Jaundice vs Hepatitis
Jaundice and hepatitis are two terms commonly encountered in internal medical practice. Even though jaundice and hepatitis are used in the same sentence and used to identify the same patient in a ward round they do not mean the same. This article will talk about both jaundice and hepatitis in detail, highlighting clinical features, symptoms, causes, investigation and diagnosis, prognosis, the course of treatment, and also the difference between jaundice and hepatitis.
The term hepatitis means inflammation of the liver. It may be due to many causes. The commonest cause of liver inflammation is the viral infection. Hepatitis A, B, C, D, E are well known viruses causing liver inflammation. Bacteria, parasites, and alcohol are other known causes of liver inflammation. Liver can inflame without any identifiable cause. Non-alcoholic steato-hepatitis is such a phenomenon.
Hepatitis A is a food and water borne infection. Children get this infection easily. Virus enters the body in food or water and incubates for 3 to 6 weeks before causing prodromal symptoms like fever, ill health, lethargy, body ache, joint pains. During the active phase, yellowish discoloration of eyes develops with liver, spleen and lymph node enlargement. Treatment is supportive. Food hygiene, strict individual use of crockery to limit spread, fluid intake, maintaining good renal function, and avoiding alcohol are important steps. There are various preventive methods. Passive immunization with immunoglobulin provides protection for 3 months and is recommended for travelers. Hepatitis A is self-limiting but fulminant hepatitis is a rare possibility. Chronic hepatitis does not occur with hepatitis A.
Hepatitis B is a blood borne infection. Blood transfusion, unprotected sexual contact, hemodialysis, intravenous drug abuse are known risk factors. After the virus enters the body, it remains dormant for 1 to 6 months before giving rise to prodromal symptoms like fever and lethargy. Extra-hepatic features are more common in hepatitis B. During the acute stage liver and spleen enlargement occur. Complications include carrier state, relapse, chronic hepatitis, cirrhosis, superinfection with hepatitis D, glomerulonephritis, and hepatocellular carcinoma. Treatment is supportive. Alcohol avoidance is essential.
Hepatitis C is a RNA virus. It is also blood borne. Intravenous drug abuse, hemodialysis, blood transfusion, and sexual contact increase the risk of contracting the disease. Chronic hepatitis is very common after hepatitis C infection.
In addition, hepatitis D only exists with hepatitis B and increases the risk of hepatocellular carcinoma. Hepatitis E is similar to hepatitis A and causes a high degree of mortality in pregnancy. Bacteria from the gastrointestinal system can ascend up along the bile ducts causing acute cholangitis. This can lead to acute bacterial hepatitis in immune-compromised individuals.
Alcoholic hepatitis is a chronic inflammation of the liver due to regular excessive consumption of alcohol. Alcoholic hepatitis can progress into acute liver failure, if alcohol consumption is not stopped and if the damage left untreated. Idiopathic inflammation of the liver can cause NASH.
Inflammation or other causes of damage to the liver may result in leakage of conjugated or unconjugated bilirubin into the blood stream and cause yellowish discoloration of skin, nails and eyes. This is called jaundice. Jaundice is a clinical sign detected by the doctor during clinical examination.
What is the difference between Jaundice and Hepatitis?
• Hepatitis is a disease while jaundice is a clinical feature.
• Hepatitis is inflammation of the liver.
• Jaundice is the yellowish discoloration of eyes, skin and nails.