Inflammation of the liver caused by certain substances a person is exposed to is called toxic hepatitis. The primary causes of toxic hepatitis include alcohol, chemicals, drugs, or nutritional supplements.
While the condition may develop within hours or days after exposure to toxins, it may happen after continuous exposure to toxins for months. Usually, the symptoms disappear when the exposure to toxins ends. However, people who experience this condition for long periods may experience permanent damage to the liver including cirrhosis, liver failure, and others.
Symptoms
In most cases, mild forms of toxic hepatitis do not cause symptoms and may be detected with a blood test only but when they occur may include the following ones. For example:
- Fatigue (extreme tiredness)
- Loss of appetite
- Rash
- Fever
- Weight loss
- Dark urine
- Belly pain
- Itching
- Jaundice (yellowing of the skin and eyes)
If any of the previous symptoms bother you, do not hesitate to visit a doctor. Furthermore, seek emergency care if you experience any of the following symptoms. For example:
- Lack of appetite
- Upper belly (abdominal) pain
- Nausea
- Vomiting
- Coma
Misuse of pain relievers (such as Acetaminophen) may lead to liver failure and cause previous symptoms.
Causes
This health problem often happens when the inflammation of the liver occurs due to exposure to toxins. Some people may develop toxic hepatitis due to overuse of over-the-counter (OTC) medicines.
In normal circumstances, the liver breaks and removes medicines and other chemicals from the bloodstream. Damage to the liver may occur due to certain byproducts that are made when the liver breaks the chemicals. However, the liver can regenerate itself but continuous exposure to toxins and chemicals may cause serious or even irreversible damage to this organ. Check below the most common causes of toxic hepatitis:
- Alcohol – People who misuse alcoholic beverages may experience this condition and even liver failure.
- Nonprescription pain relievers – These include Aspirin, Ibuprofen, Naproxen sodium, Acetaminophen, and others. The risk of damage to the liver increases if these pain relievers are taken along with alcohol.
- Prescription medicines – There are some drugs linked with serious damage to the liver. These include statins (used to treat high cholesterol), Amoxicillin-clavulanate, Phenytoin, Azathioprine, Niacin, Ketoconazole, some antiviral medications, and anabolic steroids.
- Supplements and herbs – There are some herbs that are considered dangerous for the liver. For example aloe vera, black cohosh, cascara, chaparral, comfrey, kava, ephedra, among others. Keep away supplements and herbs from the children because they may think these are candies and take high doses.
- Industrial chemicals – The most common substances that may cause liver damage are dry cleaning solvent carbon tetrachloride, vinyl chloride (used to produce plastics), polychlorinated biphenyls (such as herbicide paraquat), and others.
Risk Factors
Healthcare providers identified some factors that may elevate your risk of developing toxic hepatitis. Check some of them below:
- Misuse of OTC pain relievers – Those who take pain relievers for a prolonged time are more prone to experience liver damage.
- Liver disease – An increased risk of negative effects caused by toxins have people with liver disease including cirrhosis, nonalcoholic fatty liver disease, and others.
- Hepatitis – The risk of developing toxic hepatitis increases in people with chronic infections (such as hepatitis B or hepatitis C).
- Aging – The liver has reduced function in older people, which makes them more prone to develop this condition.
- Alcohol misuse – Heavy alcohol drinking may cause damage to the liver.
- Sex – Women are more likely to develop toxic hepatitis because they metabolize toxins more slowly than men.
- Genetic mutations – There are some genetic syndromes that negatively affect the liver enzymes production. These enzymes are involved in the process of breaking down toxins and other chemicals. As a result, the risk of developing toxic hepatitis increases.
- Industrial toxins
What Are The Potential Complications of Toxic Hepatitis?
People who experience this condition for long periods may experience some complications. These include cirrhosis (permanent scarring of the liver tissue), liver failure, and others. The only way to treat liver failure is to replace the liver with a healthy one from a donor.
How to Prevent Toxic Hepatitis?
It is not possible always to prevent toxic hepatitis because people do not know how they will react to certain substances (such as medicines). However, the following tips may help reduce the risk of developing this condition. Examples include:
- Limit medicines – It is advised to administer prescription and nonprescription medicines exactly as prescribed by your doctor to prevent unpleasant outcomes such as damage to the liver.
- Take carefully herbs and supplements – Some people may think that herbs and supplements are harmless but they should be taken cautiously because may cause damage to the liver.
- Avoid combination of alcohol with medicines – For instance, if you take Acetaminophen do not drink alcoholic beverages because it increases the risk of developing toxic hepatitis and damage to the liver.
- Protect yourself against chemicals and other toxic substances
- Do not let medicines, herbs, and supplements out of reach of children because they may mistake them for candies.
Diagnosis
Doctors usually perform the following procedures and tests to diagnose toxic hepatitis. For example:
- Physical examination – During this examination, your doctor will evaluate your medical history and will ask some questions about your symptoms. They also will check you for abnormalities linked with toxic hepatitis.
- Blood tests – These tests are performed to check levels of liver enzymes. High levels of these enzymes help doctors understand how well your liver function.
- Imaging tests – Physicians may perform imaging tests to get detailed images of your liver. They usually use ultrasound, CT (computerized tomography) scans, MRI (magnetic resonance imaging) scans, and magnetic and transient elastography (sometimes).
- Biopsy – This test is performed by using a needle to get a small sample of the liver and examine it under a microscope. A liver biopsy can confirm toxic hepatitis and exclude other conditions that cause similar symptoms.
Treatment
The treatment depends on the exact cause that damages the liver. Check below some treatment options for people with toxic hepatitis:
- Supportive care – Those who suffer from severe symptoms are more likely to get supportive therapy that includes intravenous fluids in the hospital and medicines to relieve pain and other symptoms.
- Medicines – Sometimes, doctors may prescribe some medicines to reverse damage caused by prolonged use of OTC pain relievers (such as Acetaminophen). This medicine is called Acetylcysteine.
- Emergency care – This treatment is advised for people who overdose on medicines (such as Acetaminophen or other nonprescription pain relievers). It involves medicines to reduce the toxic effects caused by painkillers.
- Liver transplant – This is a surgery that replaces the damaged liver with a healthy one. Healthcare professionals usually recommend this treatment for people with liver failure.
Frequently Asked Questions
What are the most common symptoms of toxic hepatitis?
These include:
- Yellowing of the skin and eyes (also known as jaundice)
- Lack of appetite, which may lead to malnutrition
- Fever
- Dark urine
- Itching
- Nausea
- Vomiting
- Abdominal pain
- Extreme tiredness
- Weakness
If any of the previous symptoms occur, immediately contact your doctor.
Can toxic hepatitis be cured?
In most cases, this condition is successfully treated with medicines and other procedures. For more details, consult with your physician.
What can be mistaken for toxic hepatitis?
There are some conditions that can be mistaken for this liver condition. For example:
- Drug-induced liver damage (in such cases, the symptoms are very similar to other diseases including cirrhosis, acute viral hepatitis, gallstone disease, and others)
- Nonalcoholic steatohepatitis (NASH)
- Wilson disease
- Cirrhosis
- Bile duct obstruction
- Viral hepatitis
Ask your healthcare provider if you have any other questions.
