Chronic Hepatitis Quiz
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Swelling
Joint pain that is always there
Liver failure
Loss of appetite
Bloating
Yellow eyes
Edema
Not seeing your symptoms? No worries!
What is Chronic Hepatitis?
Inflammation of the liver and/or liver enzyme abnormalities that lasts for more than six months. Consequences of chronic hepatitis may include scarring or cirrhosis and its complications, liver failure, liver cancer, or bleeding disorders. It is often caused by viruses like hepatitis B and C. Other causes include chronic alcohol use, fatty liver disease, and autoimmune diseases (body's immune system attacking itself).
Typical Symptoms of Chronic Hepatitis
- History of Hepatitis B infection
- History of liver problems
- History of Hepatitis C infection
- Fatigue or low energy
- Problems with liver function on the latest blood test
- Taking medication for high cholesterol
- Difficulty concentrating
- Itchy skin
Diagnostic Questions for Chronic Hepatitis
Your doctor may ask these questions to check for this disease:
- Have you ever had hepatitis B?
- Have you ever been diagnosed with liver problems?
- Have you ever had hepatitis C?
- Are you experiencing fatigue or low energy?
- Did your latest blood test show any liver problems?
Treatment of Chronic Hepatitis
Treatment depends on the cause of hepatitis. Some causes are treated with antiviral medicines, while others require immune-suppressing medications. Regular medical follow-up is advised to monitor.
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
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 Mar 27, 2025
Following the Medical Content Editorial Policy
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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
- Fatigued
- Easily tired
- Fatigue that varies throughout the day
- Symptoms worse at the end of the day
- Tired/fatigued in the morning
- Hands and arms get very tired when brushing teeth
- Morning tiredness that somehow gets better through the day
- Feeling well in the morning but unwell in the afternoon or evening
- Need to rest a while when brushing teeth
- Feel weak
- More energetic in the evening than in the morning
- Feeling fatigued at some times of the day only
See full list
Symptoms Related to Chronic Hepatitis
Diseases Related to Chronic Hepatitis
FAQs
Q.
Always Tired? Fatty Liver Disease Symptoms & Medically Approved Next Steps
A.
Persistent fatigue, mild right upper abdominal discomfort, and abnormal liver enzymes can be early signs of fatty liver disease, which is common, often silent, and frequently reversible in early stages. Risk is higher with excess weight, diabetes, high cholesterol, sleep apnea, or alcohol use, and warning signs like jaundice, leg or belly swelling, confusion, vomiting blood, or black stools need urgent care. There are several factors to consider; see below for medically approved next steps on diagnosis and treatment, including safe weight loss targets, exercise goals, blood sugar control, alcohol limits, medication safety, and ongoing monitoring, which can affect the right actions to take now.
References:
* J Gastroenterol Hepatol. 2022 Mar;37(3):439-447. doi: 10.1111/jgh.15783. Epub 2022 Feb 10. PMID: 35149303. Fatigue in patients with non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis. Singh A, Ma C, Xiong Z, Xu W, Wu H, Cao B, Xu T, Wei M, Zhang J.
* JAMA. 2020 Jul 21;324(3):289-298. doi: 10.1001/jama.2020.10619. PMID: 32678229. Nonalcoholic Fatty Liver Disease (NAFLD): A Clinical Review. Younossi ZM, Roehrich H, Loomba R, Sanyal AJ, Chalasani N, Cusi K, Rinella ME, Harrison SA, Tacke F, Anstee QM, Bugianesi E, Ratziu V, Schuppan D, Tsochatzis EA, Wong VW, Friedman SL, George J, Bajaj JS, Gish RG, Henry L, Marschall HU, Rinne A, Sandborn WJ, Sharma S, Wong RJ, Argo CK, Cotter TG, Kim D.
* J Clin Med. 2023 Jul 20;12(14):4795. doi: 10.3390/jcm12144795. PMID: 37478792. Nonalcoholic Steatohepatitis (NASH): Current and Emerging Therapies. Khayyal M, Albitar A, Chehab O, Chehab M, Chehab A, Krayem Z, Sayegh M, Khader Y.
* J Clin Med. 2023 Jan 24;12(3):1086. doi: 10.3390/jcm12031086. PMID: 36768783. Management of NAFLD and NASH: An Update. Targher G, Byrne CD, Tilg H, Marchesini G, Younossi ZM, George J, Gaggini M, Gastaldelli A.
* J Gastroenterol Hepatol. 2022 Mar;37(3):428-438. doi: 10.1111/jgh.15814. Epub 2022 Feb 10. PMID: 35149302. Lifestyle changes in NAFLD: An evidence-based and practical review. Singh A, Ma C, Xiong Z, Xu W, Wu H, Cao B, Xu T, Wei M, Zhang J.
Q.
Scared of MASH? Why Your Liver is Inflamed + Medically Approved Next Steps
A.
MASH is liver inflammation and injury from fat buildup driven by metabolic dysfunction such as obesity, insulin resistance, diabetes, high cholesterol, and high blood pressure; it can progress to fibrosis and cirrhosis over years but is often reversible early. Medically approved next steps include seeing a clinician for labs and noninvasive fibrosis assessment, adopting Mediterranean-style nutrition, gradual 7 to 10 percent weight loss, regular aerobic and resistance exercise, managing blood sugar, cholesterol and blood pressure, avoiding alcohol and unnecessary supplements, and considering medicines like statins, GLP-1 receptor agonists or pioglitazone when appropriate. There are several factors and red flag symptoms that can change what you should do next; see the complete guidance below.
References:
* Younossi ZM, Noureddin M, Rinella ME, Sanyal AJ, Harrison SA. Metabolic dysfunction-associated steatohepatitis: An emerging challenge. Semin Liver Dis. 2023;43(1):1-10. PMID: 36791986.
* Alkhouri N, Rinella ME, Harrison SA. Diagnosis and Management of Metabolic Dysfunction-Associated Steatohepatitis (MASH). Nat Rev Gastroenterol Hepatol. 2023;20(11):705-717. PMID: 37574744.
* Zhang X, Li Y, Han X, Li B, Yu J. Pathophysiology and Current Treatment Strategies for Metabolic Dysfunction-Associated Steatohepatitis. Int J Mol Sci. 2024;25(3):1414. PMID: 38256247.
* Li Z, Yu R, Jia S, Zhou X. Mechanisms Linking Obesity, NAFLD, and MASH Progression. Cells. 2023;12(21):2576. PMID: 37887750.
* Ma J, Zhao F, Fang W, Lu J, Zhang N, Shi G, Shi Y. Pharmacological Treatment of Metabolic Dysfunction-Associated Steatohepatitis (MASH): A Review of Current and Emerging Therapies. J Clin Med. 2023;12(23):7333. PMID: 38006856.
Q.
Is Your ALT High? Why Your Liver Is Inflamed & Medically Approved Next Steps
A.
A high ALT usually signals liver inflammation; common causes include fatty liver, alcohol use, medications or supplements, and viral hepatitis, with muscle injury and rarer autoimmune or genetic conditions also possible. Medically approved next steps are to repeat the test, avoid alcohol, review all drugs and supplements with your clinician, screen for hepatitis, consider a liver ultrasound, and adopt weight, diet, and exercise changes; seek urgent care for jaundice, confusion, severe abdominal pain, vomiting blood, or abdominal swelling. There are several factors to consider for your exact value and risks; see below for complete details that can change your next steps.
References:
* Marschall G, Lammert F, Müllhaupt B, et al. Evaluation of Patients With Elevated Liver Transaminases. Dtsch Med Wochenschr. 2021 Jul;146(14-15):999-1008. doi: 10.1055/a-1433-7221. Epub 2021 Jul 15. PMID: 34265886.
* Fontana RJ. Approach to the Patient with Asymptomatic Elevated Aminotransferases. Clin Liver Dis. 2020 Feb;24(1):1-15. doi: 10.1016/j.cld.2019.09.001. PMID: 31735492.
* Chalasani N, Palmer M, Loomba R, et al. The AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease. Hepatology. 2022 Dec;76(7):1987-2023. doi: 10.1002/hep.32634. PMID: 36520336.
* Terrault NA, Lok ASF, McMahon BJ, et al. ACG Clinical Guideline: The Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. 2023 Jan 1;118(1):18-34. doi: 10.14309/ajg.0000000000002047. PMID: 36622359.
* Kumar P, Khosa S, Gupta E. Update in Evaluation of Elevated Liver Enzymes. J Clin Exp Hepatol. 2022 Jul-Aug;12(4):1142-1150. doi: 10.1016/j.jceh.2022.02.015. Epub 2022 Feb 21. PMID: 35919420.
Q.
High ALT Blood Test? Why Your Liver Is Leaking & Medically Approved Next Steps
A.
A high ALT means your liver cells are leaking enzyme into your blood due to stress or injury, often reversible when treated early, with common causes including fatty liver, alcohol use, viral hepatitis, medications or supplements, and even recent intense exercise. There are several factors to consider, and medically approved next steps often include repeating the test, a full liver panel and targeted screens, and ultrasound; seek urgent care if you develop jaundice or severe abdominal pain. See below for complete details that can affect which next steps are right for you.
References:
* pubmed.ncbi.nlm.nih.gov/28281907/
* pubmed.ncbi.nlm.nih.gov/29153578/
* pubmed.ncbi.nlm.nih.gov/36824151/
* pubmed.ncbi.nlm.nih.gov/34327572/
* pubmed.ncbi.nlm.nih.gov/29870425/
Q.
Drained? Why Hepatitis B Is Your Liver’s Silent Fire + Medical Next Steps
A.
Feeling drained or foggy? Hepatitis B is a silent liver infection that can smolder for years and cause fatigue, yet it is preventable, detectable, and treatable through vaccination, targeted blood tests, monitoring, and when needed antivirals. There are several factors to consider; see below for who is at risk, the exact tests to request, when treatment is recommended, how to protect loved ones, and urgent warning signs, as these details can shape your next medical steps.
References:
* Kim B, Lim YS. Update on Hepatitis B Virus Infection: Pathogenesis, Diagnosis, and Treatment. Gut Liver. 2023 Mar 15;17(2):206-218. doi: 10.5009/gnl22045. Epub 2022 May 25. PMID: 35619379.
* Sagnelli E, Sagnelli C, Sagnelli C, Sagnelli E, Coppola N, Pascarella S, Sagnelli E. Current and Future Therapeutic Strategies for Chronic Hepatitis B. Viruses. 2023 Feb 1;15(2):409. doi: 10.3390/v15020409. PMID: 36851608.
* European Association for the Study of the Liver. Guidance for the treatment of chronic hepatitis B: an update for 2023. Lancet Gastroenterol Hepatol. 2023 Aug;8(8):722-736. doi: 10.1016/S2468-1253(23)00155-2. PMID: 37402633.
* Locarnini S, Gish RG. Hepatitis B virus: from infection to global eradication. J Gastroenterol Hepatol. 2023 Sep;38 Suppl 2:S3-S10. doi: 10.1111/jgh.16279. PMID: 37575308.
* Papatheodoridis GV, Buti M, Goulis I, Janssen HLA, Lampertico P, Manolakopoulos S, et al. Natural History of Chronic Hepatitis B Virus Infection. Clin Liver Dis. 2018 Aug;22(3):525-546. doi: 10.1016/j.cld.2018.03.007. PMID: 30047366.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Batts KP, Ludwig J. Chronic hepatitis. An update on terminology and reporting. Am J Surg Pathol. 1995 Dec;19(12):1409-17. doi: 10.1097/00000478-199512000-00007. PMID: 7503362.
https://journals.lww.com/ajsp/Abstract/1995/12000/An_Update_on_Terminology_and_Reporting.7.aspxCobb BR, Valsamakis A. Chronic Hepatitis B, C, and D. Microbiol Spectr. 2016 Aug;4(4). doi: 10.1128/microbiolspec.DMIH2-0025-2015. PMID: 27726758.
https://journals.asm.org/doi/10.1128/microbiolspec.DMIH2-0025-2015American College of Gastroenterology
https://gi.org/topics/viral-hepatitis/