bile duct cancer is also called extrahepatic cholangiocarcinoma.

Having colitis or certain liver diseases can increase the risk of bile duct cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.

Risk factors for bile duct cancer include the following conditions:

• Primary sclerosing cholangitis (a progressive disease in which the bile ducts become blocked by inflammation and scarring).
• Chronic ulcerative colitis.
• Cysts in the bile ducts (cysts block the flow of bile and can cause swollen bile ducts, inflammation, and infection).
• Infection with a Chinese liver fluke parasite.

Signs of bile duct cancer include jaundice and pain in the abdomen.

These and other signs and symptoms may be caused by bile duct cancer or by other conditions. Check with your doctor if you have any of the following:

• Jaundice (yellowing of the skin or whites of the eyes).
• Dark urine.
• Clay colored stool.
• Pain in the abdomen.
• Fever.
• Itchy skin.
• Nausea and vomiting.
• Weight loss for an unknown reason.

Tests that examine the bile ducts and nearby organs are used to detect (find), diagnose, and stage bile duct cancer.

Procedures that make pictures of the bile ducts and the nearby area help diagnose bile duct cancer and show how far the cancer has spread. The process used to find out if cancer cells have spread within and around the bile ducts or to distant parts of the body is called staging.

In order to plan treatment, it is important to know if the bile duct cancer can be removed by surgery. Tests and procedures to detect, diagnose, and stage bile duct cancer are usually done at the same time.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Liver function tests: A procedure in which a blood sample is checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver. A higher than normal amount of these substances can be a sign of liver disease that may be caused by bile duct cancer.
• Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
• Carcinoembryonic antigen (CEA) and CA 19-9 tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. Higher than normal levels of carcinoembryonic antigen (CEA) and CA 19-9 may mean there is bile duct cancer.
• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the abdomen, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• MRCP (magnetic resonance cholangiopancreatography): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body such as the liver, bile ducts, gallbladder, pancreas, and pancreatic duct.

Different procedures may be used to obtain a sample of tissue and diagnose bile duct cancer.

Cells and tissues are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for signs of cancer. Different procedures may be used to obtain the sample of cells and tissue. The type of procedure used depends on whether the patient is well enough to have surgery.

Types of biopsy procedures include the following:

• Laparoscopy: A surgical procedure to look at the organs inside the abdomen, such as the bile ducts and liver, to check for signs of cancer. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples to be checked for signs of cancer.
• Percutaneous transhepatic cholangiography (PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. A sample of tissue is removed and checked for signs of cancer. If the bile duct is blocked, a thin, flexible tube called a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be used when a patient cannot have surgery.
• Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes bile duct cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope is passed through the mouth and stomach and into the small intestine. Dye is injected through the endoscope (thin, tube-like instrument with a light and a lens for viewing) into the bile ducts and an x-ray is taken. A sample of tissue is removed and checked for signs of cancer. If the bile duct is blocked, a thin tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. This procedure may be used when a patient cannot have surgery.
• Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. A sample of tissue is removed and checked for signs of cancer. This procedure is also called endosonography.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• Whether the cancer is in the upper or lower part of the bile duct system.
• The stage of the cancer (whether it affects only the bile ducts or has spread to the liver, lymph nodes, or other places in the body).
• Whether the cancer has spread to nearby nerves or veins.
• Whether the cancer can be completely removed by surgery.
• Whether the patient has other conditions, such as primary sclerosing cholangitis.
• Whether the level of CA 19-9 is higher than normal.
• Whether the cancer has just been diagnosed or has recurred (come back).

Treatment options may also depend on the symptoms caused by the cancer. Bile duct cancer is usually found after it has spread and can rarely be completely removed by surgery. Palliative therapy may relieve symptoms and improve the patient’s quality of life.

Stages of Bile Duct Cancer

• The results of diagnostic and staging tests are used to find out if cancer cells have spread.
• There are three ways that cancer spreads in the body.
• Cancer may spread from where it began to other parts of the body.
• Stages are used to describe the different types of bile duct cancer.
  • Intrahepatic bile duct cancer
  • Perihilar bile duct cancer
  • Distal extrahepatic bile duct cancer
• The following groups are used to plan treatment:
  • Resectable (localized) bile duct cancer
  • Unresectable, metastatic, or recurrent bile duct cancer

The results of diagnostic and staging tests are used to find out if cancer cells have spread.

The process used to find out if cancer has spread to other parts of the body is called staging. For bile duct cancer, the information gathered from tests and procedures is used to plan treatment, including whether the tumor can be removed by surgery.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

• Tissue. The cancer spreads from where it began by growing into nearby areas.
• Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
• Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

• Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
• Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if bile duct cancer spreads to the liver, the cancer cells in the liver are actually bile duct cancer cells. The disease is metastatic bile duct cancer, not liver cancer.

Intrahepatic bile duct cancer

• Stage 0: In stage 0 intrahepatic bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the intrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
• Stage I: Stage I intrahepatic bile duct cancer is divided into stages IA and IB.

• Stage I: intrahepatic bile duct cancer
  • In stage IA, cancer has formed in an intrahepatic bile duct and the tumor is 5 centimeters or smaller.
  • In stage IB, cancer has formed in an intrahepatic bile duct and the tumor is larger than 5 centimeters.
• Stage II: In stage II intrahepatic bile duct cancer, either of the following is found:
  • the tumor has spread through the wall of an intrahepatic bile duct and into a blood vessel; or
  • more than one tumor has formed in the intrahepatic bile duct and may have spread into a blood vessel.
• Stage III: Stage III intrahepatic bile duct cancer is divided into stages IIIA and IIIB.
  • In stage IIIA, the tumor has spread through the capsule (outer lining) of the liver.
  • In stage IIIB, cancer has spread to organs or tissues near the liver, such as the duodenum, colon, stomach, common bile duct, abdominal wall, diaphragm, or the part of the vena cava behind the liver, or the cancer has spread to nearby lymph nodes.
• Stage IV: In stage IV intrahepatic bile duct cancer, cancer has spread to other parts of the body, such as the bone, lungs, distant lymph nodes, or tissue lining the wall of the abdomen and most organs in the abdomen.

Perihilar bile duct cancer

• Stage 0: In stage 0 perihilar bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the perihilar bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ or high-grade dysplasia.
• Stage I: In stage I perihilar bile duct cancer, cancer has formed in the innermost layer of tissue lining the perihilar bile duct and has spread into the muscle layer or fibrous tissue layer of the perihilar bile duct wall.
• Stage II: In stage II perihilar bile duct cancer, cancer has spread through the wall of the perihilar bile duct to nearby fatty tissue or to liver tissue.
• Stage III: Stage III perihilar bile duct cancer is divided into stages IIIA, IIIB, and IIIC.
  • Stage IIIA: cancer has spread to branches on one side of the hepatic artery or of the portal vein.
  • Stage IIIB: cancer has spread to one or more of the following:
    • the main part of the portal vein or its branches on both sides;
    • the common hepatic artery;
    • the right hepatic duct and the left branch of the hepatic artery or of the portal vein;
    • the left hepatic duct and the right branch of the hepatic artery or of the portal vein.
  • Stage IIIC: cancer has spread to 1 to 3 nearby lymph nodes.
• Stage IV: Stage IV perihilar bile duct cancer is divided into stages IVA and IVB.
  • Stage IVA: Cancer has spread to 4 or more nearby lymph nodes.
  • Stage IVB: Cancer has spread to other parts of the body, such as the liver, lung, bone, brain, skin, distant lymph nodes, or tissue lining the wall of the abdomen and most organs in the abdomen.

Distal extrahepatic bile duct cancer

• Stage 0: In stage 0 distal extrahepatic bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the distal extrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ or high-grade dysplasia.

• Stage I: In stage I distal extrahepatic bile duct cancer, cancer has formed and spread fewer than 5 millimeters into the wall of the distal extrahepatic bile duct.
• Stage II: Stage II distal extrahepatic bile duct cancer is divided into stages IIA and IIB.
  • Stage IIA: Cancer has spread:
    • fewer than 5 millimeters into the wall of the distal extrahepatic bile duct and has spread to 1 to 3 nearby lymph nodes; or
    • 5 to 12 millimeters into the wall of the distal extrahepatic bile duct.
  • Stage IIB: Cancer has spread 5 millimeters or more into the wall of the distal extrahepatic bile duct. Cancer may have spread to 1 to 3 nearby lymph nodes.
• Stage III: Stage III distal extrahepatic bile duct cancer is divided into stages IIIA and IIIB.
  • Stage IIIA: Cancer has spread into the wall of the distal extrahepatic bile duct and to 4 or more nearby lymph nodes.
  • Stage IIIB: Cancer has spread to the large vessels that carry blood to the organs in the abdomen. Cancer may have spread to 1 or more nearby lymph nodes.
• Stage IV: In stage IV distal extrahepatic bile duct cancer, cancer has spread to other parts of the body, such as the liver, lungs, or tissue lining the wall of the abdomen and most organs in the abdomen.

The following groups are used to plan treatment:

Resectable (localized) bile duct cancer

The cancer is in an area, such as the lower part of the common bile duct or perihilar area, where it can be removed completely by surgery.

Unresectable, metastatic, or recurrent bile duct cancer

Unresectable cancer cannot be removed completely by surgery. Most patients with bile duct cancer cannot have their cancer completely removed by surgery.

Metastasis is the spread of cancer from the primary site (place where it started) to other places in the body. Metastatic bile duct cancer may have spread to the liver, other parts of the abdominal cavity, or to distant parts of the body.

Recurrent bile duct cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the bile ducts, liver, or gallbladder. Less often, it may come back in distant parts of the body.

Treatment Option Overview

• There are different types of treatment for patients with bile duct cancer.
• Three types of standard treatment are used:
  • Surgery
  • Radiation therapy
  • Chemotherapy
• New types of treatment are being tested in clinical trials.
  • Liver transplant
• Treatment for bile duct cancer may cause side effects.
• Patients may want to think about taking part in a clinical trial.
• Patients can enter clinical trials before, during, or after starting their cancer treatment.
• Follow-up tests may be needed.

There are different types of treatment for patients with bile duct cancer.

Different types of treatments are available for patients with bile duct cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Three types of standard treatment are used:

Surgery

The following types of surgery are used to treat bile duct cancer:

• Removal of the bile duct: A surgical procedure to remove part of the bile duct if the tumor is small and in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope to see if there is cancer.
• Partial hepatectomy: A surgical procedure in which the part of the liver where cancer is found is removed. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some normal tissue around it.
• Whipple procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin.

After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back.

The following types of palliative surgery may be done to relieve symptoms caused by a blocked bile duct and improve quality of life:

• Biliary bypass: If cancer is blocking the bile duct and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct in the area before the blockage and sew it to the part of the bile duct that is past the blockage or to the small intestine to create a new pathway around the blocked area.
• Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains the bile into a bag on the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
• Percutaneous transhepatic biliary drainage: A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If the bile duct is blocked, a thin, flexible tube called a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

• External radiation therapy uses a machine outside the body to send radiation toward the cancer.
• Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

External and internal radiation therapy are used to treat bile duct cancer.

It is not yet known whether external radiation therapy helps in the treatment of resectable bile duct cancer. In unresectable, metastatic, or recurrent bile duct cancer, new ways to improve the effect of external radiation therapy on cancer cells are being studied:

• Hyperthermia therapy: A treatment in which body tissue is exposed to high temperatures to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs.
• Radiosensitizers: Drugs that make cancer cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more cancer cells.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer. It is not yet known whether systemic chemotherapy helps in the treatment of resectable bile duct cancer.

In unresectable, metastatic, or recurrent bile duct cancer, intra-arterial embolization is being studied. It is a procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells.

Treatments for Bile Duct Cancer

Intrahepatic Bile Duct Cancer

Resectable Intrahepatic Bile Duct Cancer

Treatment of resectable intrahepatic bile duct cancer may include:

• Surgery to remove the cancer, which may include partial hepatectomy. Embolization may be done before surgery.
• Surgery followed by chemotherapy and/or radiation therapy.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done.

Unresectable, Recurrent, or Metastatic Intrahepatic Bile Duct Cancer

Treatment of unresectable, recurrent, or metastatic intrahepatic bile duct cancer may include the following:

• Stent placement as palliative treatment to relieve symptoms and improve quality of life.
• External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.
• Chemotherapy.
• A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.

Perihilar Bile Duct Cancer

Resectable Perihilar Bile Duct Cancer

Treatment of resectable perihilar bile duct cancer may include the following:

• Surgery to remove the cancer, which may include partial hepatectomy.
• Stent placement or percutaneous transhepatic biliary drainage as palliative therapy, to relieve jaundice and other symptoms and improve the quality of life.
• Surgery followed by radiation therapy and/or chemotherapy.

Unresectable, Recurrent, or Metastatic Perihilar Bile Duct Cancer

Treatment of unresectable, recurrent, or metastatic perihilar bile duct cancer may include the following:

• Stent placement or biliary bypass as palliative treatment to relieve symptoms and improve the quality of life.
• External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.
• Chemotherapy.
• A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.
• A clinical trial of chemotherapy and radiation therapy followed by a liver transplant.

Distal Extrahepatic Bile Duct Cancer

Resectable Distal Extrahepatic Bile Duct Cancer

Treatment of resectable distal extrahepatic bile duct cancer may include the following:

• Surgery to remove the cancer, which may include a Whipple procedure.
• Stent placement or percutaneous transhepatic biliary drainage as palliative therapy, to relieve jaundice and other symptoms and improve the quality of life.
• Surgery followed by radiation therapy and/or chemotherapy.

Unresectable, Recurrent, or Metastatic Distal Extrahepatic Bile Duct Cancer

Treatment of unresectable, recurrent, or metastatic distal extrahepatic bile duct cancer may include the following:

• Stent placement or biliary bypass as palliative treatment to relieve symptoms and improve the quality of life.
• External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.
• Chemotherapy.
• A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.

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