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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This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
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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.
My Liver Enzymes Are High: Should I Be Worried? Plus Your Action Plan
A.
Slightly elevated liver enzymes without symptoms are common and often temporary, but they still need follow-up, and urgent care is needed if you develop jaundice, dark urine, pale stools, severe abdominal pain, vomiting, confusion, or fever with abdominal pain. An effective action plan is to ask how high and which enzymes are elevated, repeat testing, stop alcohol for 4 to 6 weeks, review all meds and supplements with your clinician, improve metabolic health, and consider further tests like hepatitis screening, iron studies, or ultrasound as advised. There are several factors to consider that can change your next steps; see the complete guidance below.
References:
* Balakrishnan M, et al. Approach to the Patient With Elevated Liver Enzymes. Clin Liver Dis. 2021 Feb;25(1):1-15. PMID: 33220993.
* Pratt DS, et al. What to do with abnormal liver function tests? BMJ. 2016 Aug 24;354:i4247. PMID: 27558509.
* Chalasani N, 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 Jun;67(6):2083-2105. PMID: 29671092.
* Chalasani NP, et al. ACG Clinical Guideline: The Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury. Am J Gastroenterol. 2021 Jul 1;116(7):1359-1388. PMID: 34099616.
* Kwo PY, et al. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. 2017 Jan;112(1):18-35. PMID: 27922250.
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.
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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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Maheshwari A, Ray S, Thuluvath PJ (2008). Acute hepatitis C. Lancet (London, England).
https://pubmed.ncbi.nlm.nih.gov/18657711/Kwong S, Meyerson C, Zheng W, Kassardjian A, Stanzione N, Zhang K, Wang HL (2019). Acute hepatitis and acute liver failure: Pathologic diagnosis and differential diagnosis. Seminars in diagnostic pathology.
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/