Acute Hepatitis Quiz
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Both hips hurt
Fatigued
Yellow eyes
Have a fever
Have a headache
Bruise easily
Cannot take a deep breath because of stomach pain
Not seeing your symptoms? No worries!
What is Acute Hepatitis?
Sudden inflammation of the liver with various causes, including alcohol and infections.
Typical Symptoms of Acute Hepatitis
- Stomach or abdominal pain that prevents deep breathing
- Fatigue or low energy that is worse in the morning
- Fever
- Took potentially contaminated water or raw shellfish in the last two months
- Feels a hard lump in upper right abdomen
- Fatigue or low energy
- Yellowish eyes or skin
- Swelling or protrusion under ribs
Diagnostic Questions for Acute Hepatitis
Your doctor may ask these questions to check for this disease:
- Are you experiencing stomach or abdominal pain that prevents you from taking deep breaths?
- Do you experience fatigue or low energy that is worse in the morning?
- Do you have a fever?
- Have you consumed contaminated water or raw oysters in the past 2 months?
- Do you feel a hard lump in your upper right abdomen?
Treatment of Acute Hepatitis
Treatment depends on the cause, but is mostly supportive with adequate fluids and removal of the cause, such as alcohol. In the case of hepatitis virus infection, treatment can vary. Some forms of viral hepatitis improve on their own. Other hepatitis infections may be life-long and require special antiviral medications to attempt a cure. Hospitalization and regular follow-up may be needed to monitor the liver's well-being until it recovers.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 19, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Swelling under ribs right side
- My body is hot
- Recurrent fevers
- Swelling in right abdomen below ribs
- Periodic fever (>100.4°F / 38°C)
- Area under right rib cage hurts
- Fever then no fever then fever again
- Remittent fever of 102.2°F / 39°C
- Bloating under ribs
- Extremely high fever of 106.7°F / 41.5°C or higher
- Fever of 100.4°F / 38°C or more for weeks
- Painless lump under right rib cage
- Stomach was uncomfortable, then had a fever
- Tender spot under right rib cage
- Stomachache and diarrhea before a fever
See full list
Symptoms Related to Acute Hepatitis
Diseases Related to Acute Hepatitis
FAQs
Q.
High ALT? Why Your Liver is Inflamed + Medically Approved Next Steps
A.
High ALT means your liver is inflamed or irritated, most commonly from fatty liver, alcohol, viral hepatitis, medications or supplements, or less often muscle injury; very high levels or symptoms like jaundice, confusion, severe pain, dark urine, or vomiting need urgent care. There are several factors to consider; see below to understand more that could change your next steps. Medically approved next steps include repeating the test, reducing or stopping alcohol, reviewing all medicines and supplements, improving metabolic health and weight, and getting targeted labs and imaging, with persistent elevations beyond 6 months needing further evaluation. Full details and context are outlined below.
References:
* Al-Dabbagh MA, Tandon P. Approach to the Patient With Elevated Liver Biochemical Tests. Med Clin North Am. 2023 Sep;107(5):909-923. doi: 10.1016/j.mcna.2023.05.008. Epub 2023 Jul 21. PMID: 37604344.
* Kwo PY, Thistlethwaite JR, D'Souza P. Evaluation of asymptomatic patients with persistently elevated liver enzymes. Clin Liver Dis. 2021 May;25(2):299-311. doi: 10.1016/j.cld.2021.01.001. Epub 2021 Feb 9. PMID: 33863486.
* Vilarinho S, Cupo R, Sanyal A. The role of liver biopsy in the diagnosis and management of nonalcoholic fatty liver disease. Dig Dis Sci. 2023 Oct;68(10):3825-3836. doi: 10.1007/s10620-023-08034-7. Epub 2023 Jul 27. PMID: 37495908.
* Chalasani N, Younossi Z, Lavine JE, Charlton AM, Cusi K, Ellett M, et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018 Jan;67(1):328-357. doi: 10.1002/hep.29367. PMID: 28714183.
* Kwo PY, Cohen SM, Lim JK. Drug-induced liver injury: a review. Clin Liver Dis. 2023 Nov;27(4):649-663. doi: 10.1016/j.cld.2023.08.002. Epub 2023 Aug 10. PMID: 37805216.
Q.
High AST Blood Test? Why Your Liver Is Elevated & Medically Approved Next Steps
A.
A high AST signals cell injury in the liver or other tissues like muscle, most often from fatty liver, alcohol use, viral hepatitis, medications or supplements, or recent strenuous exercise, and the degree of elevation guides how urgent the situation is. Medically vetted next steps include repeating the test after pausing alcohol, hard workouts, and nonessential supplements, reviewing all medicines, checking ALT and other labs, and getting imaging if needed; seek urgent care for very high values or red flag symptoms like jaundice or severe pain. There are several factors to consider, so see the complete details below to understand more and choose the right next steps for you.
References:
* Dulai PS, Bhargava M, Sirlin CB, Loomba R. Evaluation of Elevated Liver Enzymes. J Am Fam Physician. 2017 Mar 15;95(6):345-353. PMID: 28290748.
* Toh T, Alzahrani N, Wong R, George J. Transaminase elevation in asymptomatic patients: What should the gastroenterologist do? World J Gastroenterol. 2016 Oct 7;22(37):8263-8272. doi: 10.3748/wjg.v22.i37.8263. PMID: 27729742.
* Friedman LS. Evaluation of Asymptomatic Transaminitis. Clin Liver Dis. 2018 Feb;22(1):79-89. doi: 10.1016/j.cld.2017.08.006. Epub 2017 Oct 16. PMID: 29127993.
* Pratt DS. Approach to the Patient With Abnormal Liver Chemistries. Med Clin North Am. 2020 Jan;104(1):1-14. doi: 10.1016/j.mcna.2019.08.002. Epub 2019 Oct 31. PMID: 31761159.
* Lee TH, Friedman LS. Approach to the Patient With Abnormal Liver Enzymes. Gastroenterology. 2022 Jul;163(1):31-45.e1. doi: 10.1053/j.gastro.2022.03.061. Epub 2022 Apr 21. PMID: 35472149.
Q.
High AST? Why Your Liver Is Stressed & Medically Approved Next Steps
A.
High AST signals cell stress or injury, often from the liver, but it does not always mean permanent damage; causes range from fatty liver and alcohol use to viral hepatitis, medications or supplements, and muscle injury, and the AST to ALT pattern plus how high the number is guide urgency. Next steps usually include repeat testing, a review of alcohol and all meds or supplements, targeted labs and an ultrasound, lifestyle changes, and urgent care if levels are very high or you have warning signs like jaundice, dark urine, severe fatigue, or confusion. There are several factors to consider; see the complete details below to understand more and choose the safest next steps for your situation.
References:
* Oh RC, Hurley LB, Roberts AE. Clinical Practice Guideline: Evaluation of Abnormal Liver Enzymes. Am Fam Physician. 2020 Feb 1;101(3):174-184. PMID: 32004245.
* Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. 2017 Jan;112(1):18-35. doi: 10.1038/ajg.2016.517. Epub 2016 Dec 13. PMID: 27958348.
* Saso M, Tsochatzis EA. Non-alcoholic fatty liver disease and its impact on the management of chronic liver disease. Clin Med (Lond). 2021 May;21(3):e265-e271. doi: 10.7861/clinmed.2021-0164. Epub 2021 May 1. PMID: 33958376; PMCID: PMC8130882.
* Singal AK, Kamath PS, Dunn KR. Alcoholic Hepatitis: Clinical Presentation, Diagnosis, and Treatment. Semin Liver Dis. 2020 May;40(2):142-152. doi: 10.1055/s-0040-1701389. Epub 2020 Feb 19. PMID: 32074554.
* Fontana RJ. Drug-induced liver injury (DILI). Semin Liver Dis. 2013 Aug;33(3):304-12. doi: 10.1055/s-0033-1351779. Epub 2013 Aug 8. PMID: 23929315.
Q.
Hepatitis A? Why Your Liver Is Inflamed and Medically Approved Next Steps
A.
Hepatitis A is a contagious virus that inflames the liver, usually clears without chronic damage, and most often spreads through contaminated food or water; common symptoms include fatigue, nausea, upper right abdominal pain, dark urine, and jaundice. Medically approved next steps center on supportive care and preventing spread: rest, hydrate, eat light, avoid alcohol, review all medications with your doctor, get a blood test for diagnosis, consider vaccination or immune globulin after exposure, and seek urgent care for confusion, severe swelling, persistent vomiting, or worsening jaundice. There are several factors to consider; see below for key details that can shape your next steps.
References:
* Wong KK, Ho JR, Ho BH, Lee KK. Hepatitis A: An Update. Clin Liver Dis. 2021 Nov;25(4):721-736. PMID: 34575917.
* Terrault NA, Lok ASF, McMahon BJ, Lim JK, Belle SH, Chung RT, Janssen HLA, Kaplan DE, Kim WR, Miller V, Neuschwander-Tetri BA, Reau N, Smith BD, Wong JB. AASLD Practice Guidance on Prevention, Diagnosis, and Treatment of Hepatitis A. Hepatology. 2020 Nov;72(5):1839-1861. PMID: 33179240.
* Sagnelli E, Sagnelli C, Gualtieri L, D'Aleo F, Brancaccio M, Zampino R, Coppola N. Hepatitis A: A Public Health Concern. Viruses. 2020 Sep 28;12(10):1085. PMID: 32998394.
* Sarna M, Shiffman ML. Hepatitis A virus infection in the vaccine era. Nat Rev Gastroenterol Hepatol. 2019 Feb;16(2):103-113. PMID: 30425333.
* Kanda T, Goto T, Hiroishi K, Imazeki F, Yokosuka O. Immunology of hepatitis A virus infection. World J Gastroenterol. 2015 Mar 28;21(12):3568-76. PMID: 25834316.
Q.
Is it Hepatitis? Why Your Liver is Inflamed & Medically Approved Steps
A.
Liver inflammation can be hepatitis, but not always; causes include viral infections, alcohol, fatty liver related to metabolism, autoimmune disease, and medication or supplement injury, confirmed with blood tests and imaging. Medically approved steps are to see a doctor promptly, avoid all alcohol, review every medication and supplement, get tested for viral hepatitis, and follow lifestyle and follow-up plans, with urgent care for severe pain, confusion, heavy jaundice, or persistent vomiting. There are several factors to consider; see below for complete details that could affect your next steps.
References:
* Zhang, Y., Yu, D., Wang, T., Zhang, S., Zhang, B., Wang, Y., Zhang, W., Chen, J., & Ma, X. (2021). Hepatitis: Etiology, Pathogenesis, Diagnosis and Treatment. *Frontiers in Pharmacology*, *12*, 769502. https://doi.org/10.3389/fphar.2021.769502
* Stefan, N., Häring, H.-U., & Cusi, K. (2020). Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). *BMJ (Clinical Research Ed.)*, *370*, m3317. https://doi.org/10.1136/bmj.m3317
* Liberal, R., Mieli-Vergani, G., & Vergani, D. (2019). Autoimmune hepatitis: Diagnosis and treatment. *World Journal of Gastroenterology*, *25*(2), 171–182. https://doi.org/10.3748/wjg.v25.i2.171
* Chalasani, N., & Hayashi, P. H. (2019). Drug-induced liver injury: A comprehensive review. *Journal of Clinical and Translational Hepatology*, *7*(3), 263–272. https://doi.org/10.14218/JCTH.2019.00019
* Fontana, R. J., & Durkalski, V. (2021). Acute Liver Failure. *Clinics in Liver Disease*, *25*(4), 721–740. https://doi.org/10.1016/j.cld.2021.06.002
Q.
Is It Hepatitis B? Why Your Liver Is at Risk & Medically Approved Next Steps
A.
Hepatitis B is a common viral infection that targets the liver, often without symptoms, yet it can progress from acute to chronic disease with risks of cirrhosis, liver failure, and liver cancer; it is preventable by vaccination and confirmed with simple blood tests. If you were exposed or have symptoms, get tested promptly, speak with a clinician about monitoring versus antiviral treatment, consider post-exposure options, and know the red flags that need urgent care; there are several factors that change the right plan by timing, risk group, and test results, so see details below.
References:
* Terrault NA, Lok ASF, McMahon BJ, et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2023 Guidance. Hepatology. 2024 Jan 1;79(1):6-54.
* Rehermann B, Naggie S. Hepatitis B Virus Infection. N Engl J Med. 2023 Mar 16;388(11):1015-1025.
* Tang L, Zhou K, Hou J. Hepatitis B Virus Infection: An Overview of Its Natural History and Progression to Chronic Hepatitis. Viruses. 2022 Jul 25;14(8):1621.
* Gao S, Yu D, Jiang H, Ma X, Zang S. Pathogenesis of Liver Fibrosis in Chronic Hepatitis B Virus Infection. Front Immunol. 2022 Mar 2;13:841499.
* Lampertico P, Cherubini G, Viganò M. Novel approaches for chronic hepatitis B. J Hepatol. 2022 Jan;76(1):210-221.
Q.
Milk Thistle for Women 65+: Vital Benefits for Liver & Aging Health
A.
Milk thistle may support liver cell protection, medication metabolism, antioxidant defenses, and mild digestive comfort in women 65+, with early evidence for modest blood sugar and cholesterol benefits, but it is not a cure and should complement medical care. There are several factors to consider; see the key safety and how to details below and talk with your clinician first, especially if you take multiple medications or have liver related symptoms.
References:
* Kumar A, Singh A, Singh A, et al. Silymarin: A comprehensive review of its hepatoprotective potential. Phytother Res. 2020 Aug;34(8):1753-1768. doi: 10.1002/ptr.6672. Epub 2020 May 16. PMID: 32419409.
* Soliman A, El-Said HM, Attia N, et al. Targeting Liver Fibrosis: Role of Silymarin. Front Pharmacol. 2021 Oct 7;12:756383. doi: 10.3389/fphar.2021.756383. PMID: 34685376; PMCID: PMC8529249.
* Hadar R, Al-Rifai H, Rida A, et al. Antioxidant and anti-inflammatory effects of silymarin in chronic diseases. Front Pharmacol. 2022 Jul 26;13:951475. doi: 10.3389/fphar.2022.951475. PMID: 35957016; PMCID: PMC9361730.
* Rauf A, Khan M, Khan H, et al. Silymarin as a potential candidate to ameliorate aging-related diseases. Phytomedicine. 2023 Apr;110:154625. doi: 10.1016/j.phymed.2023.154625. Epub 2023 Feb 28. PMID: 37025217.
* Yao J, Duan Y, Zhang Z, et al. Clinical Efficacy and Safety of Silymarin in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2021 Jul 15;2021:6644026. doi: 10.1155/2021/6644026. PMID: 34283935; PMCID: PMC8298018.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
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https://pubmed.ncbi.nlm.nih.gov/31405537/Han SH, Saab S, Martin P (2000). Acute Viral Hepatitis. Current treatment options in gastroenterology.
https://pubmed.ncbi.nlm.nih.gov/11096609/