Internal Medicine

Symptoms of hepatitis C.

introduction

Hepatitis C can manifest itself through various symptoms. Some sufferers feel a feeling of pressure in the right upper abdomen, with others, the skin turns yellowish (jaundice). Some people who have contracted hepatitis C even remain asymptomatic. The following article provides an overview of the most common symptoms of hepatitis C.

Frequency of symptoms in hepatitis C.

In the most common cases of hepatitis C there are no symptoms and 25% of those infected have mild to more severe symptoms of acute viral hepatitis. In 50-80% of the sick, there is a chronic course of hepatitis C. By definition, chronic hepatitis C is when the symptoms persist with virus detection for 6 months. In 20% of all those affected, this chronic infection sooner or later leads to cirrhosis of the liver (connective tissue remodeling of the liver with impairment of liver functions).

Symptoms of acute hepatitis C.

Jaundice (jaundice: yellowing of the skin and eyes)
itching
Feeling sick (fatigue, tiredness, fever)
Vomiting, nausea, abdominal pain, diarrhea
Loss of appetite
Pain in muscles and joints
Sense of pressure in the right upper abdomen
Weight loss
Sudden liver failure (very rare)

If a hepatitis C infection is suspected, the doctor should contact you Hepatitis C test be asked.

Symptoms of chronic hepatitis

Non-specific symptoms in particular are typical of hepatitis C. These include:

Exhaustion, tiredness
Decreased efficiency
Cognitive limitations (limitations in thinking ability)
Weight loss
Feeling of pressure or pain in the right upper abdomen

Jaundice as a symptom of hepatitis C.

Jaundice is also called jaundice in medical jargon. This is a yellowing of the skin, the mucous membrane and the sclera (white part of the eyes). The coloring comes about because the so-called bilirubin is deposited there.

The liver is an important organ in the metabolism of the human body. Among other things, the liver is used for detoxification and the disposal of waste products. With the help of bilirubin, fatty substances are disposed of from the body. If there is a disease of the liver, such as hepatitis C, this detoxification process is disturbed. The bilirubin is still produced, but it can no longer be excreted. That is why it is deposited in the body after a certain period of time. In the sclera the yellow color is usually noticeable from an amount of 2 mg / dl, in the skin a bilirubin value of over 3 mg / dl is necessary.

Jaundice is often accompanied by severe itching. In addition, the urine turns dark with simultaneous discoloration of the stool. This is because the bilirubin cannot be excreted in the stool. Instead, parts have to be washed out of the body through the urine.

Read more on the subject at: Jaundice

Right upper abdominal pain with hepatitis C.

The liver is in the upper right abdomen. There it lies immediately behind the ribs. This bony structure protects it well against mechanical influences from outside the body. In addition, the liver is encased in a solid capsule. On the one hand, this serves to protect the organ; on the other hand, the liver is connected to the surrounding organs and structures via this capsule.

Hepatitis C is an acute or chronic inflammation of the liver. Due to the inflammatory processes, the liver initially enlarges as water is stored (Liver edema). Changes in the liver itself cannot be perceived through pain because there are no corresponding nerve fibers there. Pain only occurs when the liver capsule is stretched. The capsule is connected to pain-conducting nerve fibers and can trigger the feeling of pain in the brain. In most cases, this pain cannot be assigned to a specific point, rather the pain is felt in the entire right upper abdomen.

Read our related topic: Upper abdominal pain on the right side

Loss of performance in hepatitis C.

The loss of performance primarily refers to the decline in physical performance. In hepatitis C, this is mainly due to the reduced metabolic performance of the liver.

For one thing, the foods that the person ingests are not properly metabolized. This means that significantly fewer nutrients enter the body. So at some point there will be a chronic lack of energy. Also, there is usually a lot of glycogen in the liver. Glycogen is the storage form of carbohydrates. If, for example, you need energy during physical exertion, the glycogen can be broken down from the liver and made available to the body. This mechanism is disturbed in hepatitis C, so that there is a lack of energy reserves.

Fatigue / exhaustion with hepatitis C.

The tiredness and exhaustion caused by hepatitis C are referred to as organic fatigue.In this case, the cause of this exhaustion is not a lack of sleep. Instead, a disease leads to the body needing more rest. The course of the symptom can be very different. Some are initially slightly tired and exhausted. This becomes stronger and stronger as the disease progresses. For other sufferers, the fatigue occurs suddenly. Both variants can lead to permanent physical weakness and fatigue.

When hepatitis C becomes chronic, the body has to constantly fight against inflammation. This requires an increased expenditure of energy and performance and this alone can lead to increased tiredness. At the same time, the liver can no longer fully perform its metabolic tasks. As a result, the body lacks nutrients that are needed for energy production. In addition, potentially toxic substances accumulate in the body. Both of these put additional strain on the body and cause fatigue. In the advanced stages of hepatitis C, toxins can be deposited directly in the brain. There they directly disrupt brain function and can cause tiredness or mental confusion (Encephalopathy) trigger.

Rash from hepatitis C.

Many liver diseases are associated with very unspecific symptoms, so that they are often difficult to diagnose, especially at the beginning. Therefore, one should pay attention even to small signs. These signs include in particular the so-called liver skin signs. They cannot be specifically assigned to a single liver disease, but raise the general suspicion of liver disease.
The liver skin signs can be felt in different parts of the body. Small vessel abnormalities in particular are common on the head and trunk. The superficial, very small blood vessels are stretched so that red, reticulated structures can be seen on the surface of the skin. The most common feature are the so-called Spider naevi. In the case of very advanced liver damage, larger, deeper vessels can also be affected. They form a so-called "caput medusae" around the navel.
There are also special liver skin signs on the hands and feet. The nails can enlarge, they are usually more rounded and bulge outwards. This phenomenon is known as watch glass nails. In addition, red rashes appear on the palms and soles of the feet.

Itching in hepatitis C.

With hepatitis C, as with many other liver diseases, severe itching (also called pruritus) can occur. The exact origin of this itching has not yet been clarified, but it is assumed that it is strongly linked to the deposition of bile acids in the skin.

The liver needs bile acids in order to eliminate fatty substances. If the liver is damaged, the bile acids can no longer be removed. They remain in the body and are deposited in the skin. There they probably irritate the nerve endings and lead to itching. Since the excretion of bile acids and bilirubin work in a similar way, itching occurs (Storage of bile acids) and jaundice (Storage of bilirubin) mostly together.

Cirrhosis of the liver in hepatitis C.

Liver cirrhosis is a secondary disease of hepatitis C. The chronic damage to the liver leads to the destruction of the liver cells. At the same time, the liver tissue is remodeled so that more and more fibrous structures are created. This remodeling means that a lot of connective tissue is created in the liver instead of actual liver cells. The function of the liver suffers due to the decrease in liver cells. Metabolic functions are restricted. On the one hand, this leads to waste products remaining in the body and causing jaundice and / or itching.

On the other hand, urgently needed materials are no longer sufficiently produced. This can affect blood clotting, for example. The coagulation factors come mainly from the liver. Therefore cirrhosis of the liver can lead to bleeding tendencies. Cirrhosis of the liver can also cause a disturbance of the blood circulation. Since the liver vessels are also remodeled with connective tissue, high blood pressure occurs especially in the liver. As a result, the blood backs up into the organs in front of it: The spleen enlarges and water can be retained in the abdomen (= Ascites) come.

Liver cirrhosis is ultimately irreversible (irreversible) and inevitably leads to liver failure. In addition, the risk of developing liver cancer in cirrhosis is significantly higher. In rare individual cases (approx. 1%), life-threatening fulminant liver destruction with liver failure can occur, so that the affected person can often only be helped by a liver transplant. Such a severe course is observed especially in patients who already have an immune system suppressing (immunosuppressive) Have illness.

Read more on the subject at: Symptoms of cirrhosis of the liver

Liver cancer associated with hepatitis C.

Liver cancer is a disease that usually arises from cirrhosis of the liver or hepatitis. In the case of hepatitis C, the liver is initially inflamed. The inflammatory processes eventually lead to liver cirrhosis, from which hepatocellular carcinoma (liver cancer) develops. An important co-factor in the development of liver cirrhosis and liver cancer is alcohol addiction (Alcohol abuse) and a second infection with the hepatitis B virus.

The symptoms in liver cancer are the same as in liver cirrhosis. So far, only the surgical removal of the affected liver area has been proven to be an effective therapy. If this is not possible, a liver transplant can also be considered under certain circumstances. Radiation therapy and the local injection of chemotherapeutic agents are also sometimes used.

Read more on the subject at: Liver cancer symptoms