Hepatitis refers to inflammation of the liver. Toxic hepatitis is inflammation of the liver resulting from an insult to the liver cells caused from toxic chemicals. These chemicals range from common household products such as washing detergents, liquid solvents to medications including over the counter, prescription and herbal medicines.
Liver: The major organ responsible for metabolism of toxic compounds
The liver is highly susceptible to injury from external chemicals due to the fact that it is taxed with the work of metabolizing such compounds into less toxic compounds for safe excretion from the body.
Some intermediate products in the process of metabolism can be very toxic to the liver cells. Damage to the liver cells elicit an inflammatory response from the body’s immune system resulting in hepatitis. Certain circumstances predispose a person to toxic hepatitis such as a liver damaged by excessive alcohol consumption.
Possible causes and risk factors of toxic hepatitis
Some chemicals such as paracetamol and many herbal medicines are outright damaging to the liver. However, others only cause liver damage in a minority of the population. This has been attributed to genetics. It is thought that some individuals have defective enzymatic pathways that are involved in the breakdown of a given chemical hence prolonging its damaging effects in the body.
Signs and Symptoms of toxic hepatitis
Toxic hepatitis has a similar clinical presentation to other types of hepatitis such as viral hepatitis. Abdominal discomfort, pain in the right upper part of the abdomen, nausea and vomiting, fever and jaundice are the common clinical complaints present in a patient with toxic hepatitis. The physician may find an enlarged liver during clinical examination and deranged liver enzymes during laboratory investigation. An ultrasound of the liver may be done so as to visualize the state of the liver. A biopsy of the liver is usually not indicated.
Diagnosing toxic hepatitis
There is no specific test that exists to prove the diagnosis of toxic hepatitis. Laboratory investigations are done to rule out other common causes of hepatitis such as hepatitis viruses. The doctor will rely heavily on history elicited from the patient to make a diagnosis. Close attention is given to any medications ingested in the recent past, any chemical exposures that may have occurred at home or at the workplace. It is important for the patient to give a clear and concise history to enable the doctor to pinpoint the cause of the toxicity. It is better to give information and let the doctor decide its usefulness rather than withhold and end up being misdiagnosed.
Possible complications of toxic hepatitis
Inflammation of the liver may result in scarring during the healing process. Scar tissue limits the capability of the liver to perform at its maximum capacity. Eventually this may result in liver failure.
Treating toxic hepatitis
The mainstay of therapy of toxic hepatitis is withdrawal of the offending agent and ensuring that further exposure is avoided. The liver regenerates and repairs itself and function is restored to normal. Even if damage to the liver is long standing, there is still potential of normal liver function being restored. No other form of therapy is indicated.
Preventing toxic hepatitis
Prevention of toxic hepatitis is simple; just avoid the offending chemical. With the recent widespread use of herbal medications and supplements, it is important to ensure that the product is approved by the relevant food and drug safety authorities.