World Hepatitis Day 2020

World Hepatitis Day occurs every year on 28th july. This is done to bring all the world together a common theme that is to create awareness among the people about this virus named hepatitis.

What Is Hepatitis ?

Hepatitis is commonly caused by an infective virus which refers to an inflammatory condition of the liver. Hence Infective hepatitis is otherwise known as viral hepatitis. We can say that this is the common cause of jaundice. Hepatitis may occur in two ways, these include autoimmune hepatitis and hepatitis. Whereas autoimmune hepatitis refers to an inflammatory condition of the liver and hepatitis is caused as a secondary result of medications, drugs, toxins, and alcohol.

Types

Hepatitis may occur due to six types of viruses. These are classified as following:

  1. Hepatitis A
  2. Hepatitis B
  3. Hepatitis C
  4. Hepatitis D
  5. Hepatitis E and
  6. Hepatitis G virus

Every type of individual different virus is responsible for each type of virally transmitted hepatitis. Among all these types hepatitis B and C are mostly becoming chronic among the people and dangerous too.

Hepatitis A and E are always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E sometimes can be dangerous in pregnant women.

Symptoms

The symptoms of infective hepatitis are:

  • Fever
  • Anorexia
  • Headache
  • Rapid Weight Loss
  • Loss Of Muscle Tone
  • Nausea
  • Vomiting and
  • Abnormal Discomfort

The colour of urine changes from dark yellow to red and feces become whitish. These may develop into jaundice. These symptoms may continue for 4-8 weeks. If we neglect viral hepatitis, it may lead to cirrhosis of liver.

As discussed before, acute hepatitis B, C, D and G may lead to chronic hepatitis. While hepatitis A and E are self limiting.

Dietary Management

Principle: A high protein, high carbohydrate, moderate fat is recommended. Small quantity of meals in regular time intervals are better to tolerate. Avoid overfeeding.

Energy:

In nasogastric feeding stage about 1000 kcals are supplied. In severe conditions 1,600 kcals to 2000 kcals are suggested.

Protein:

For the liver cells to regenerate an adequate supply of protein is needed. Protein requirement varies according to the severity of the disease. With severe jaundice, 40 g is recommended while in mild jaundice 60-80 g of protein is suggested. With hepatic coma, protein containing foods are withheld as liver cannot metabolise protein and only high carbohydrate containing foods are given.

Fats:

Fats make the food more palatable and increase calorie intake. During hepatic coma and coma, due to the severe liver failure, fats are not metabolized by the liver and so fat is restricted. In severe jaundice 20 g and in moderate jaundice 20-30 g of fat are recommended. In other cases of jaundice, fat needs to be restricted only if there is obstruction to bile flow that does not permit fat digestion and produce fatty diarrhoea.

Carbohydrates:

High carbohydrate content in the diet is essential to supply enough calorie so that tissue proteins are not broken down for energy purpose. When fever, nausea and vomiting are present, intravenous glucose is suggested. As soon as the patient can take oral feeds, intravenous feeding should be stopped and fruit juice, sugar, jaggery and honey are given not only to provide carbohydrate but also to supply adequate electrolytes.

Vitamins:

They are essential to regenerate liver cells. 500 mg of vitamin C, 10 mg of vitamin K and supplement of B complex are essential to meet the daily needs. If anorexia, nausea or vomiting is there, the vitamin may be given by injection.

Minerals:

If food is not taken orally then a careful watch should be kept on the serum sodium and potassium levels. Oral feeds of fruit juice, vegetable and meat soups with added salt, given orally or through a nasogastric tube help in maintaining the electrolyte balance. Normal serum level of sodium and potassium must be maintained through supplements.

Foods To Be Taken:

  1. Cereal porridge
  2. Soft Chapatis
  3. Rice
  4. Bread
  5. Skimmed Milk
  6. Tapioca
  7. Potato
  8. Yam
  9. Fruits and Fruit Juices
  10. Sugar and Jaggery
  11. Honey
  12. Biscuits
  13. Soft Custards without butter cream
  14. Non-stimulant Beverages

Foods To Be Avoided

  1. Pulses
  2. Beans
  3. Meat and Meat Soups
  4. Fish
  5. Chicken
  6. Egg
  7. Ghee, butter or oil Recipes
  8. Bakery Products
  9. Dried Fruits
  10. Nuts
  11. Spices
  12. Papads
  13. Chutneys
  14. Alcoholic Beverages
  15. Fried Items
  16. Cream
  17. Whole Milk

Intravenous Feeding

With severe nausea and vomiting it may not be possible to take oral feeds. Intravenous administration of 10 % glucose solution is recommended. It is better to do with a doctor suggestion.

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