This chronic condition is characterized by inflammation of the liver and necrosis; it occurs when the immune systems attacks the cells of the liver, it can lead to liver cirrhosis and it can also lead to fulminant hepatitis in rare cases when left untreated, for now, it has no cure. Autoimmune hepatitis was formerly known as Lupoid hepatitis.
The exact cause of autoimmune hepatitis is still unknown but genetics and environmental factors have a role to play in triggering this disease. If this condition is diagnosed early, drugs are given that suppress the immune system but in some cases where the condition is not responding to treatment or the liver has been severely damaged, a liver transplant is done.
Causes of autoimmune hepatitis
This condition which occurs when the immune system attacks and targets the liver instead of pathogens has no known cause but possible reasons for this maybe exposure to toxins, viruses or drugs like minocycline, nitrofurantoin, statins and hydralazine; and researchers think it can be caused by interaction of genes controlling the functions of the immune system.
Types of autoimmune hepatitis
Two main types have been identified and they are:
Type 1: This is the most common type of this disease and it can occur at any age; it mostly comes along with other autoimmune disorders like celiac disease, rheumatoid arthritis or ulcerative colitis. This is the most common form of autoimmune hepatitis in North America and 70% of the patients are females.
Type 2: This type is usually common in children and young people (2 to 14 years of age) but adults can also develop it; other autoimmune diseases may accompany it.
Signs and symptoms
This disease shows symptoms which can be minor, moderate or severe; it may come on suddenly in some, signs and symptoms includes: fatigue, abdominal pain and discomfort, loss of menstruation in women, loss of appetite, joint pains, pale coloured stool, fatigue, itching due to accumulation of bile, skin rashes, jaundice (yellowing of the skin and eyes), abdominal distention (swelling), an enlarged liver and spider angiomas (abnormal blood vessels on the skin).
How is autoimmune hepatitis diagnosed?
- A blood test can be used to diagnose this condition: a sample of blood is taken from the patient and this sample is tested for the presence of antibodies that distinguish this type of hepatitis from other viral hepatitis and disorders that share the same symptoms. Antibody test can also help the doctor know which type of autoimmune hepatitis a patient have.
- A liver biopsy is carried out to confirm the diagnosis, determine the degree of damage and the type of damage done to the liver. A small amount of liver tissue is removed during this procedure using a thin needle; this needle is passed into your liver through the skin and the sample taken by using ultrasound to guide the biopsy, this sample is analyzed in the laboratory. Some people avoid liver biopsy because of its side effects; they claim it increases the levels of the enzymes in the liver and it takes years to come down, so in this case you can tell your doctor that you want a fibro scan instead.
What are the health complications of autoimmune hepatitis?
Untreated autoimmune hepatitis can lead to irreversible scarring of the liver; irreversible scarring or cirrhosis of the liver occurs when the healthy tissues of the liver are replaced with scar tissues, this blocks the normal flow of blood in the liver, this condition liver cirrhosis will lead to:
Esophageal varices: This condition can lead to enlarged veins in the esophagus; this occurs when the portal vein is blocked and blood is forced to return into other blood vessels, especially those in the stomach and esophagus. The blood vessels in the stomach and esophagus have thin walls and when they get filled with blood beyond what they can carry, they burst and bleed; this can lead to massive bleeding in the stomach or esophagus. This is a life threatening condition that requires immediate medical attention.
Liver cancer: Cirrhosis increases the risk of cancer and some patients with cirrhosis of the liver end up having liver cancer.
Ascites: This condition can lead to retention of fluids in the abdomen; it causes uncomfortable symptoms and obstructs breathing. Fluid in the abdomen is usually a sign of advanced liver cirrhosis.
Liver failure: This condition can lead to severe damage of the liver which becomes permanent or irreversible; the liver is unable to function properly and a liver transplant is the only option that can save the patient.
What are the risk factors for autoimmune diseases?
Sex: Females are mostly affected by this condition; men can be affected also but it is more common in women.
Heredity: Research evidence suggests that there is an increased risk if this disease runs in the family.
A History of Certain Infections: Certain infections like measles, herpes simplex or Epstein-Barr virus can lead to autoimmune hepatitis; this disease has also been linked with Hepatitis A, B and C infections.
Having an Autoimmune Disease: Autoimmune diseases raises the risk of this condition; autoimmune diseases like celiac disease, rheumatoid arthritis or hypothyroidism can likely develop or lead to autoimmune hepatitis.
How is this condition treated?
Treatment works best and is most effective when this condition is diagnosed early; the disease can be controlled easily, it can be stopped from getting worse and it may even reverse some damages to the liver.
Treatment for the two types of autoimmune hepatitis is to stop or slow the immune system’s attack on the liver; this will slow the progression of the diseases, medications will be given and these drugs lower the activity of the immune system.
Common drugs given are prednisone and azathioprine; prednisone reduces the activities of the immune system and also reduces swellings while azathioprine suppress the immune system, prevents it from making autoantibodies and block immune reactions that leads to inflammation; sometimes they are given together.
Long term use of prednisone can cause severe side effects like osteoporosis, diabetes, high blood pressure, acne, thinning of the hair and skin, anxiety, confusion, broken bone, obesity, cataracts and glaucoma. Most people are put on this drug for at least 18 to 24 months and many are on it for life. The disease subsides but returns when the drug is stopped.
To reduce the risk of side effects; doctors prescribe prednisone at a high dose during the first month of treatment, then gradually reduce the dose over the next several months until they get to the lowest possible dose that can control the disease. Azathioprine is usually added to avoid the side effects of prednisone.
Side effects of azathioprine are low levels of white blood cells, inflammation of the pancreas, skin rash, liver damage, vomiting and nausea. A patient taking this drug is put on routine white blood cells count to monitor their white blood cell counts. If the side effects are so severe, these drugs are discontinued especially in those who already have cirrhosis.
Liver transplant: In cases where the condition was diagnosed late and severe irreversible damages have been done to the liver, a transplant is used to correct it. A transplant can also be carried out when medications are not working or the liver has failed.
This procedure involves removing and replacing the diseased liver with that from a healthy donour. When the donour is still alive; a portion of the liver is cut and both livers begin regenerating new cells almost immediately. In some cases; livers are gotten from deceased organ donours.
The patient is made to fast for 8 hours before the transplant and is hospitalized for one to two weeks after the transplant to make sure the transplant is functioning properly. The patient will be monitored for bleeding, signs of liver rejection and infection.
How can this condition be prevented?
Prevention is the best treatment for this and research has shown that some things and lifestyle can trigger this condition and they include:
Alcohol: Alcohol on its own is a toxin and it is poisonous to the liver; when the liver processes it, it brings out more toxins as by-products. So avoiding or reducing your intake of Alcohol if you are a heavy drinker is a sure way of preventing this disease.
Smoking: Smoking and tobacco smoke is dangerous to the health of every one; it causes liver damage and it can increase the severity of damages done to the liver. Do not expose yourself to cigarette smoke if you don’t smoke.
Diet: Poor diet has been linked with autoimmune hepatitis; so replace anything not healthy in your diet with nutrient rich and healthy natural foods, fruits and vegetables that will empower your immune system, regulate its functions and help it to function properly. Also eat lots of anti-inflammatory foods.
Exercise: A sedentary lifestyle increases the risk for this condition and it can hasten the progression in those who already have the disease. Mild and gentle exercise like walking regularly will benefit the body immensely.
Practice regular washing of hands: Some viruses, bacteria and other parasites have been linked with autoimmune hepatitis; high levels of ammonia in the body results from waste products of bacteria or parasites in the body, this is why regular washing of hands is important because we don’t know when we pick up germs and parasites and they enter our bodies when we eat with unwashed hands.
Are they natural remedies for this condition?
Yes, there are home remedies that can help and they include:
Turmeric: Its active compound Curcumin energizes the body, fights diseases and cleanses the liver. It reduces pain and alleviates inflammation.
Garlic: This clears toxins from the body, guards against autoimmune diseases and helps in the treatment of autoimmune hepatitis.
Apple cider vinegar: Too much ammonia in the body can lead to autoimmune hepatitis and this apple cider vinegar helps to reduce the levels of ammonia in the blood and it also alkalizes the body.
Selenium: This mineral aids healthy functioning of the liver, it prevent and fights inflammation.
Vitamin D: This vitamin controls the activities of the immune systems and it also prevents inflammation. Expose yourself to sunrise or sunset, you can foods rich in vitamin D or you can take the supplements.
Vitamin E: It supports normal and healthy functioning of the liver and it also fights inflammation.
Omega-3 fatty acids: This help to relieve the symptoms of autoimmune hepatitis; they fight inflammation, reduce immune responses and reduces the risks of healthy people having autoimmune hepatitis.
Lemons: This fruits are rich in vitamin C which helps in strengthening the immune systems and eliminating toxins from the body. Fresh lemon water should be taken every morning to stimulate the liver and decrease symptoms of autoimmune hepatitis.
Green tea: This tea is rich in anti-inflammatory compounds; it reduces the symptoms and risks of autoimmune hepatitis.
Raw fruit juices and smoothies: Homemade fruit juices and vegetables smoothies will improve immune functions and get rid of toxins in the body; it fights against autoimmune hepatitis and other types of diseases. To get most of the nutrients from plants and vegetables; it is advised to do smoothies because no part is thrown away.
Take two glasses of vegetable and fruit smoothies every day, this will improve your health and fight off the condition. Good smoothie combination for autoimmune hepatitis is apple, carrot, beet, spinach, celery and capsicum. Avoid fruits and vegetables that are not fresh because they can damage the liver.
Carrots: This vegetable reduces the symptoms; it is rich in antioxidants which reduce liver damage, it has many minerals and vitamins that boost immune functions.
Rose hip: This is a natural treatment for autoimmune hepatitis; 5 grams of the powdered supplement is taken ever day for six months.
Flavonoids: Flavonoids like Apigen and Luteolin produce the human autoimmune T-cells; they reduce the symptoms of autoimmune hepatitis, inhibit inflammation and cellular autoimmunity.
N-acetyl cysteine: The recommended dose is 1800 mg to 2400 mg daily;
Water: Drink plenty water if you are down with this condition; it eliminates toxins and chemicals from your body; note that only purified or boiled water should be taken in.
Apples: This fruit have high content of pectin which detoxifies and cleanse the liver and the digestive tracts; it also boosts the immune systems and reduces the symptoms of autoimmune hepatitis.
Milk thistle: Its active compound silymarin protects the liver form damages and it reduces inflammation.
Walnuts: These nuts are rich in Arginine which detoxifies the power and empower the immune system to fight diseases.
L-ornithine: This helps to remove ammonia from the body which can cause this condition.
Cabbage: Intake of fresh cabbage stimulates the liver to flush out toxins and it relieves the symptoms of autoimmune hepatitis.
Asparagus: This powerful plant detoxifies the body and reduces the levels of ammonia; eat it two to three times a week.
Olive oil: This boosts detoxification of the liver by making lipid base which sucks up harmful toxins from the body. It improves general health and protects against autoimmune hepatitis.
Have enough rest: Have not less than 8 hours of sleep at night and also try to catch a good nap in the afternoon; this will reduce stress and empower the body to fight off the disease.
Avoid or reduce stress: Stress suppresses the activities of the immune system and makes the situation worse; so avoid stress, hard physical activities and hard labour.