Learn how the new prebiotic soluble fibers benefit bowel health and many GI disorders
The Liver
The liver is the largest organ in the body. It is found high in the
right upper abdomen, behind the ribs. It is a very complex organ and
has many functions. They include:
- Storing energy in the form of sugar (glucose)
- Storing vitamins, iron, and other minerals
- Making proteins, including blood clotting factors, to keep the body healthy and help it grow
- Processing worn out red blood cells
- Making bile which is needed for food digestion
- Metabolizing or breaking down many medications and alcohol
- Killing germs that enter the body through the intestine
The liver shoulders a heavy work load for the body, and almost never complains. It even has a remarkable power to regenerate itself. Still, it should not be taken for granted. The liver is subject to illnesses that can lead to permanent damage. One example is autoimmune hepatitis, a condition in which the body fights against its own liver.
What is Hepatitis?
When cells in the body are injured by such things as chemicals or
infection, the area that is wounded becomes inflamed. Hepatitis is
inflammation of the liver, which in turn causes damage to individual
liver cells. It is most often caused by viral infection. However, it
can also be caused by alcohol, certain drugs, chemicals or poisons,
or other diseases.
Hepatitis may be either acute or chronic. In acute hepatitis, the inflammation develops quickly and lasts only a short period of time. The patient usually recovers completely, but it can take up to several months. Occasionally, a person fails to recover fully, and the hepatitis becomes chronic. In other words, it continues at a smoldering pace. Chronic hepatitis can develop over a number of years without the patient ever having acute hepatitis or even feeling sick. As the liver repairs itself, fibrous tissue develops, much like a scar forms after a cut or injury to the skin heals. Advanced scarring of the liver is called cirrhosis. Over time, cirrhosis irreversibly damages the liver, eventually ending in liver failure.
What is Autoimmune Hepatitis?
The immune system consists of different types of white blood cells
that help to fight infections. Some of these cells produce
antibodies. Antibodies act as warriors. They defend the body by
destroying bacteria, viruses and other foreign materials. There are
different kinds of antibodies, each fighting against a specific
foreign substance. Thus, the immune system protects the body against
outside invasion by germs. But sometimes, the immune system
mistakenly recognizes the body's own organs as foreign. It can
develop antibodies against these organs. This can cause various
illnesses, such as rheumatoid arthritis and lupus. These illnesses
are called autoimmune disorders because the body is literally
fighting against itself.
When the immune system attacks the liver in this way, it is called autoimmune hepatitis. Autoimmune hepatitis is not caused by a virus or bacteria, so it is not a contagious disease. Exactly what triggers the immune system against the liver is unknown. The inflammation is usually chronic, and without treatment it can cause serious injury to the liver.
Symptoms
and Diagnosis
Autoimmune hepatitis occurs mainly in adolescent or young adult women
(about 70% of the time). However, there have also been cases of older
women and men developing the disease. Early symptoms are the same as
those for most types of hepatitis: fatigue, abdominal discomfort, and
aching joints. These early symptoms are sometimes mild and mistaken
for other illnesses, such as the flu. So, it is wise for people with
these symptoms to consult a physician. When autoimmune hepatitis
progresses to severe cirrhosis, there may be jaundice (yellow
coloring to the skin and eyes), marked swelling of the abdomen from
fluid inside the abdomen, intestinal bleeding, or mental confusion.
The physician often suspects autoimmune hepatitis from the patient's medical history. For example, patients with other autoimmune diseases -- thyroiditis, ulcerative colitis, diabetes mellitus, vitiligo (a patchy loss of pigment in the skin), Sjogren's syndrome (a condition causing dry eyes and mouth) -- are more likely to have autoimmune hepatitis. A definite diagnosis of autoimmune hepatitis is obtained with blood testing. Two antibodies that may develop in the blood are the ANA (antinuclear antibody) and the SMA (smooth muscle antibody). Also, a certain type of blood protein called gamma globulin is frequently elevated. A liver biopsy is always needed to determine how much inflammation and scarring has developed. This exam is performed under local anesthesia. A slender needle is inserted through the right lower chest to extract a small piece of liver tissue. The tissue is then examined under a microscope. This information allows the physician to tailor the treatment to each individual patient.
Treatment
The treatment of autoimmune hepatitis is aimed at curbing the
autoimmune response, and therefore the damage to liver cells. It is
most effective when begun at an early stage of the disease. In most
cases, the initial treatment is with a cortisone drug, usually
prednisone (trade names: Deltasone, Orasone). Sometimes a second
drug, such as Imuran, may be added. The medication is taken daily,
usually for at least a year. The physician may attempt to taper and
stop treatment if the patient is doing well. However, a relapse often
occurs, and the medication then must be restarted and taken
indefinitely. There may be side effects with prednisone, such as
swelling of the face, retention of fluid, and weight gain. Long-term
treatment with these drugs may also cause loss of bone. This can lead
to osteoporosis, or even severe damage to joints such as the shoulder
and knee. Therefore, the physician uses the lowest dosage possible to
decrease symptoms, improve liver tests, and slow liver damage.
Unfortunately, a few patients do not respond well to treatment, especially if the disease is diagnosed late and cirrhosis is well advanced. When the patient no longer responds to treatment with medication and liver damage is severe, a liver transplant is considered.
Liver Transplantation
Liver transplantation is now an accepted form of treatment for
chronic, severe liver disease. Advances in surgical techniques and
the use of new drugs to suppress rejection have dramatically improved
the success rate of transplantation. The outcome for patients with
autoimmune hepatitis is excellent. Survival rates for this condition
at transplant centers are well over 90 percent, with a good quality
of life after recovery.
Summary
Autoimmune hepatitis is inflammation of the liver. The inflammation
is a result of the immune system developing antibodies against the
liver. It is not a contagious disease, but it is a serious chronic
disease that can lead to irreversible cirrhosis, and eventually to
liver failure. However, the outlook for patients with autoimmune
hepatitis is generally very favorable. With early diagnosis, drug
treatment to prevent serious liver damage is effective in most
patients. For those few patients who do not respond to other
treatment, successful liver transplantation is now a standard form of
therapy when liver damage is severe.
Learn how the new prebiotic soluble fibers benefit bowel health and many GI disorders
Related Diseases
Autoimmune
Hepatitis | Hepatitis
B | Hepatitis
C | Cirrhosis
Related Procedures
Liver
Biopsy | Liver
Transplant
This material does not cover all information and is not intended as a subsitute for professional care. Please consult with your physician on any matters regarding your health.
© Copyright Chek Med Systems®, Inc., All Rights Reserved.
Patient Ed
| Diseases
| Procedures
| Diets
| Drugs
| Endoscopy Images
| Links
Jackson Siegelbaum Gastroenterology
| 423 North 21st Street, Suite 100 | 2626 North 3rd Street., Suite 3A | |
| Camp Hill, PA 17011 | Harrisburg, PA 17110 | |
| (717) 761-0930 | Phone: (717) 238-3111 |
Fax: (717) 761-0465
Email: contact@gicare.com
Web: gicare.com
© Copyright 2006 Jackson Siegelbaum Gastroenterology. All Rights Reserved.