Diet for viral hepatitis: Tips to Avoid Liver Damage From Hepatitis – Hepatitis Center
Tips to Avoid Liver Damage From Hepatitis – Hepatitis Center
What Not to Eat or Drink
Keep in mind that an unhealthy diet can contribute to liver damage. If you eat too much high-calorie greasy, fatty, or sugary food, you’ll gain weight and fat will begin to build up in your liver. A “fatty liver” can contribute to developing cirrhosis, or scarring, of the liver. Fat in your liver can also interfere with the effectiveness of drugs that target the hepatitis virus.
Avoid the following:
- Saturated fats found in butter, sour cream, and other high-fat dairy foods, fatty cuts of meat, and fried foods
- Sugary treats like cookies, cake, soda, and packaged baked goods
- Foods heavily laced with salt
Many experts recommend that hepatitis patients also avoid raw or undercooked shellfish, which can harbor viruses and bacteria. You may consider limiting your consumption of processed foods as well, since they can contain chemical additives and high levels of salt.
Because your liver is battling the hepatitis virus, take special precautions to protect against any disease that would increase the chances of liver damage. Wash all meats, fruits, and vegetables to remove any potentially harmful residues, and wash your hands thoroughly before and after handling food to prevent cross-contamination.
Supplements for Hepatitis
People with hepatitis should talk to their doctors about taking a multivitamin once a day, says Christine Gerbstadt, MD, RD, a doctor and a registered dietitian in Sarasota, Fla., as well as a spokesperson for the American Dietetic Association. B vitamins in particular can help spur healing.
“You really want to make sure your body has everything it needs,” Dr. Gerbstadt says.
However, you also need to make sure that you don’t take in too much of certain vitamins and minerals through the use of supplements, since some can cause liver damage. Be cautious of:
Hepatitis patients looking for herbal remedies may consider milk thistle, available in capsules and other forms. Milk thistle may have some restorative properties, suggests Gans. Some studies have found that milk thistle can improve liver function in hepatitis and cirrhosis patients. However, you should always consult with your doctor before trying any supplement or herb, especially if you have hepatitis.
What to Eat for Better Management
The goal of a hepatitis diet is to minimize stress on your liver, which is already compromised by the inflammation that defines the condition. Perhaps surprisingly, an ideal eating plan for chronic hepatitis is simply one that aligns with healthy eating guidelines for all adults provided by the U.S. Department of Agriculture (USDA). A nutritious diet can help you maintain an optimal weight and may help you to preserve healthy liver function.
While you may need to adjust your diet based on your specific diagnosis, the guiding principles of basic nutrition are likely to give your body what it needs without further taxing your liver.
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When hepatitis, of which there are several types, persists for longer than six months, it is deemed chronic. Symptoms may not develop until the condition becomes more severe, usually when liver damage has already begun.
Diet can support the liver and help manage symptoms of hepatitis. Constant fatigue is the most common one; others include diarrhea, joint pain, and trouble eating full meals. Research has demonstrated that malnutrition and loss of muscle mass become more common as the condition progresses. Some people also have a difficult time maintaining a healthy weight.
Following the eating guidelines recommended by nutritional experts and endorsed by the USDA will help you to sustain energy levels throughout the day, maintain muscle mass, and keep your body at a healthy weight. You can tweak your plan as needed to manage symptoms such as stomach discomfort as they arise.
In some people, chronic hepatitis progresses and more significant liver damage occurs. Certain nutritional adjustments may be required. For example, people with decompensated cirrhosis develop extensive liver scarring and may need to follow a special diet to accommodate a liver that can no longer function properly.
Your healthcare provider can help you determine how tailored your diet should be.
How It Works
The 2015-2020 Dietary Guidelines emphasize eating a wide variety of nutrient-dense foods—that is, those that provide great nutritional value and few calories. People are also encouraged to develop an overall pattern of healthy eating rather than focusing on single food groups.
By nature of it being a regular plan for healthy eating, a hepatitis diet is rather straightforward. That said, if following it means a drastic change in your previous eating habits, adjusting to it—like any other diet—will take some time and effort.
Since eating for chronic hepatitis is no different than eating for optimal health, it’s important to think about adopting the healthy eating pattern for life.
Even if you don’t experience hepatitis symptoms or issues like loss of muscle mass or malnutrition, a healthy diet will help you improve your wellness and prevent other chronic diseases, such as heart disease and diabetes.
What to Eat
Fruits and vegetables: Fruits and vegetables provide your body with vitamins and minerals important for a healthy body. Consuming these fiber-rich foods may also help you decrease your intake of less healthy foods, such as fatty meats or sugary treats, as they are quite filling.
Consumption of leafy green vegetables, in particular, may provide benefits to those managing hepatitis. Studies have shown that these can lessen the fatty acid composition in your liver.
Grains: Foods in the grain category include bread, pasta, rice, and oats. Dietary guidelines suggest that at least half of the grains you consume be whole grains, rather than refined grains (such as white bread, white rice, or white pasta). Whole grains help boost your protein intake, which can help you to maintain muscle mass.
Protein foods: Consuming the right amount of protein is important when you have chronic hepatitis. Eating enough protein can help you to avoid malnutrition and muscle wasting. But consuming too much protein can lead to complications including a condition known as encephalopathy. Experts advise that you consume 1 to 1.5 grams of protein per kilogram (kg) of body weight (1 kg equals about 2.2 pounds). Lean meats, milk, nuts, and cheese are all good sources of protein.
Coffee: Studies have shown that drinking a caffeinated beverage like coffee reduces the risk for advanced liver scarring in people with chronic hepatitis. So far, evidence suggests that consuming two large cups of coffee—or about 100 milligrams (mg) of caffeine—is associated with a significant reduction in advanced scarring. This seems to be beneficial with drip coffee, but not espresso.
Healthy fats: Dietary guidelines advise that you consume less than 10% of calories per day from saturated fats and eliminate trans fats completely. They suggest that you replace both of these with healthier fats. Saturated fats are found in red meat and full-fat dairy products. Trans fats (partially hydrogenated oils) are being gradually eliminated, but you may occasionally still find them in some foods including fried snack foods or processed baked goods.
Healthy plant-based fats such as olive, sunflower, or avocado oils provide polyunsaturated and monounsaturated fatty acids that are associated with health benefits including a reduced risk for heart disease. However, all fats and oils should be consumed in moderation.
Consuming too much fat can lead to problems, especially for those living with chronic hepatitis, including fatty deposits in the liver, fatty inflammation, and fatty cirrhosis.
Excess salt: Per the USDA’s guidelines, a healthy eating pattern limits added sodium/excess salt. Heavily processed foods, including snack foods, fried foods, convenience foods, and microwavable meals often are what put someone over the limit, which is 2,300 mg a day for most people. (Ideally, you should consume less.)
If chronic hepatitis progresses to liver cirrhosis, there can be an accumulation of fluid in the abdomen, a condition called ascites. People with ascites should restrict their sodium intake to less than 1000 mg per day.
Excess sugar: Nutrition experts are increasingly concerned about added sugars contained in many popular foods. As such, nutritional guidelines suggest that you consume less than 10% of calories a day from added sugars, which are often found in sweetened sodas, juice drinks, and other sugary treats.
People with hepatitis should be especially careful to consume sugar in moderation. Studies have shown that hepatitis is associated with an increased risk of diabetes. Reducing your intake of added sugar can help to decrease this risk.
Excess iron: The liver plays a key role in the metabolism and excretion of iron. Some people with chronic hepatitis aren’t able to release iron properly from the body and may experience iron overload, increasing the risk of tissue damage in the liver. For this reason, people with chronic hepatitis may need to reduce the amount of iron-rich foods in their diets. These foods include red meat, liver, oysters, lentils, apricots, and iron-fortified cereals.
However, iron is an essential part of your diet, so do not cut it out entirely. It is also important to note that vitamin C increases the absorption of iron from food. If you’ve been advised to reduce your iron intake, you may also need to reduce your intake of foods that are high in vitamin C, like citrus fruits, strawberries, kale, and broccoli.
You may also want to speak to your healthcare provider before taking a multivitamin, as most contain both nutrients.
Alcohol: Alcohol consumption causes increased stress on your liver and can put you at higher risk for liver damage. If you have chronic hepatitis, experts advise that you avoid alcohol.
There is no specific meal timing pattern recommended for those with chronic hepatitis. But many people with the condition prefer to consume small frequent meals rather than two to three large meals each day to maintain energy levels.
One of the jobs of the liver is to store glycogen, which is used by the body for immediate energy. Most people can store relatively large amounts of glycogen in their livers, but when the liver is damaged, scar tissue takes away valuable storage space. As a result, the liver can’t store as much glycogen as it once could.
Consuming small, frequent meals (making sure to include carbohydrates) allows your body the chance to replace its glycogen reserves on a steady basis.
There are several healthy cooking tips that may be especially helpful for you when managing chronic hepatitis:
- Use low-fat cooking methods: One important function of the liver is to produce bile, which the body uses to process dietary fats. However, depending on the damage to your liver, you might not be able to prepare enough bile to properly process a meal that’s high in fat. As a result, you might suffer indigestion. One solution is to eat lower-fat foods (such as fruits, vegetables, and low-fat dairy). You can also use lower-fat methods to prepare your food. Roast or grill lean meats, veggies, and seafood. Many cooks use applesauce instead of butter in baked goods or use non-stick cooking spray instead of oils when cooking.
- Add flavor without sodium: Use fresh herbs and spices to add flavor to your meals without adding salt. You might also be able to flavor your food with citrus or vinegar. Some seasoning blends may also be helpful, but be careful to read labels. Certain brands use salt as a primary ingredient in their blends and may not be as helpful in lowering your sodium intake as you might hope.
- Learn to make healthy juices or smoothies: Some hepatitis support organizations suggest you drink homemade juices when you aren’t comfortable consuming whole meals. Juice doesn’t provide the same health benefits as eating whole fruits or vegetables, but it can provide quick energy and some vitamins and minerals. Keep in mind that store-bought juices and smoothies may contain added sugars.
- Do some prep work: There may be days when you are too tired to prepare a full meal. On those occasions, you might be tempted to make less nutritious, but more convenient, choices. Try to take advantage of your higher-energy days and prepare meals and snacks in advance. Make healthy, “quick-grab” selections like veggies sticks and hummus or fruit slices with peanut butter. You can also prepare full meals (e.g., chicken breast with vegetables and brown rice) to be stored in the refrigerator or freezer and reheated.
Those who follow special diets and have been diagnosed with chronic hepatitis can still adhere to the healthy eating recommendations provided by the USDA with simple modifications.
For example, health experts suggest that vegetarians and vegans increase the consumption of soy products (particularly tofu and other processed soy products), legumes, nuts, seeds, and whole grains when meat, poultry, and seafood are eliminated.
If you follow a gluten-free diet, choose grains such as quinoa, oats, millet, or buckwheat that don’t contain the allergen.
While most experts simply recommend that you follow basic nutritional guidelines when managing chronic hepatitis, there are a few considerations to take into account.
In order to maintain your energy, it is important that you consume the right number of calories each day. You can work with your healthcare provider and get a referral to a registered dietitian who can provide personalized recommendations.
You can also use a calorie calculator to make sure that you are getting the right number of calories each day. Calorie estimates are based on your age, gender, and activity level.
Some people with chronic hepatitis, especially those with alcoholic hepatitis or advanced cirrhosis, may not be getting enough of the fat-soluble vitamins and necessary minerals they need.
Some people are able to get these vitamins and minerals by making adjustments to their diet, but others may need physician-prescribed supplements. Follow-up with any testing that your doctor recommends to check your levels, and avoid taking any supplements without your doctor’s OK, as some may contain ingredients that are harmful to your liver.
The liver has an amazing capacity to keep doing its job even while damaged, but eventually, too much damage will reduce liver function. Therefore, it’s in your best interest to reduce its exposure to toxins such as:
- Unnecessary medicines: Even though medicines are beneficial, they are still toxic chemicals that must be processed by your liver. It’s important to follow your doctor’s advice and take the medicines that you need (as directed) and avoid the ones that you don’t. Check with your doctor before taking any new medication.
- Pesticides and herbicides: Though these can be absorbed through your skin, they are still toxins ultimately processed by the liver.
- Household chemicals: We use chemicals daily, sometimes without a second thought. People with chronic hepatitis should take extra caution to reduce exposure to these through fumes, ingestion, and skin absorption.
- Tobacco products: Studies have found that there is an interactive effect between cigarette smoking and different types of hepatitis. For that reason, smoking is not advised if you have been diagnosed with chronic hepatitis.
- Recreational drugs: The use of recreational drugs can significantly impair your energy levels and your health in general. As such, they should be entirely avoided.
There is limited research investigating the relationship between exercise and chronic hepatitis. While the USDA guidelines suggest that regular physical activity can help people achieve and maintain good health and reduce the risk of chronic disease, the diminished energy levels experienced by many who have chronic hepatitis can make regular physical activity challenging.
However, if energy levels allow, studies suggest that patients with chronic hepatitis can and should enjoy regular physical exercise limited only by symptoms.
A Word From Verywell
Healthy eating recommendations are important for everyone, but choosing nutritious foods is especially important if you are managing chronic hepatitis. Take some time to learn about the healthy eating guidelines provided by the USDA. Fill your kitchen with nutritious foods so healthy snacks and small bites are ready when you need quick energy. Work together with your healthcare provider and a registered dietitian so that you can develop a meal plan that helps you keep your energy levels stable and your weight healthy.
A Basic Diet for Hepatitis
Foods You Should Avoid
Alcohol – No brainer. The most important change for anyone diagnosed with hepatitis is the complete elimination of alcohol from his or her life.
Wheat and Gluten – Gluten can be highly inflammatory; thus adopting a gluten-free diet can be beneficial to your liver. The inability to properly digest and process gluten creates a chronic state of inflammation which leads to “leaky gut” syndrome. This allows toxins and pathogenic organisms to infiltrate your blood, presenting a chronic toxic overload to your liver. The long-term outcome of this is often non-alcoholic fatty liver disease, the “gateway disorder” that can progress to other more serious liver diseases. At this point, liver enzyme levels will be elevated.
Tap Water –Your tap water may contain more than you bargained for, including heavy metals, chlorine, fluoride, inorganic chemicals and compounds that the liver is not able to process. Even the shower you take every day has toxins in it which are absorbed through the skin and inhaled through the lungs. Filtered water is of course better than tap water. Consider having your water tested to decide what is most appropriate for you and your family. For greater safety, you may want to consider drinking bottled water. Distilled water is another possibility, but there is some controversy over its benefits; therefore you may wish to take distilled water in moderation.
Junk Foods – These are our favorite foods but the name fits. Junk is junk, meaning worthless. Our body does not get a good source of nutrition from junk foods and, most often, they are full of all the things we need to stay away from – including fats, sugars, empty calories, chemicals and additives. Our poor livers don’t need this added stress.
White Flour (unless it is organic and unbleached) – Bleached white flour has been chemically processed. Lots of vitamins and minerals are lost during the process; about 78%. When we consume this chemically-altered product our bodies need extra vitamins and minerals in order to process it and utilize it. Instead, try these recipes for gluten-free all-purpose flour or gluten-free whole-grain flour.
Hydrogenated Oils – Hydrogenated (they are refined) oils are another product that is hard for the liver to handle. This includes any type of oil or fat that hardens when cold. A better choice would be flaxseed oil or virgin olive oil.
Dairy Products – Dairy foods are extremely hard to digest. Because those with liver disease (especially cirrhosis) are more susceptible to small intestine bacterial overgrowth than those with a healthy liver, they are also more likely to experience the symptoms of lactose intolerance. Additionally, a growing number of clinicians are recognizing that eating dairy may cause small intestine bacteria overgrowth exacerbating digestive issues in patients with a liver disease.
Fruit Juices – These beverages are high in concentrated sugar. Sugar is a shock to the liver, stresses the digestive process, stresses the pancreas, and it feeds the Hepatitis C virus.
Artificial Sweeteners – The first word gives you the first clue: artificial. These sweeteners are extremely hard for the liver to process, adding additional burden to the liver. In addition to artificial sweeteners, high fructose corn syrup is no better on the liver and, while sugar isn’t exactly liver friendly, if you’re going to eat it – do so in moderation.
Processed Foods – We all know processed foods contain unnatural substances, preservatives, fillers and chemically treated substances. Commonsense tells us this is not healthy for us.
Updating and recharging your diet is both a mental and physical commitment – and you can do it!
Changing your eating habits can be difficult, and it definitely takes will power. However, altering your diet can have profound effects on overall health – including improved mood, energy and much more.
If you prefer, start slowly by swapping one bad food with one good food. For example, before reaching for salty potato chips, try eating baked chips instead. Rather than indulge in a bowl of ice cream, choose fruit. Both have a sugary boost – but fruit is so much healthier! Steer clear of alcohol by opting for flavored water or herbal tea.
Helpful Hints to Keep Your Healthy Eating on Track
- Plan your meals out in advance. This leaves less room for hasty decisions when you’re hungry and on the go.
- Chop up fresh vegetables and keep them in containers as soon as you get home from the farmer’s market or grocery store. Crunchy carrots, cucumbers, celery and tomatoes will be waiting when you’re ready for a snack.
- If chopping fresh vegetables is too time consuming, consider adding Natural Wellness’ UltraNourish to your diet. UltraNourish, a protein shake focused on liver health, contains fruits, vegetables, fiber, antioxidants and probiotics that are missing from your diet. And now it’s also available in chocolate and vanilla chai! Chocolate UltraNourish and Vanilla Chai UltraNourish contain the same healthy ingredients as unflavored UltraNourish. It’s simple, healthy and delicious!
Foods You Should Eat
- Beans, all kinds
- Walnuts and other nuts
- Vegetables (potatoes in moderation). Don’t forget that UltraNourish contains vegetables, fruits and so much more!
- Kale – It’s a superfood for your liver!
- Lots of vegetable juices, freshly juiced by you
- Homemade vegetable soup
- Fresh fruit in moderation (2-3 pieces per day)
- Lemonade made with fresh lemons and mildly sweetened or lemon water.
- Spices and Herbs
- Herbal teas, iced or hot
- Organic virgin olive oil
- Flaxseed oil
You can take almost any recipe and convert it into a healthy dish simply by using healthy foods.
If you’re a fan of shakes and smoothies, you might be interested in a complete list of recipes for UltraNourish. From Pumpkin Spice Green Smoothie, to Apple Banana Nutter Smoothie – there are tons of recipes to keep you full and satisfied all month long!
Eating Habit Tips
- Eat four, small meals per day. Never eat a large meal at one time.
- Do not eat for five hours before bedtime.
- Try new foods – you may just like them by accident.
- Drink lots of distilled water throughout the day.
- Take a digestive aid with each meal.
- Eat slowly and not in front of the TV.
- Prepare your foods ahead of time whenever possible so they are ready when you are. You can prepare soups, beans, chili beans and more – and freeze them in microwavable containers.
- Salt – if you do not have a problem with retaining fluids and you do not have high blood pressure then a little added salt is fine. You can tell if you are retaining fluids by pressing on your shin bone. Press and hold for five seconds; if it’s indented after releasing pressure you are retaining fluids and should reduce your salt intake.
- Chew, chew, chew. The digestive process starts in the mouth. The chewing action begins the release of digestive juices. Chew, chew, chew. Are you finished chewing?
- If you feel tired, you maybe have eaten too much or the wrong foods. Try lying down.
- Do not eat when you are angry, frustrated or bored. Instead, go take a walk and talk to yourself. This is a great way to relieve your stress.
Remember to make your changes slowly but surely. It took years to learn those bad habits and it will take time to break them.
Tips for Those with Cirrhosis
The majority of the is the same but there are a few important differences:
- Do not eat raw vegetables; steam them instead. These include carrots, potatoes, cauliflower or any “hard to chew” vegetables. Juicing is preferred.
- Avoid alcohol, hot sauces, spicy foods, fried foods, fatty foods and salty foods.
- Suggested fresh juices:
- Carrot, beet, cucumber
- Carrot and spinach
- Carrot, celery, parsley
- Take 2-3 plums with pits and crush them. Add one cup of boiling water, mix and obtain the juice. Drink in the morning and the evening.
- Cook soybean sprouts and adzuki beans (1/2 and 1/2 in amounts), cook into a light soup and eat.
- Add lecithin to foods and take as a supplement, up to 1,500 mg per day.
- Take 800 mg of Vitamin E per day in dry form. If you have not taken Vitamin E before, start with a lower dosage (200 mg per day) and slowly increase.
- Good foods to eat are broccoli, Brussels sprouts, cauliflower, onions, garlic, legumes (beans and lentils), cabbage, peppers (mild), whole grains, artichokes, beets, dandelion, and herbs such as cinnamon, licorice and turmeric.
- Do not take Vitamin C with meals as it enhances the absorption of iron. Take at least 1-2 hours after eating.
Eat healthy and live longer! Proper diet is a must for all of us.
Healthy Eating for Chronic Hepatitis
What is chronic hepatitis?
Chronic hepatitis is an inflammation of the liver that lasts at least 6 months. It is caused by viruses such as hepatitis B or C, alcohol, fatty liver, autoimmune hepatitis and certain drugs, which damage liver cells.
Over time, people with chronic hepatitis may develop symptoms of the condition. Fatigue, or a feeling of tiredness that does not go away after resting, is the most common symptom of chronic hepatitis. Many people lose their appetite and get upset stomachs. People with hepatitis may also suffer from fever, diarrhea, and joint pain.
Some people with chronic hepatitis may develop cirrhosis, or scarring of the liver. Your nutrition needs may change depending on your liver function. If you have cirrhosis, speak to your health care provider or a registered dietitian about your diet.
Do I need a special diet?
No. You can meet your nutrition needs by eating a balanced and varied diet. Use Eating Well with Canada’s Food Guide to help plan your meals. This will help you stay well.
To read more about using Canada’s Food Guide, see https://food-guide.canada.ca/en/.
If you are not sure that your current way of eating is healthy, talk to a registered dietitian.
What if I am too tired to prepare meals?
It can be hard to eat if you are too tired to make meals or are not feeling well. Aim to keep healthy snacks and easy-to-make foods available, such as:
- Whole grain bread, naan, bagels or crackers with nut or seed butter
- Vegetables with hummus or a yogurt-based dip
- Fresh, frozen or canned fruit with yogurt or soft tofu
- Canned fish with whole grain crackers or toast
- Hot cereal with nuts and seeds or trail mix
- Reduced sodium (salt) canned bean or lentil soup with whole grain crackers
When you have the energy to cook, make more than you need. Put the leftovers in the freezer to have at another meal.
If your symptoms get worse or do not go away, talk to your health care provider.
How much protein do I need?
Most people with hepatitis need the amount of protein recommended in Canada’s Food Guide. Eat foods with protein at each meal:
- 2 to 3 servings a day of Meat and Alternatives such as lean meat, poultry, fish, eggs, legumes (beans and lentils), tofu, nuts and seeds
- 2 to 3 servings a day of Milk and Alternatives such as milk, fortified soy beverage, and yogurt
What if I’m losing weight?
If you are underweight, losing weight without trying, or have a small appetite, you may not be eating enough calories to meet your needs. To help prevent weight loss, try eating small amounts of food more often and choose foods that are higher in calories.
Here are some examples of high calorie foods to include at meals and snacks:
- Nuts, seeds and their butters
- 2% or 3. 25% whole milk, high fat yogurt and cheese
- Yogurt smoothies and meal replacement drinks
- Fish, poultry, tofu, legumes, lean meat and egg
- Olive or canola oil, and non-hydrogenated margarine (used in cooking, salad dressings, dips, or as a spread)
Limit candy, chips, donuts, pop, sweetened specialty coffee and tea, energy drinks and sports drinks. These foods give you energy but do not give you important nutrients like protein, vitamins and minerals.
What if I am overweight?
Healthy eating and being active can improve your overall health at any size. Reaching and maintaining a healthy weight can help keep your liver healthy and prevent chronic diseases like diabetes. If you are concerned about your weight and would like healthy eating or physical activity advice, call 8-1-1 and ask to speak with a registered dietitian or qualified exercise professional.
Do I need to take vitamin and mineral supplements?
Maybe. People with hepatitis may not absorb or use nutrients properly. If you are not eating well, or have vomiting or diarrhea, you might need a multivitamin/mineral supplement. Do not take high doses of any vitamin or mineral, especially iron, copper, manganese, niacin or vitamin A, unless your health care provider tells you to. High doses of some vitamins and minerals can be toxic. Talk to your health care provider before you take any supplements or herbal products.
Is it okay to drink alcohol?
No. Alcohol can damage your liver and make the problems caused by hepatitis worse. To be safe, do not drink alcohol. If you would like support to help you limit or avoid alcohol, talk to your health care provider or call 8-1-1 for more information.
What about physical activity?
Physical activity can improve appetite, decrease stress, lessen depression, and help you maintain a healthy body weight. If you have been inactive for a long time, increase your activity slowly.
Participating in physical activity is safe for most people. If you have other medical conditions or injuries, check with your health care provider or a qualified exercise professional before becoming more active.
For More Information
For information on nutrition, food choices and physical activity, call 8-1-1 to speak to a registered dietitian or qualified exercise professional.
For more information, see:
For substance use information and support, visit Mental Health and Substance Use Supports in B.C. www2.gov.bc.ca/gov/content/mental-health-support-in-bc
Hepatitis A | NIDDK
In this section:
What is hepatitis A?
Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.
Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. In rare cases, hepatitis A can be severe and lead to liver failure and the need for an emergency liver transplant to survive. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.
You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.
How common is hepatitis A?
In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked. 1 However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.1 Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.2
Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.
Who is more likely to get hepatitis A?
People more likely to get hepatitis A are those who
- travel to developing countries
- have sex with an infected person
- are men who have sex with men
- use illegal drugs, including drugs that are not injected
- experience unstable housing or homelessness
- live with or care for someone who has hepatitis A
- live with or care for a child recently adopted from a country where hepatitis A is common
People who travel to developing countries are more likely to get hepatitis A.
What are the complications of hepatitis A?
People typically recover from hepatitis A without complications. In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults older than age 50 and in people who have another liver disease.3
What are the symptoms of hepatitis A?
Some people have symptoms 2 to 7 weeks after they come in contact with the virus.3 People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include
Some people infected with hepatitis A have no symptoms, including many children younger than age 6.3 Older children and adults are more likely to have symptoms.
What causes hepatitis A?
The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by
- eating food made by an infected person who did not wash his or her hands after using the bathroom
- drinking untreated water or eating food washed in untreated water
- placing a finger or an object in your mouth that came into contact with an infected person’s stool
- having close personal contact with an infected person, such as through sex or caring for someone who is ill
You cannot get hepatitis A from
- being coughed on or sneezed on by an infected person
- sitting next to an infected person
- hugging an infected person
A baby cannot get hepatitis A from breast milk.4
How do doctors diagnose hepatitis A?
Doctors diagnose hepatitis A based on symptoms and a blood test. A health care professional will take a blood sample from you and send the sample to a lab. A blood test will detect antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies and show whether you have acute hepatitis A. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you are immune to hepatitis A, due to either past hepatitis A infection or hepatitis A vaccination.
How do doctors treat hepatitis A?
Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.
Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.
See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.
How can I protect myself from hepatitis A infection?
You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.
If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.
You can protect yourself from hepatitis A by getting the hepatitis A vaccine.
Hepatitis A vaccine
All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.
Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.
If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, talk with your doctor about how to prevent getting hepatitis A. If possible, try to get both shots of the hepatitis A vaccine before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.
Reduce your chance of infection
You can reduce your chance of getting hepatitis A by washing your hands thoroughly with soap and warm water for 15 to 30 seconds
- after using the toilet
- after changing diapers
- before and after handling or preparing food
When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.
When traveling in a developing country, drink bottled water.
Prevent infection after contact with the virus
If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if
- you live with, have had sex with, or have had close contact with someone who has hepatitis A
- you shared illegal drugs with someone who had hepatitis A
- you ate food or drank water possibly containing the hepatitis A virus
You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.
How can I prevent spreading hepatitis A to others?
If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and don’t prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.
Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.
You are most contagious—able to spread the virus to others—during the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.5
What should I eat and drink if I have hepatitis A?
If you have hepatitis A, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.
 Surveillance for Viral Hepatitis – United States, 2017. Centers for Disease Control and Prevention, Division of Viral Hepatitis website. www.cdc.gov/hepatitis/statistics/2017surveillance/index.htm. Reviewed September 10, 2019. Accessed September 11, 2019.
 Centers for Disease Control and Prevention. National notifiable diseases surveillance system, weekly tables of infectious disease data. Centers for Disease Control and Prevention, Division of Health Informatics and Surveillance website. https://wonder.cdc.gov/nndss/static/2018/52/2018-52-table2H.html. Accessed September 19, 2019.
 Hepatitis A questions and answers for the public. Centers for Disease Control and Prevention, Division of Viral Hepatitis website. www.cdc.gov/hepatitis/hav/afaq.htm. Reviewed March 13, 2019. Accessed August 14, 2019.
 Rac MW, Sheffield JS. Prevention and management of viral hepatitis in pregnancy. Obstetrics and Gynecology Clinics of North America. 2014;41(4):573–592.
 Centers for Disease Control and Prevention. Chapter 9: Hepatitis A. In Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:135–148.
Hepatitis B Foundation: Healthy Liver Tips
People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today!
- Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver.
- Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver.
- Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus.
- Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Read more.
- Check with your pharmacist about any over-the-counter drugs (e. g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.
- Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.
- Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular — cabbage, broccoli, cauliflower — have been shown to help protect the liver against environmental chemicals.
- Limit foods and drinks with added sugars including sodas, fruit juices, desserts, packaged snacks and other foods that contain added sugar.
- Limit foods containing saturated fats including fatty cuts of meat and foods fried in oil.
- Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with a bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage.
- Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer.
- Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.
Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So protect your liver and your health.
Diet | Hepatitis C Trust
The liver is important to the metabolism of iron.
Although it varies from person to person, most of the iron we consume leaves the body naturally.
People with chronic hepatitis C sometimes have difficulty in releasing iron. This can result in an overload of iron in the liver, blood and other organs. This overload can increase tissue damage in the liver.
Menstruating women are less likely to experience iron overload due to their loss of blood each month.
Because of this, people with chronic hepatitis C should reduce the amount of iron-rich foods in their diets. These include red meats, liver, oysters, lentils, apricots and iron-fortified cereals. However, iron is an essential part of your diet so do not cut it out entirely.
It is important to avoid taking iron supplements, unless advised by your doctor. It can make liver damage worse because the body has no way of removing excess iron and it accumulates in the organs and tissues, including the liver. Multivitamin tablets often include iron, so check the label.
Also, beware that vitamin C increases the absorption of iron from food.
Fat can cause abnormalities such as fatty deposits in the liver, fatty inflammation or fatty cirrhosis.
Of course, small amounts of fat should be consumed as part of a balanced diet.
Replacing saturated fats with unsaturated fats can improve your health by helping to lower cholesterol levels in your blood.
Saturated fats are mostly found in fatty meats and full-fat dairy products, as well as in cakes and biscuits. Unsaturated fats are found in fish and foods that come from plants. These include olive oil, nuts, avocado and margarines.
The effect of eating fatty foods is a separate issue to gaining weight.
Protein is necessary for the building and maintenance of muscle, and the repair and healing of the body. 60-120 grams per day of protein is adequate for an adult.
Large amounts of protein in the diet can lead to a build-up of protein breakdown products in the blood. This is because they are normally removed through the liver.
If the levels of protein breakdown products are high, a complication known as encephalopathy can occur. This condition affects mental function and often causes brain fog.
Several older studies illustrate that a diet which cuts out protein from meat improves the symptoms of encephalopathy. However, recent studies suggest it is preferable to continue eating adequate amounts of protein as low protein intake can contribute to malnutrition.
It is difficult to strike a balance between getting the protein that your body needs without causing a build-up of protein breakdown products in the blood. Roughly 1-1.5 grams of protein per kilogram of body weight is advisable.
Cirrhosis can lead to an accumulation of fluid in the abdomen. This is known as ascites, and it is a symptom of end stage liver disease.
People who experience ascites should restrict their sodium intake to less than 1000mg per day.
This is difficult as many foods have a surprisingly high salt content. If it is necessary for you limit your sodium intake, avoid adding salt to food and check the salt content of food products you consume.
You might like to use an app such as Sodium Tracker to help you track your sodium intake. It can help you to add up the amount of sodium in every food product you eat each day, which you can find on nutritional informational labels. Please go to this link for more information go here: https://appsto.re/gb/Qxr7B.i
There appears to be a connection between hepatitis C and issues with regulation of blood sugar levels. This increases the risk of developing diabetes.
The link between hepatitis C and insulin resistance is expanded upon here: http://www.hepctrust.org.uk/information/hepatitis-c-and-overall-health
The liver regulates blood sugar levels by converting the food we eat into substances the body can use. They are then released as energy when the body need them.
People with end stage liver disease have difficulty in regulating blood sugar. One remedy is to have small, frequent meals that keep blood sugar levels more constant.
Coffee / Caffeine
Recent studies have suggested that daily consumption of caffeinated drinks is associated with less advanced liver scarring in people with hepatitis C.
100mg of caffeine (equivalent to 2.5 cups of coffee) is associated with roughly one-third reduction in advanced scarring, but higher intake is not believed to produce a further benefit.
Studies suggest that leafy vegetables can lessen the fatty acid composition in your liver, and help to protect against artherogenic fatty acids which form fatty deposits in arteries.
A build-up of fatty deposits in arteries can cause a condition called atherosclerosis which is a major risk factor for coronary heart disease. There is more information about hepatitis C’s link to CHD here: http://www.hepctrust.org.uk/information/hepatitis-c-and-overall-health
Great leafy vegetables to eat include kale, collard greens, sweet potato greens, spinach and cabbage.
Including juices in your diet can be useful for people with hepatitis C.
Juicing does not necessarily provide more health benefits than eating whole fruit and vegetables, but drinking juices can help to get energy when eating large meals is not possible.
It is also important to keep whole fruit and vegetables as a part of your diet because juices don’t contain any fibre.
What are good combinations to try?
Store-bought juices can be expensive, but making them yourself with a juicer can save you money.
Apples, beetroot, broccoli, carrots, celery, cucumber, ginger, parsley, watercress and wheatgrass can all be good for your liver.
Popular combinations include:
● Carrot, apple, beetroot and ginger
● Cucumber, carrot and beetroot
● Celery, carrot and beetroot
nutritional rules for chronic forms of hepatitis
What kind of nutrition should be followed for chronic hepatitis? What is diet number 5a? Find out from our article.
Chronic hepatitis is a diffuse liver damage, the main characteristics of which are inflammation, damage to liver cells (hepatocytes) and impairment of its functions. Chronic hepatitis is considered when the pathology does not resolve within six months. 1 The course of the disease can be stable or progressive with the gradual development of fibrosis, in which connective tissue cords form in place of the liver tissue, and cirrhosis, when liver function is critically impaired.
Among the most common causes of chronic hepatitis are hepatitis B and C viruses, the toxic effects of alcohol, autoimmune processes and metabolic disorders. 2 The disease is usually asymptomatic, so it is often diagnosed late. 1
General rules of nutrition for chronic hepatitis
Back in the middle of the last century, the Pevzner system was developed in the Soviet Union of 15 diets for each disease, including those related to the liver.The system was used in all hospitals and sanatoriums in the country. Over the years, these diets have improved, but they have not been able to get rid of the shortcomings, the most important of which is uniformity. The entire system is designed for a person aged 20-30 years, weighing 70 kg. 3 In addition, some of these diets have almost the same chemical composition and energy value and differ slightly from each other in cooking methods and salt content. Therefore, it is important to understand that your doctor can prescribe your individual diet after all the necessary examinations and diagnosis.
Do you need special nutrition if nothing hurts? According to Russian authors, even with a satisfactory condition, patients with chronic hepatitis are prescribed a sparing diet specially designed for people with liver disease. With exacerbations (an active process of inflammation), nutrition becomes more stringent. 4 The diet is aimed at eliminating functional disorders of the liver and biliary system, the process of digestion and synchronization of the functioning of the gastrointestinal tract. 4 First, let’s get acquainted with the basic principles of nutrition for chronic hepatitis.
- It is important to eat at certain times and not overeat, especially before bed. This maintains the normal mode of operation of the endocrine glands involved in digestion.
- Do not eat foods that strongly irritate the mucous membrane of the stomach, duodenum and upper small intestine, as these organs can also be involved in the pathological process.
Foods that should be restricted include:
– seasonings and spices,
– smoked meats and spicy dishes,
– vegetables rich in essential oils (onions, radishes, garlic).
- Ice cream, cold juices, mineral waters are also not recommended, as they can cause spasm of the pylorus, sphincter of Oddi and biliary tract.
- The use of alcohol is prohibited.
During the recovery period or between exacerbations, patients are usually prescribed the main version of the standard diet.It is balanced in terms of protein (85–90 g), fat (80–90 g) and carbohydrates (300–330 g). The energy value of the diet is 2200–2500 kcal.
Allowed foods for hepatitis
- Vegetarian, dairy, fruit soups;
- low-fat types of meat and fish in boiled, baked form, as well as once or twice a week and fried, but without breading;
- One or two eggs two to three times a week or omelets, with poor tolerance – egg white omelets;
- fruits and vegetables.There should be a sufficient amount of them in the diet. Vegetables can be eaten in the form of salads and side dishes, some vegetables are consumed raw. Fruit can be consumed in its natural form, as well as in the form of compotes, jelly, mousse, jelly, puddings, etc. ;
- cold milk, for intolerance – boiled or diluted with water;
- yogurt is obligatory;
- butter and vegetable oils;
- snacks – not spicy, not smoked or too salty, with care;
- mild cheese;
- sauces and seasonings not based on meat and fish broths, not spicy;
- black and white bread, baked yesterday, dried;
- biscuits and other products made from uncooked dough;
- tea is weak, it is possible with milk, vegetable and fruit juices, rosehip broth;
- sugar, jam and honey in the amount specified in the carbohydrate composition of the diet.
Prohibited foods for hepatitis
- Rich broths;
- fatty meats: goose, duck, lamb, fatty pork;
- milk for intolerance;
- hot, smoked, salty snacks;
- hot sauces, meat, fish;
- fresh bread;
- Certain types of fruits and vegetables: legumes, spinach, sorrel, sour fruits;
- muffins, pastries, cakes;
- strong tea, coffee, cocoa, alcohol;
Diet for different types of hepatitis
If chronic hepatitis in an active form (roughly speaking, characterized by the presence of symptoms and an increase in transaminases) is diagnosed, then more severe dietary restrictions and an integrated approach to therapy may be recommended.Nutritional therapy remains one of the important factors in maintaining the state of liver function along with pharmacotherapy. It is especially important to follow the food intake regimen, to eat in small portions.
Since in chronic active hepatitis, the biliary tract can also be involved in the pathological process, foods rich in dietary fiber should be added to the diet, which contribute to the excretion of bile acids. 4 These are vegetables, fruits, whole grains (cereals), bran. For the same purpose, it is recommended to change the ratio between vegetable and animal fats to 50/50% (usually it is recommended to adhere to a ratio of 30/50%).With an exacerbation of the process, a diet with mechanical and chemical sparing is prescribed (warm mashed food).
With inactive (persistent) hepatitis without vivid clinical manifestations and symptoms and laboratory abnormalities, a more varied diet may be recommended. 5 There is no need for pureed food, food can be steamed, boiled or baked, including in a microwave oven. The product-specific restrictions listed above remain.The temperature of hot dishes should not exceed 65 degrees, the temperature of cold foods should not be lower than 15 degrees. With both active and inactive hepatitis, alcohol is categorically excluded – there is no “safe” dose of alcohol for patients with this disease. 6
Weekly menu (example)
|Day of the week||Breakfast||Lunch||Lunch||Afternoon snack||Dinner|
|Monday||Two-egg white omelet, lemon tea||Apple||Vegetarian pea soup, boiled chicken with pasta, tea||Homemade croutons without fillers||Boiled fish, buckwheat porridge, kefir|
|Tuesday||Curd casserole, tea||Low-fat yogurt||Vegetarian borsch, boiled beef with prunes, mashed potatoes, dried fruit compote||Cookies biscuits||Carrot cutlets, protein omelet, kefir|
|Wednesday||Semolina porridge, milk tea||Toasted bread sandwich with mild cheese||Pumpkin puree soup, pollock baked with vegetables, berry jelly||Dry biscuit||Chicken cutlets, boiled rice, kefir|
|Thursday||Low-fat cottage cheese with sour cream, tea with lemon||Grated carrot salad with raisins||Vegetarian kulesh soup with rice, chicken roll, rosehip broth||Homemade croutons without fillers||Steamed chicken breast, boiled potatoes, kefir|
|Friday||Oatmeal porridge in milk with water 50/50, tea||Cucumber and bell pepper salad with vegetable oil||Fruit soup, meatballs with rice, tea||Cookies biscuits||Fish cutlets, rice, kefir|
|Saturday||Vermicelli casserole, milk tea||Banana||Vegetarian bean soup, boiled chicken in milk sauce, boiled potatoes, dried fruit compote||Dry biscuit||Steamed chicken breast, mashed potatoes, kefir|
|Sunday||Pilaf with dried fruits, dried fruit compote||Low fat yogurt||Milk soup with noodles, cabbage rolls, berry jelly||Homemade croutons||Boiled veal with milk sauce, green beans, kefir|
And remember that the doctor can choose the diet that is optimal for you, taking into account the situation and individual needs.
Nutrition for liver diseases
When you feel good and feel healthy, you hardly think about what, how and when you eat. Ill, people begin to drink handfuls of pills, dietary supplements, vitamins, forgetting that food can also be therapeutic.
First of all, we turn to women – keepers of the hearth, who make a lot of efforts to feed their families not only tasty, but also healthy food.
What is diet food?
Diet food – food, balanced in composition (amno acids, vitamins, minerals, fatty acids, etc.), regular, with sufficient energy value.
The ratio between proteins, fats and carbohydrates for persons with average physical activity should be 1: 1: 4. In terms of the energy value of the diet, proteins are 14%, fats —30, carbohydrates —56%. Of the total amount of proteins, 50-60% must be of animal origin.Vegetable oils make up 20-25% of the total amount of fats, and in some diseases 30-35%.
Table Guidelines – Standard:
• Don’t overeat! Overeating leads to obesity, heaviness in the stomach, aggravated health problems. The thinnest nation in the world is the British, as soon as a child can hold a spoon by himself, his mother loses interest in how much he eats. Do you remember yourself? “A spoon for mom, a spoon for dad …”
• Watching TV, reading newspapers, in which, unfortunately, not always good news impairs appetite and assimilation of food.Remember how Professor Preobrazhensky from Dog’s Heart did not recommend reading Soviet newspapers while eating?
• Chew your food well! Remember, digestion starts in the mouth!
• Try to eat at the same time. Irregular food intake destabilizes the work of the glands of the digestive system and leads to the development of various diseases, most often the gastrointestinal tract. Healthy adults are recommended 3 or 4 meals a day, and in some diseases, 5-6 meals a day are indicated.
People who have problems with the liver, bile ducts are advised to diet number 5:
• Eating should be regular, 4-5 times a day. Do not overeat
• It is advisable to steam, bake, stew, possibly grill without adding oil
• Avoid fasting, intake of cold foods and drinks
• Do not eat foods that irritate the mucous membrane of the stomach and intestines – seasonings, spices, smoked meats , spicy dishes, vegetables with a high content of essential oils (radish, radish, onion, garlic, horseradish), alcohol.
• Fatty meats (goose, duck, lamb, pork) and fatty fish, as well as brains, liver, lard, lamb fat as difficult to digest and rich in cholesterol, are not allowed.
Dishes that can be eaten:
1. Vegetarian soups, or in the “second” broth (vegetable, cereal, fruit, milk). Vegetarian cabbage soup.
2. Black and white bread – yesterday’s baked goods, dried. Cookies and other products made from non-fancy dough (biscuits). Excluded are pastries, pastries, cakes, pastries.
3. Vegetables in sufficient quantities – boiled and raw (carrots, cabbage, watermelon, etc. in the form of salads and side dishes), except for legumes, tomatoes, spinach, sorrel
4. Lean meats (beef, chicken, turkey, rabbit) and fish in boiled, baked form.
5. Non-acidic cottage cheese (at least 150-200 g every day) or products made from it (cheese cakes, lazy dumplings, puddings, casseroles).
6. Eggs in the form of protein omelets, and with good tolerance, you can take 1 egg 2 times a week (soft-boiled).
7. Milk (not cold, not fat), kefir.
8. Butter and vegetable oil 25-30 g / day. (sunflower, olive). Sour cream is allowed as a seasoning for dishes (1 tsp).
9. Non-spicy types of cheese are allowed.
10. Fruits and berries in their natural form: apples, grapes, prunes, strawberries, etc.,
11. Drinks – weak tea, tea with milk, vegetable and fruit juices, rosehip decoction, compotes, jelly, juices of raw vegetables, fruits and berries, except for sour varieties. Alcohol, strong coffee and cocoa are prohibited.
12. Sugar, honey, jam are given within the usual carbohydrate diet. Chocolate – limit.
In acute viral hepatitis, diet N 5 “a” is prescribed (stricter than diet 5). At the same time, the food should be more gentle – well-boiled porridge, meat mainly in steam form (cutlets, dumplings, etc.), black bread, raw vegetables, fruits, berries are excluded. As the condition improves, the diet gradually expands to the fifth diet.
Diet for patients with liver cirrhosis
For most patients with liver cirrhosis, 80-100 g of protein and 2500 kcal per day are sufficient.
In patients with chronic hepatic encephalopathy, dietary protein is limited to approximately 50 g per day, with plant proteins being preferred.
Alcohol is absolutely contraindicated for patients with liver cirrhosis !!!
Food should be cooked without added salt (see Low sodium diet) Salt should not be on the table!
100 g of beef or poultry, rabbit or fish and one egg per day are allowed. One egg can replace 50 g of meat
Milk is limited to 1 glass per day.You can eat low-fat sour cream
You can eat boiled rice (without salt)
Any vegetables and fruits are allowed fresh or in the form of dishes prepared at home
Low sodium diet
If you have been advised on a sodium-restricted diet, salting of food is excluded, and the total amount of sodium should not exceed 1.5-2 grams per day. Sodium restriction results in reduced doses of diuretics, faster resolution of ascites, and shorter hospital stays.
How do I follow a sodium-restricted diet?
• Do not add salt to food (salt shakers should not be on the table !!!)
• Keep a food diary in which you count the amount of sodium received from food
• Do not eat canned, ready-made frozen, dried foods, factory sauces
• Avoid fast food
• Avoid any food containing baking powder (baking powder) and baking soda (cakes, biscuits, cakes, baked goods)
• To improve the taste of food, use fresh or dry herbs (not ready-made packaged seasonings !!!), lemon juice , balsamic vinegar, peppers, onions and garlic
• Be patient – it may take several weeks for you to get used to the low sodium diet
If you are receiving diuretics, daily record your weight, daily urine output (the difference between the fluid you drink and the fluid excreted), the volume of your abdomen (measured with a tape at the navel level) and the amount of sodium received from food. Weight loss should not exceed 1000 g per day in patients with ascites and peripheral edema and 500 g per day in the presence of only one ascites. Correct adherence to the recommendations of the attending physician will allow you to prevent complications of diuretic therapy and reduce the length of hospitalization.
Approximate sodium content in the daily diet for a patient with liver cirrhosis.
Semolina porridge with cream and sugar or baked fruit ≈ 20 mg
1 egg ≈ 170 mg
50-60 g of bread with unsalted butter and marmalade (jelly or honey) ≈ 220 mg
Tea or coffee with milk ≈ 10 mg
Vegetable salad ≈ 50-70 mg
Soup without salt ≈ 800-1000 mg
90 g white fish ≈ 150 mg
Potatoes 3 pcs.≈ 20 mg
Fruit (fresh or baked) ≈ 15-30 mg
• Afternoon snack
50-60 g of bread ≈ 220 mg
Unsalted butter, jam or tomato ≈ 5-10 mg
Tea or coffee with milk ≈ 10 mg
Greens or lettuce ≈ 16-30 mg
Sour cream ≈ 40 mg
100 g of beef, poultry meat ≈ 80 mg
Pasta ≈ 10 mg
Fruit (fresh or baked) or fruit juice and gelatin jelly ≈ 15 -30 mg
Tea or coffee with milk ≈ 10 mg
TOTAL: 1900-2000 mg sodium per day
Approximate sodium content in food (mg / 100 g)
Rye bread 390–600
Wheat bread 360–590
Bakery products 380–580
Dairy products :
Whole milk 50
Cream, sour cream 30-50
Cottage cheese 40
Unsalted butter 7-15
Dutch cheese 1100
Kostroma cheese, Lithuanian 960
Russian cheese 820
Mayonnaise 500- 520
Chicken eggs 140
Cooked sausages 722-1057
Cooked-smoked sausages 1544–1764
Semi-smoked sausages 1458–1636
Raw smoked sausages 1748–2429
Mackerel 10 0
Salted Atlantic herring 4800
Vegetables (fresh, frozen):
Parsley, greens 84
Canned vegetables 540-700
pearl barley 0
Fruit (fresh, frozen):
Black currant 7
dried apricots 0
Mineral water “Borjomi” 200
Mineral water “Slavyanovskaya” 80
Mineral water “Essentuki No. 4″ 290
Tomato juice 880
Soy sauce 1000
Diet for hepatitis C.How to eat with hepatitis C. Treatment of Hepatitis C.
Hepatitis C therapy is carried out in a complex manner. In order to quickly recover, you should follow the doctor’s recommendations and follow a special diet.
What is a diet for hepatitis C? The disease affects liver cells, so the load on the organ must be minimized. With the help of a special diet, you can achieve liver recovery and speed up the treatment time.
The doctors of the first Danilovsky multidisciplinary medical center on Avtozavodskaya will also prescribe a diet that will help alleviate the condition and relieve the liver from increased work.You should always take care of your health, because it is an integral part of a happy life. Do you need medical attention? Visit our medical center.
Nutrition for hepatitis C
The diet for hepatitis C is “table number 5”. This diet was specifically designed to reduce the burden on the liver. The list of permitted foods includes dishes that contribute to the restoration of the organ: foods and dishes such as lean fish and meat, vegetable and milk soups, buckwheat, beets, jelly and olive oil have a beneficial effect on the liver.
It is important to know that when treating hepatitis C, it is prohibited to drink alcohol and smoke cigarettes. Bad habits slow down the liver recovery process, as they negatively affect the regeneration of hepatocytes.
During therapy, you should refrain from eating fatty foods. Such food puts a lot of stress on the liver, therefore, during the treatment of hepatitis C, you should limit the intake of fatty foods.
Also, in the treatment of hepatitis C, the practice of avoiding fried foods. Patients are allowed to eat steamed food, as well as boiled and baked food.
The usual portions should be reduced, but instead the number of meals should be increased. Meals for hepatitis C should be five times a day. The food should not be too hot.
The use of an abundant amount of salt also affects the liver. Fertilizing food with salt during treatment is best kept to a minimum. During the treatment of hepatitis C, you must drink plenty of fluids. It is with water that accumulated slags and toxins are flushed out of the body.
Fast food on the run and dry food is something you should forget about forever.Eating should be done slowly and chewed thoroughly. It is better to replace mayonnaise with low-fat yogurt or sour cream. With hepatitis C, it is better to refuse ice cream, since this product is abundantly saturated with fats. Hot spices irritate the liver, so these dishes are best left aside.
Duration of the diet
Only a doctor can determine the duration of the diet. Typically, a therapeutic diet is recommended to adhere to throughout the year. Only in combination with diet, bed rest and the use of the required amount of water in the treatment of hepatitis C can you achieve great results.
Specialists of the first Danilovskiy multidisciplinary medical center at Avtozavodskaya treat liver diseases – hepatitis A, B, C, D and E, as well as cirrhosis and fatty degeneration. Take good care of your health – we will be happy to help you!
which foods have a good effect on the liver
Hepatitis C is a disease that damages one of the main auxiliary organs of the digestive system (and the body as a whole) – the liver.Therefore, everyone who has been diagnosed with such a diagnosis must follow a diet, regardless of concomitant diseases. Lifestyle is one of the important conditions for maintaining one’s health until the moment when treatment is started and carried out.
Oatmeal is the best breakfast for liver problems
Basic principles of the diet
Calorie intake for hepatitis should not be lower than normal 1 :
- For men – 2500-2700 kcal per day.
- For women – 2000-2400 kcal per day.
In this case, carbohydrates and proteins, and not fats, should become the main source of energy.
- 1 g of protein food and 1 g of carbohydrates = 4 kcal.
- 1 g Fat = 9 Cal.
You should strive for the following ratio of proteins, fats and carbohydrates in the diet:
- Proteins – 30% (vegetable and animal).
- Fats – up to 20% (vegetable and animal).
- Carbohydrates – 50%.
If we take as an example the daily caloric intake of 2500 kcal, then the ratio of calories from proteins, fats and carbohydrates should be something like this:
- 2500 x 0.3 = 750 kcal from proteins, that is, 187 g of protein.
- 2500 x 0.2 = 500 kcal from fat, that is, 55 g of fat.
- 2500 x 0.5 = 1250 kcal from carbohydrates, that is, 312 g of carbohydrates.
If you have never followed a diet and have no idea how many calories and macronutrients are in foods, you can start by adding all the foods you eat to the calorie counting app. It will show the ratio of consumed proteins, fats, carbohydrates.
The restriction of fatty foods in the diet is explained by the fact that in this way you facilitate the work of the liver.It is not necessary to completely eliminate fat from the diet, since it is as important a nutrient as proteins and carbohydrates. It is enough to limit them in the composition of finished products and as a means for frying.
Braising without oil is one of the ways to prepare dishes with a diet
Allowed and prohibited foods
With hepatitis, it is not so much certain foods that are prohibited, but cooking methods:
- Fried. It is difficult to digest, loads the already suffering liver, and also dramatically increases the amount of fat in the diet.
- Pickled, spicy. It has an irritating effect on the gastrointestinal tract, stimulates the increased production of bile.
- Canned food, industrial products with flavor enhancers, flavors. The consumption of foods with artificial additives additionally burdens the liver.
At the same time, most products (including coffee, many types of bread and confectionery, starchy vegetables, meat and fish, natural spices, fruits, etc.) are not excluded from the diet at all.
Coffee and low-fat sweets (for example, marshmallows, marshmallows) are allowed for hepatitis
Alcohol is completely prohibited for patients with hepatitis C. In any quantity, it aggravates the pathological processes in the liver, destroys its cells and reduces the chances of recovery after treatment.
If you want to undergo treatment and regain your health, you need to forget about alcohol, even in minimal doses.
Table number 5 for hepatitis
One of the examples of how you can eat with hepatitis is table number 5 in the diet system developed by the Soviet nutritionist Mikhail Pevzner.This is a gentle diet for patients not only with viral hepatitis, but also with cholecystitis and pancreatitis.
Main characteristics of table No. 5:
- Methods of cooking – cooking, stewing, baking without oil.
- Dishes are served warm, cold dishes are excluded.
- The amount of salt is limited, but not completely excluded.
Recommended products and dishes
Prohibited foods and dishes
Low-fat types of meat and fish
Vegetable soups limited to 2-3 per week)
All types of cereals, pasta, wheat bread
Vegetables, raw and stewed, herbs, fruits
Vegetable and butter (raw, not for frying; within the permitted amount fat)
Tea, coffee, juices, compotes
Strong meat broths
Canned meat and fish
Smoked foods, lard
Spicy, spicy foods
Mayonnaise, mustard, lard
Fatty fermented milk products
Food should be as possible ti fractional – 4-5 times a day (3 main meals and 2 light snacks), overeating should not be allowed.
But what about hepatoprotectors?
A huge segment of the market for various dietary supplements is occupied by the so-called hepatoprotectors – additives (usually of plant origin), advertising of which says that they help the liver, restore its cells, remove toxins, and so on. But to date, no such drug has been registered as a medicine, there are no studies confirming their effectiveness. At best, they are useless and harmless.
It is impossible, without changing your lifestyle, to maintain your health only with the help of dietary supplements.A much more effective step towards recovery is to quit bad habits and stick to your diet.
1 With a sedentary lifestyle or little activity.
diet for hepatitis, table number 5
Any diagnosis, no matter how severe it may be, helps a person to rebuild, take a new look at his life, start taking serious care of his health, physical and mental state.
All this should fully apply to such a serious disease as hepatitis.Hepatitis is inflammation of the liver caused by a viral infection. There are five main hepatitis viruses called types A, B, C, D and E. Hepatitis C causes chronic disease in hundreds of millions of people and is the most common cause of cirrhosis and liver cancer. Herbal complex Coopers Neo will help to strengthen the protection of the liver. It gently cleanses and restores liver cells, stimulates the production and outflow of bile, reduces its viscosity, strengthens the membranes of liver cells, and reduces the threat of liver cirrhosis.
Hepatitis viruses pose a great health risk – approximately 240 million people worldwide are chronically infected with hepatitis B and approximately 150 million with hepatitis C.
Millions of people live with viral hepatitis, but even more are at risk of infection. Most people with chronic hepatitis C infection do not know they have a virus, because often hepatitis is asymptomatic for decades – until chronic liver disease develops.Therefore, they are at high risk of developing severe chronic liver disease and may unknowingly transmit the virus to others. A powerful natural antibiotic Detox +, which has strong anti-inflammatory and antiviral properties will help to strengthen the immune system. It cleanses the body at the cellular level, removes harmful substances and toxins from the cell, has high antitumor activity, and prevents cell degeneration.
Like the Human Immunodeficiency Virus (HIV), hepatitis B virus is transmitted by contact with the blood and other body fluids of an infected person.However, hepatitis B is much more infectious than HIV.
Vaccination gives protection against hepatitis B. The hepatitis B vaccine has a high safety and efficacy rate. Since 1982, more than one billion doses of the vaccine have been used worldwide. The vaccine prevents the development of chronic forms of the disease by 95% and is effective for at least 20 years. Vaccination against hepatitis B also protects against hepatitis D infection, but does not protect against hepatitis C.
Diet as a way of life
Like any serious illness, hepatitis requires regular medical supervision.However, a lot depends on the patient himself. Self-discipline, a certain lifestyle and, which is especially important in hepatitis, the correct diet. As the philosopher and humanist Albert Schweitzer said: “Each patient carries his own doctor within himself.” And this internal doctor, in no way replacing the attending physician, can bring great benefits to the body.
The main commandments are like this:
· Avoid alcohol and tobacco.
· Try to sleep 7 to 9 hours a day.
· Do not skip food, do not drive yourself to an acute feeling of hunger. Usually, people overeat when they get tired.
· Maintain good physical shape.
· Monitor your weight.
· Eat a diet low in fat, high in fiber, vegetables, fruits, and whole grains.
· Alternate relaxation with an active lifestyle.
· Avoid stressful situations.
· Always be in a good mood.
Diet for hepatitis – one of the means of treatment (table number 5). Its main task is to help the liver to recover. Foods should not provoke additional metabolic disturbances and damage to liver cells. Food should be gentle, that is, regular, complete, contain vitamins, minerals and at the same time consist of easily digestible foods.
Key recommendations on which there is no disagreement among nutritionists
Avoid trans fats.Such fats are found in margarine, baking fats, fast food, canned foods. Read labels carefully and avoid partially hydrogenated oils. Check crackers and cookie labels for trans fat.
· Eat a diet low in saturated fat and cholesterol. Some fats are necessary for the body, however, their consumption should be limited to 30% per day. Typical foods containing saturated fat are butter, ice cream, whole milk, and red meat.Limit your intake of fried foods.
· Try to eat as many fresh vegetables and fruits as possible. Choose brightly colored vegetables and fruits – each color corresponds to a specific group of vitamins and minerals. Juices and dried fruits contain too many calories and are not a complete substitute for fresh fruits.
· Give preference to whole grains.
· Consume vegetable proteins. Legumes, nuts, and seeds are good sources of vegetable protein.Of animal proteins, fish and poultry are preferable.
· Minimize foods with added sugar.
· Do not exceed the recommended amount of salt.
· Canned foods often contain too much salt.
· Drink 6-8 glasses of water a day.
· Watch the calorie intake – calorie expenditure should exceed their intake, unless your goal is to gain weight.
· Avoid fancy diets.Choose those that have long been proven to be effective and safe.
· Fasting, even short-term, is unfavorable. To reduce vomiting, food should be taken 4-5 times a day in small portions.
· Food should be neither hot nor cold – only at room temperature.
· Do not trust diets that promise quick miraculous results.
vegetarian soups, vegetable oil, boiled or steamed lean meats: beef, veal, rabbit.Of fish, cod, navaga, pike perch, carp are preferable. From dairy products: low-fat cottage cheese, kefir, yogurt, acidophilic milk, milk with a low fat content. A variety of cereals are useful: buckwheat, oatmeal, rice, semolina, bread – yesterday. Be sure to eat vegetables and fruits: fresh, baked, boiled – they are the real “kings” of the liver diet. Most dishes should be semi-liquid, or chopped with a blender, grated, in a meat grinder. For dessert – sugar, jam, honey.
And in no case should you ignore vitamins, whose supply in patients with hepatitis is depleted. The best sources of vitamin C: rose hips, black currants, red peppers, sea buckthorn, Brussels sprouts, red and cauliflower, strawberries, rowan berries. In second place in importance are vitamins of group B. They participate in metabolism, support liver function, strengthen immunity and help the activity of the nervous system and hematopoietic organs. Most of this vitamin is found in cereals, potatoes, tomatoes, dairy products.
Folic acid also improves liver function. There is a lot of it in parsley, spinach, lettuce, onions. Vitamin A is essential for the normal functioning of the immune system, reduces the risk of infections, and is considered a powerful antioxidant. They are rich in carrots, pumpkin, bell peppers, spinach, broccoli, parsley, peaches, apricots, apples, watermelon, melon, rose hips.
Not allowed :
sweets, ice cream, cakes, buns – a sick liver doesn’t like them. Any irritants in the form of pepper, spices, garlic, vinegar, mayonnaise, mustard, horseradish, pickles, smoked meats, coffee, chocolate are removed from the diet.To prevent fluid from retaining in the body, salt intake is minimized to 2 g per day. Strong broths, fatty meats – lamb, pork, goose, duck, as well as lard, fatty fish, pickled, salted, pickled vegetables and fruits – are banned. The damaged liver does not tolerate egg yolks, brains, kidneys, smoked meats, sausages, wieners, sausages, canned meat, mushrooms.
What you need to know about viral hepatitis C?
I have hepatitis C
What you need to know about viral hepatitis C?
Information prepared and kindly provided by Dr. Larisa Yurievna Bredneva.Contains 2011 updates.
The information is intended for educational purposes. It cannot be used as a substitute for consulting a doctor.
What is hepatitis C virus?
Hepatitis C virus (HCV) is an infectious disease that occurs as a result of infection with the hepatitis virus, and leads to damage to liver cells of varying severity. Viral hepatitis C can be acute or chronic.
How can you get infected with hepatitis C virus?
The hepatitis C virus is transmitted by direct contact with human blood.For example, you can become infected if:
- Have you ever used drugs and shared syringes or needles.
- You received blood transfusions, blood components or organ transplants from donors with hepatitis C virus.
- You have ever been on hemodialysis and may have contact with blood on the equipment.
- Have you ever worked in a health care setting and had frequent blood contact at your work, especially accidental needle sticks.
- Your mother was diagnosed with viral hepatitis C.
- You have had sex with an infected hepatitis C virus.
- You lived with a person infected with hepatitis C and used their personal hygiene items, such as shaving utensils and a toothbrush, which may contain blood particles.
- You have undergone any operations, including dental ones.
Is the hepatitis C virus sexually transmitted?
Yes, but this rarely happens.The likelihood of sexual transmission through unprotected sexual contact with a person infected with the hepatitis virus is 3-5%. To reduce your partner’s risk of infection, practice barrier protectors (latex condoms).
Can you get the hepatitis C virus from family members?
Yes, but this rarely happens. Family members are infected through direct contact with the blood of an infected person.
Can I get hepatitis C through tattooing?
There is no data on the transmission of the hepatitis C virus through tattooing.However, in the absence or poor infection control, there is the potential for transmission of the virus.
Is it possible to get infected with vinegar from mosquitoes or other blood-sucking insects?
The hepatitis C virus is not transmitted by the bites of mosquitoes and other blood-sucking insects.
How often does chronic hepatitis C virus infection develop?
Approximately 75-85% of infected people develop chronic infection.
Is chronic viral hepatitis C serious?
Chronic viral hepatitis is the leading cause of cirrhosis, primary liver cancer and liver transplants. In the USA, according to statistics, 8-10 thousand patients die annually from complications of viral hepatitis C.
How long can hepatitis C virus survive in the environment and be infectious?
Hepatitis C virus can survive on surrounding surfaces at room temperature for at least 16 hours, but not more than 4 days.
How to disinfect? What should be used to disinfect hepatitis C virus on surrounding objects?
Clean up any blood spatter, including dried blood, using a solution containing one part household bleach, disinfectant and 10 parts water to disinfect the surface. Use gloves when cleaning surfaces containing blood.
How can people infected with the hepatitis C virus prevent the spread of the virus to others?
- Do not donate blood, organs, other tissues, or sperm.
- Do not share personal items such as toothbrushes, manicure sets or shaving accessories that may contain your blood.
- Seal your wounds and cuts.
- Practice safe sex.
How can a hepatitis C patient protect their liver?
- Stop drinking alcohol.
- See a doctor with experience in managing viral hepatitis regularly.
- Do not start taking any new medications, over-the-counter forms, herbs, or other medications without your doctor’s advice.
- Get vaccinated against hepatitis A and B.
What else should a hepatitis C patient know?
The hepatitis C virus is not spread by coughing, sneezing, hugging, through water or food, using shared utensils, cups, casual contact. Those infected with the hepatitis C virus should not be suspended from work at school, caring for children, etc.Involvement in a support group can help patients cope with viral hepatitis C.
Can viral hepatitis C manifest itself in other organs and systems (other than the liver)?
A small percentage of patients with chronic hepatitis C virus infection may develop other organ damage. This is due to a violation of the immune system, the occurrence of autoimmune reactions directed against the body’s own cells. These lesions include glomerulonephritis, mixed essential cryoglobulinemia, porphyria, and several others.
Is there a vaccine to prevent Hepatitis C virus infection?
What tests are used to diagnose hapatitis C?
The most accessible diagnostic method is the determination of Anti-HCV (antibodies to the hepatitis C virus). This test is the primary screening test. If it is positive, it should be confirmed. The presence of Anti-HCV establishes the fact of infection in the past or present. For an accurate diagnosis of hepatitis C, the next step is performed, PCR diagnostics (polyserase chain reaction), which allows you to determine the RNA of the hepatitis C virus in the blood.A qualitative test for detecting the presence or absence of hepatitis C virus confirms both the presence of infection and the fact of replication (multiplication) of viruses in the body. Negative PCR does not prove that the subject is not infected: the virus may be present in the blood in an insignificant amount and cannot be detected by the PCR method. A negative result may be in those infected in the past, as well as in convalescents. If a diagnosis of viral hepatitis C is assumed and the PCR is negative, the analysis should be repeated. A quantitative test for detecting the amount of hepatitis C virus allows one to judge about 90,030 the activity or speed of multiplication of viruses.The higher the tier load, the more active the replication of viruses. High viral load is a factor that reduces the effectiveness of antiviral therapy.
Can liver enzymes, including ALT, be normal in chronic hepatitis C?
Chronic hepatitis C is characterized by periodic fluctuations in liver enzymes. ALT activity can rise and fall towards normal values. In some patients, normal liver enzyme levels are recorded for more than a year, but the development of chronic liver disease continues.If the liver enzymes are within normal limits, the patient should be monitored several times within 6-12 months. If the indicators remain normal, they should be monitored at least once a year.
How long after infection with viral hepatitis C is it possible to determine the RNA of the pathogen by PCR?
By PCR, hepatitis C virus can be detected 1-2 weeks after infection.
What does the term “genotype” mean?
The term “genotype” refers to the genetic makeup of a virus or organism. At least 6 genotypes of the hepatitis C virus are known, in Ukraine most often 90,030 genotypes are registered.
Why is it necessary to determine the genotype of the virus?
Knowledge of the C genotype is necessary for the preparation of recommendations and treatment tactics. Patients with genotypes 2 and 3 respond better to antiviral therapy, for these patients a 24-week course of combination therapy is sufficient, while patients with genotype 1 require a longer, 48-week course of therapy.
Can a patient be infected with different genotypes of the virus?
Yes, due to an unproductive immune response. Previous infection does not protect against reinfection with the same and other genotypes of the virus. For these reasons, there is no effective pre- and post-exposure prophylaxis (eg, immunoglobulin).
What is a liver biopsy for?
Liver biopsy is taking a small piece of liver tissue with a special needle and examining it under a microscope.A liver biopsy is necessary to assess the extent of liver damage, especially in asymptomatic patients. This study allows you to identify the degree of damage, monitor the course of the disease and the effectiveness of treatment.
Diagnostics of the state of liver tissue without biopsy
Currently, there are absolutely safe and fairly reliable diagnostic tests that can detect fibrosis from the very beginning of its formation. These are Fibrotest and Fibroscan.
What is Fibrotest?
This data is obtained using a patented algorithm based on the determination of specific biomarkers of fibrosis in the venous blood of a patient, taking into account his age, sex, height and body weight. There are several types of tests, which for the convenience of assessing their clinical significance are grouped into two complexes: Fibro / Acti Test and Fibro Max.
What is Fibroscan?
This is a pulse elastometry of the liver (measurement of the elasticity of the liver tissue). The principle of the method is that the density of the liver is directly proportional to the stage of fibrosis.
How fibrotest and fibroscan differ from liver biopsy?
These are minimally invasive methods that provide higher accuracy in identifying the early stages of fibrosis. Fibrotest allows you to detect the smallest functional changes in the liver, when these changes have not yet led to anatomical defects. Also, these methods are indispensable when there are contraindications for liver biopsy, for example, with blood clotting disorders.
Pregnancy and breastfeeding
Does a pregnant woman need to be tested for anti-HCV?
No. The risk of infection with the hepatitis C virus in a pregnant woman is not higher than in a non-pregnant woman. However, if a pregnant woman has risk factors for hepatitis C virus infection, she should be screened for anti-HCV.
What is the risk of transmission from a woman infected with the hepatitis C virus to a child?
Infection is possible only during childbirth and it is not possible to prevent it today.According to statistics, during childbirth, 4 out of 100 newborns from HCV infected mothers become infected, most of them do not have symptoms of the disease.
What is the risk of perinatal transmission of hepatitis C virus if the mother is also infected with human immunodeficiency virus (HIV)?
If the mother is diagnosed with hepatitis C virus and HIV co-infection, the chance of infection of the fetus can be up to 19%.
Should a woman with viral hepatitis C refuse to breastfeed?
No.There is no evidence of transmission of hepatitis C virus through feeding. Mothers with hepatitis C virus infection should consider not breastfeeding if they have cracked or bleeding nipples.
When should a baby born to a mother with hepatitis C virus be tested for possible infection at birth?
Children under 18 months of age should not be screened as maternal anti-HCV may persist until this age. If it is desirable to establish the diagnosis before 18 months, a PCR study of the child should be performed at the age of 1-2 months.PCR should be repeated at the next visit, regardless of the result of the initial examination.
Treatment of chronic viral hepatitis C
Treatment of viral hepatitis should be started as early as possible!
The earlier therapy is started, the more chances for a complete cure are!
To date, treatment with a combination of pegylated interferon and ribavirin is recognized as the most effective worldwide. The use of this scheme allows to achieve a persistent virological response in 60-95% of patients (up to 60% in patients infected with the most common genotype 1, and up to 95% in patients infected with genotypes 2 and 3).Interferon alone is a treatment option for patients for whom ribavirin is contraindicated. Ribavirin is ineffective when used alone.
When is hepatitis C more difficult to treat?
According to statistics, it is more difficult to treat hepatitis C in men, people over 40 years old, in overweight patients, in patients with normal transaminase activity, with a high viral load, with 1 b virus genotype. The presence of cirrhosis of the liver at the time of initiation of treatment worsens the prognosis.
What will happen if after the course of treatment the patient is not among those who have been cured?
Courses and special re-therapy regimens are provided for people in whom the result of treatment was not achieved or was incomplete (there was a relapse of infection
immediately after treatment).
The drugs and treatment protocols for hepatitis C are constantly being improved, their effectiveness is growing and may turn out to be higher than the previous treatment regimen, which did not give the desired result.
Even in the absence of a persistent virological response, interferon therapy reduces the severity of fibrosis in the liver and can significantly extend the time before the onset of such formidable complications of viral hepatitis C as liver cirrhosis and hepatocellular carcinoma.
Is it possible to get infected and get sick with hepatitis C again?
Yes, you can get infected and get sick again. Even if the treatment was successful, immunity to the hepatitis C virus is not developed, therefore, re-infection (including with another type of HCV) causes the disease.
What are the contraindications to antiviral therapy?
- Clinically significant concomitant diseases (malignant tumors, unstable angina pectoris, severe obstructive pulmonary disease).
- Clinically decompensated liver disease *.
- Uncontrolled autoimmune diseases.
- Pregnancy or planned pregnancy in the patient or patient’s sexual partner, or unwillingness to use adequate pregnancy control.
- Documented lack of patient adherence to previous treatment or inability to complete prescribed examinations.
- Severe uncontrolled psychiatric illnesses, in particular depression with a risk of suicide.
- Current injecting drug use.
- Current alcohol abuse.
- Age under 3 years old.
- Individuals with individual intolerance to any drug for the treatment of hepatitis C.
What research needs to be done before starting therapy?
You need monthly consultations with your attending physician to examine and evaluate the results of laboratory tests, as well as to ensure that side effects of treatment or complications are recognized and corrected in time, and serious adverse events do not develop at all.
- Screening for depression and alcohol intake.
- Biochemical markers of liver damage and assessment of liver function, including determination of ALT, albumin, bilirubin (in particular direct), prothrombin time.
- Leukocyte count, hemoglobin level, hematocrit, platelets.
- Determination of thyroid function.
- Serum creatinine.
- Serum glucose or glycosylated hemoglobin (HbA1C) in patients with diabetes mellitus.
- Pregnancy test (for women of childbearing age).
- Definition of HIV infection.
- HBsAg, Anti-HBc, anti-HBs, anti-HAV (total).
- Quantification of HCV RNA.
- HCV genotype.
- Liver biopsy to determine the severity of liver disease (in particular with HCV genotype 1), fibrotest, fibroscan.
- Examination of the fundus to detect retinopathy in patients with diabetes mellitus and arterial hypertension.
- Serum ferritin, iron saturation, antinuclear antibodies.
- Toxicological study of urine for the presence of opiates, cocaine, amphetamines.
Can children with chronic viral hepatitis receive interferon therapy?
FDA approved a combination of antiviral drugs for the treatment of viral hepatitis C starting at age 3.
What is co-infection?
The term co-infection means the simultaneous presence of two or more viruses.Since the routes of transmission in viral hepatitis B, C and HIV are similar, it is possible to simultaneously become infected with two or even three viruses.
Hepatitis B / Hepatitis C coinfection
Like hepatitis C, hepatitis B can cause severe liver damage, including cirrhosis and primary liver cancer. HBV / HCV coinfection is poorly understood, but studies have shown that coinfection can lead to more severe liver damage than infection with only one of the viruses.
What is the prevalence of HCV infection among injecting drug users?
The most recent surveys show that one third of young people who inject drugs (aged 18-30) are infected with HCV. Infection rates among the elderly and former injecting drug users are generally higher, ranging from 70% to 90%.
What is the risk of contracting viral hepatitis C from cocaine use?
Limited epidemiological data are available to indicate an additional risk associated with cocaine use.
What are the characteristics of viral hepatitis C in HIV-infected people?
Most research suggests that HIV infection leads to more aggressive hepatitis C.
There is no consensus on when to start HIV treatment. According to the latest data, patients with a CD4 count below 350 cells in 1 mm3 and a viral load exceeding 55,000 copies in 1 ml need treatment. The standard treatment for HIV infection is the combined use of several antiretroviral drugs.
HIV infection can be effectively treated in most patients with viral hepatitis C. Some drugs used in the treatment of HIV infection, such as protease inhibitors, can cause a temporary increase in ALT and other liver biochemical parameters. Most patients with hepatitis C virus infection can take drugs to treat HIV infection if liver parameters are closely monitored.
General rules for the treatment of HCV infection can be applied to HIV-infected patients.Treatment of hepatitis C in these patients is more demanding and should be longer. HIV-infected patients with a CD4 count of less than 200 cells / mm3 are not considered good candidates for HCV infection and require 90,030 antiretroviral therapy primarily.
The importance of deciding on antiviral therapy
In the long term, treatment is your best chance to stay as healthy as possible and for as long as possible.
The condition of untreated patients is not getting better: the virus continues to damage the liver.Patients who start antiviral therapy earlier respond better to treatment.
Whether or not to start taking antiviral therapy is one of the most significant decisions you have made in your life. For many, treatment helps to reduce the viral load in the blood to undetectable levels, and has a positive effect on the structure of the liver.
The course of antiviral therapy for many seems to be a difficult and long-term task, and it always seems easier to do nothing at all, but to wait for a better or more convenient case in the future.This is very tempting: constantly, under some pretext, to postpone treatment. Six months or 1 year of treatment is not as long as it seems right away if you want to maintain your quality of life and health.
Be honest with yourself and answer the following questions:
Was antiviral therapy more successful and effective than it is now?
Will I ever be stronger, healthier, more ready to make a decision than I am now?
The answer to the first question is simple.We have learned a lot about hepatitis C and some progress has been made in treatment.
You can form the answer to the second question by communicating with your doctor.
By making an informed decision about therapy, you can end up with a good result and feel better. Many patients completed their treatment successfully. Just completing the treatment is a success in itself. Dealing with stress is an important control factor during therapy. Living with a chronic illness is stressful.Try to maintain a realistic view of your health and a positive outlook on life.
It is necessary to know that during the therapy of chronic hepatitis C there may be side effects associated with the intake of antiviral drugs. Side effects are different for each patient. Some patients do not report side effects, while others pay attention to poor drug tolerance.
If you are receiving antiviral therapy:
It is necessary to correctly recognize the side effects you are experiencing.How to deal with side effects should be learned, including situations where it is necessary to seek the help of a doctor.
You should know which side effects are serious and that if they develop, you should immediately consult a doctor.
Side effects of treatment should always be evaluated and monitored by a physician.
An important component of successfully managing side effects is establishing a pre-treatment support group that can include family and friends.
Maintaining a positive attitude during treatment is a very difficult and important task. There is no scientific evidence on how the general attitude of the patient affects the treatment process. However, many patients report the importance of maintaining a positive mindset. A positive attitude is a process, not an ultimate goal. Don’t program yourself to fail. Be considerate of yourself.
How to maintain a positive attitude during treatment?
Before starting treatment, make a list of the reasons why you started treatment, constantly re-read it when it is difficult for you.The reasons that prompted you to start treatment may be different:
To improve your health.
To live longer.
To make you feel like you have done everything that you can do.
To live for your children, grandchildren, loved ones.
Just to get rid of the virus.
To reduce the symptoms of hepatitis and improve quality of life.
For the prevention of cirrhosis and liver cancer.
In order not to become a burden to others.
When you wake up in the morning, think gratefully of the people who support you during your treatment and that you have the opportunity to receive treatment. Remind yourself each night that another day of treatment is over and you are one day closer to your goal of completing your treatment. Keeping in a good mood is much easier if you look after yourself all the time. If you look good, you generally feel better.
Try to follow these tips:
- Take a shower or bath daily.
- Listen to soothing music.
- Take care of the beauty of your hands and nails.
- Moisturize skin constantly.
- Take care of your hairstyle, it should be attractive and easy to maintain.
- Men do not forget about shaving.
- Women, if you regularly used makeup before starting therapy, do not forget to do so during treatment.
- Get dressed, even if you spend all day on the couch, choose comfortable clothes.
- Wear colors that make you feel your best.
Moderate exercise is strongly recommended for all HCV-infected patients, except those with acute hepatitis. Physical activity will improve your overall well-being and help you stay positive and motivated. Exercise can relieve stress and help you stay fit. However, excessive exercise can exacerbate the disease.Choose light types of exercise, such as walking, hula hoop, swimming, dancing, gardening, yoga, qigong practice.
Slowly increase the load until the desired level is reached. Talk to your doctor before embarking on any exercise program.
Regular exercise contributes to:
- Increased muscle mass, strength and endurance.
- Energy potential improvement.
- Reduce stress.
- Increased bone strength.
- Reducing cholesterol and triglyceride levels.
- Increased appetite.
- Improve sleep.
- Stabilization or prevention of CD4 cell decline in HIV-infected individuals.
However, don’t overdo it! Exercising for 20 minutes, at least 3 times a week, will lead to a significant improvement in your physical condition and you can feel better. Choose activities that you enjoy.
Several dietary guidelines for viral hepatitis C:
Eat a healthy and balanced diet with lots of vegetables and fruits.
Try to refrain from excess sugar, salt and fatty foods.
Read all labels to familiarize yourself with the ingredients of the food you purchase.
Proteins from meat, poultry, fish and vegetable sources may be most beneficial.
Do not eat raw or undercooked shellfish. they are harmful to patients with hepatitis C.
Avoid taking large doses of vitamins A and D.
Do not take vitamins and herbs without consulting your doctor.
What symptoms should I call a doctor immediately?
Thoughts to harm yourself or others.
Persistent increase in body temperature, its increase.
Decreased vision clarity, loss of vision.
Difficulty breathing (shortness of breath on exertion with exertion is common with therapy).
Recurrence of psoriasis.
Unusual bleeding or bruising.
Severe abdominal or back pain.
What medications should not be taken while taking antiviral therapy?
You should not take didanosine while you are taking ribavirin. Talk to your doctor about any medications you are taking.
Antiviral Therapy Side Effects Guide
Nearly all patients taking pegylated interferons experience flu-like symptoms during treatment, such as muscle and joint pain, headache, chills, and fever.Most often, these symptoms occur 2-24 hours after the injection. Fortunately, they are usually most pronounced at the beginning of treatment. Flu-like symptoms are unpleasant, but you can manage them.
The appearance of temperature is associated with the intake of pegylated interferon. The rise in temperature is usually more pronounced after the first few injections and usually occurs on the first or second day after the administration of interferon.
Seek help immediately if:
Temperature is over 38 ° C and lasts more than a day;
When chills or severe weakness appear;
In this case, the temperature may be associated with an infection, and you need specific treatment.Your Doctor will find out what your situation is related to.
Talk to your doctor about taking paracetamol or ibuprofen * half an hour before your pegillated interferon or after an injection when you have a fever. This can reduce the temperature associated with the injection. Drink enough fluids, with a weight of 70 kg, you should drink at least 8 glasses of water per day. Visit your doctor if your temperature is:
above 38 ° C, if this does not follow after an interferon injection.
above 38 ° C: repetitive or lasting more than 24-48 hours.
* Caution: high doses of paracetamol cause severe irreversible changes in the liver, aggravated by the simultaneous intake of alcohol. Taking Ibuprofen increases the risk of gastrointestinal bleeding in patients taking anticoagulants and steroids, the risk increases with the simultaneous intake of alcohol.
Muscle pain is the result of inflammation in the muscles that occurs while taking pegylated interferon.Ribavirin can also cause muscle inflammation and loss of fluid in your blood vessels, which can lead to muscle pain (dehydration is partly responsible for muscle soreness after prolonged exercise).
Talk with your doctor about taking paracetamol, or ibuprofen, to relieve muscle pain.
Do moderate-intensity exercise.
Use a warm, damp washcloth to rub over painful areas.
Take warm baths.
Drink plenty of fluids.
About 60% of patients taking antiviral therapy have headaches. Stress, insomnia, unhealthy diet can be the cause of headache. Headache can also be associated with a direct result of interferon, as well as anemia (low red blood cell count) caused by ribavirin.
Drink plenty of fluids.
Take warm, soothing baths.
Relax in a quiet, dark room.
Try to reduce your stress levels.
If you have persistent headache for more than 24 hours, contact your doctor immediately.
Discuss paracetamol or ibuprofen * with your doctor
If you have had migraine attacks (a certain type of headache often associated with visual disturbances), talk with your doctor about taking medication
Avoid loud sounds, bright lights, alcohol, caffeine and foods containing tyramine (such as cheese and chocolate) and phenylalanine (used as artificial sweeteners).
Many patients on antiviral therapy have trouble sleeping. This occurs due to the stimulation (arousal) of certain areas of the body. Lack of sleep can trigger other side effects, including weakness, irascibility, poor mood and headache, and make your overall condition much worse. Adequate sleep and rest are the keys to successful treatment.
Make eight hours of sleep a regular habit.
Avoid reading and watching TV in bed.
Turn off the TV and computer one hour before bed.
Try to go to bed and get up at the same time.
Try to get some sleep during the day.
Limit fluid intake in the evening to avoid going to the bathroom at night.
If you feel anxious while taking ribavirin, take the tablets at 4 pm or 5 pm instead of just before bed.
Avoid eating large amounts of food, excess exercise, tobacco and caffeine before bed.
Do little exercise regularly, but refrain from exercise at least 4 hours before bed.
Chamomile tea is one of the most widely used teas for improving sleep. For better relaxation, place small lavender herb pillows or cotton cloths dipped in lavender oil near the bed. Remember, however, if you are using herbs, be very careful.
Feelings of fear and anxiety
Many patients report anxiety during antiviral therapy.This is a side effect of drugs, especially interferon, and is difficult to prevent. You may feel anxious and nervous.
Use relaxation techniques (yoga, meditation, deep breathing)
Avoid stimulants such as caffeine (coffee and tea).
If you feel unwell, tell your doctor about your symptoms and he will recommend medications to improve your well-being.
Many patients on antiviral therapy are angry about things that normally do not cause them emotion.This can even happen to people who have never been irritated. You may find yourself yelling at people in transport, although this has never happened to you before. By being aware of your temper, you can expect and control it better. If your family and friends know that you are taking medication that may be causing your reckless behavior, it will be easier for them to understand you.
Use relaxing technologies (yoga, meditation, deep breathing).
Breathe deeply, count to 10.
Share your feelings with friends and family.
Join a support group.
If you are tired, depressed, or sleepy, find ways to deal with these side effects.
Try to make your work less stressful.
For example, discuss flexible working hours with your supervisor if it can help you.
Depression and discouragement
Let’s face it, any chronic illness can cause depressed mood.Therefore, it is not surprising that many patients feel worthless and guilty. Depression is a spectrum of different symptoms. Its typical symptoms are:
Melancholy, sadness, anxiety, or irritability.
Difficulty falling asleep, repeated awakening at night or awakening too early.
Loss of interest in work, food, sex life.
Feelings of guilt and inferiority, hopelessness in relation to the future.
Difficulty concentrating and constant fatigue.
Weight loss or, conversely, weight gain.
Excessive concern for their own health.
Thoughts of suicide and death.
Antiviral therapy can increase the symptoms of depression, and symptoms usually appear within the first four weeks of starting treatment, although depression can begin at any point in therapy. If you suffered from depression before starting therapy, tell your doctor about it – they will help you cope with this condition.
Taking pegylated interferon usually causes feelings of powerlessness.If you find your condition more than slightly exhausted – perhaps you feel 90,030 worthless, useless, or driven to complete despair, having lost interest in your favorite pastime – you are depressed. This condition can be corrected
by changing the dose of interferon or prescribing antidepressants. After the end of therapy, these sensations will disappear within 1-2 weeks. Be sure to discuss your condition with your doctor. It is important for you to have a social circle with which you can share your feelings and doubts during treatment.Your family and friends can be a source of support for you and help you cope with your worries.
If you feel you are capable of harming yourself or are considering suicide, seek help immediately.
Do what brings you pleasure, for example, read books, visit your favorite cafes, performances, museums.
Learn to manage your emotions.
Develop habits: eat, go to bed, take medicine at the same time.
Avoid eating large amounts of sugar.
Keep a journal of any negative thoughts and feelings that affect your mood; this will help you and your doctor know how you are feeling on a daily basis.
It is important for you to have a social circle with which you can share your feelings and doubts during treatment. Your family and friends can be a source of support for you and help you cope with your worries. Spend time with people who can support you.
Join support groups.
Discuss with your doctor the options for treating depression.
Remember that depression is a controlled condition.
If you are taking medication for depression, make sure you follow your doctor’s instructions correctly.
Increase your intake of omega-3 acids.
Patients with hepatitis usually feel tired and weak.
Fatigue is one of the first side effects of antiviral therapy. This is partly due to the fact that interferon stimulates your immune system, and ribavirin has a toxic effect on red blood cells, reducing them (this condition is called “anemia”).Dysfunction of the thyroid gland, accompanied by a decrease in the level of thyroid hormones, can also cause fatigue.
Explore your limits and don’t overwork yourself. Do only those activities that really need to be done.
Try to go to bed and get up at the same time every day.
When planning any activity, consider taking breaks for rest or short naps.
Get regular little exercise, but refrain from exercise at least 4 hours before bed.
Watch your posture.
Eat healthy foods to maintain your weight.
Remember to drink plenty of water throughout the day, especially after taking the pills.
If the weakness is significant within 1–2 days after the IFN injection, take 325 to 1000 mg of paracetamol * before the injection. (Talk to your doctor about this.
Remember that health is the most important thing. Learn to say no to your friends and family who overestimate your strength, ask them to help you.
Loss of concentration, memory and the ability to think clearly
Tips for improving memory:
Keep a regular diary of medication and side effects.
Do not forget to take medicines with you, put them in a special container.
Use the timer settings on your wristwatch, alarm clock, electronic organizer, or computer to remind you of your medication.
Get into the habit of planning your day the night before.
Perform one task at a time, not several tasks at the same time.
Pay attention to what you want to remember, repeat several times.
Use sticky notes to remind you of your plans.
Oral cavity, stomach, digestion
Antiviral therapy can lead to decreased appetite. It is important to adhere to a complete diet during and after therapy. Your body needs good nutrition and healthy food to fight the hepatitis C virus and repair the damage caused by it.
Take a walk or exercise to relax before eating.It can boost your appetite.
Take food 5-6 times a day in small portions instead of three meals a day. For example, 8:30 for breakfast, 10:00 for a light snack, 12:30 for lunch, 15:00 for a light snack, 17:30 for dinner, and 19:30 for a light snack.
Eat your favorite food, even if you don’t eat much.
Drink freshly prepared home-made drinks with food additives instead of meals. Drink drinks through a straw if you find them less appetizing.
Store snacks such as boiled eggs, cheese and butter wherever you can.Store snacks that don’t need to be refrigerated by your bed or TV.
Stock up on small portions of frozen food, easy and simple to prepare.
Try to use different types of food to prepare the most interesting dishes.
Watch television on cooking.
Make your meal enjoyable – eat with others, eat in a pleasant place with candles.
If possible, do not drink liquids at the same time as meals.This will make you full sooner.
Bad taste in the mouth, change in taste
Pegylated interferon can cause a bitter or metallic taste in the mouth. Ribavirin can cause mouth inflammation and dehydration, which can create a dry and unpleasant taste in your mouth.
Drink plenty of water.
Sour foods can mask metallic taste. Drink orange, cranberry, pineapple juice, and lemon drink. Add apple cider vinegar, lemon juice, pickle, or seasonings to your meals.
Marinate meat, chicken, fish or turkey in apple cider vinegar, wine, mayonnaise, soy sauce. Add fresh and dry herbs or condiments to (such as onion, garlic, chili, rosemary, cumin, basil, oregano (mint), thyme, mustard, horseradish, ketchup).
Avoid canned foods. Eat fresh or frozen foods.
Eat cold foods such as popsicles, sorbet, fruit yogurt, frozen yoghurt to freeze the taste buds. Eat frozen grapes, orange slices, or melon and watermelon slices.Use lemon lozenges to help reduce or eliminate bad taste in your mouth that does not go away after eating.
Do not eat citrus fruits or drink citrus juices immediately before or after brushing your teeth.
Eat dark chocolate.
Rinse your mouth with tea, salt water, or water with baking soda before meals. This will help freshen up the palate.
Use glass, china, plastic packaging instead of metal.
Observe oral hygiene.
Remember that your palatability will recover after the end of the therapy.
Dry mouth and thick saliva
Ribavirin destroys red blood cells, resulting in dehydration. This causes dry mouth or thickened saliva.
Use sugar-free candy, ice cubes, chewing gum to moisturize the mouth.
Start and end your day with a glass of water.
Add sauces, juices, yoghurts to food.
Dip bread, crackers, biscuits in soup, milk, juice or hot chocolate.
Keep a glass of liquid near your bed in case you come in for a drink at night.
Rinse your mouth with a mild saline solution.
Drink plenty of fluids, water with lemon juice, lemon tea.
Talk to your doctor about other oral moisturizers to treat dry mouth.
Inflammation of the oral cavity and throat
All patients are recommended to be examined and treated by a dentist before starting treatment.During treatment, inflammation of the mouth and throat is possible. If you usually have sores in your mouth, your condition may worsen during treatment as a result of decreased immunity. Talk to your doctor: many factors can cause stomatitis and aphthous lesions in the mouth.
Observe oral hygiene.
Use a soft toothbrush.
Do not use toothpastes containing sodium lauryl sulfate.
Drink plenty of water.Adequate hydration is important to maintain health, especially during hepatitis B treatment. Eat chopped foods or mashed potatoes. Baby food can be a great substitute for other foods.
Drink nectars instead of juices.
Drink instant drinks or milkshakes instead of solid foods.
Use a straw.
Eat warm or cold food, not hot food.
Rinse your mouth with warm, salted water.
Consult your doctor regarding the use of lidocaine for oral care.This can relieve the discomfort of oral inflammation.
Keep a food diary to identify possible causes of inflammation and eliminate foods that cause inflammation from your diet.
Use high tannin tea and herbs (chamomile, sage, peppermint) for mouthwash.
Talk to your doctor about taking probiotics containing Lactobacillus.
Echinacea may speed up the healing process of aphthae, however, in patients with HIV, Echinacea is contraindicated.
Salty, sour, spicy foods.
Coarse food like dry toast, muesli.
Chili powder, hot sauce, pepper, curry, cloves, nutmeg. 90,030 Drinks containing carbonate salts (cola).
Citrus fruits (oranges or grapefruits).
Nausea and vomiting
Nausea is a common side effect and can be caused by both interferon and ribavirin. Repeated vomiting can lead to dehydration and chemical imbalance in the body.If you experience frequent vomiting or nausea, consult your doctor.
Eating a diet containing bananas, rice, applesauce, tea, and toast.
Eat small, snack meals every 2-4 hours instead of 2 or 3 meals a day.
Take ribavirin with meals.
Eat food that is cool or chilled to room temperature. Fruit or chilled cheese sandwiches are good. Hot food can contribute to nausea and vomiting.
When vomiting, support yourself with soups, juices, frozen fruits.
Foods to help with nausea and vomiting:
Salty foods such as crackers, pretzels.
Mint, chamomile, ginger tea will calm your stomach.
Cold mineral water with gas.
Talk to your doctor about the use of medicines that reduce nausea.
What to avoid:
Do not lie down for an hour after eating.
Avoid odors and foods that cause nausea.Open windows to reduce the smell of food being cooked.
Do not eat during severe nausea.
Avoid very sweet, hot, fatty, spicy, strong-smelling foods.
Diarrhea (diarrhea) may occur during therapy. In some patients, diarrhea is a manifestation of side effects. Diarrhea can cause dehydration and weakness, so it is very important to make up for lost fluid loss.
Eat a diet containing bananas, rice, applesauce, tea and toast.Eat small meals often.
To replenish lost fluids, drink a variety of drinks (water, herbal teas) at room temperature throughout the day.
Eat foods high in soluble fiber: oatmeal, rice, bananas, applesauce, fruit jelly.
Drink and eat foods that contain a high percentage of potassium carbonate, a substance that is lost in diarrhea. It contains bananas, peeled tomatoes, fish, chicken, meat, apricot, orange, mango and peach juices.
Eliminate spicy, fried, fatty foods.
Drink a glass of liquid after each bowel movement.
Talk to your doctor about taking medicines for diarrhea.
What to avoid:
Avoid fatty, fried, spicy and overly sweet foods.
Limit caffeinated beverages such as coffee and cola.
Do not consume dairy products for three days after symptoms have subsided.
Avoid foods and drinks that can cause cramps and bloating, such as beans, cabbage, broccoli, Brussels sprouts, fresh peppers, sodas, and onions.
Limit the use of sugar-free chewing gum, sorbitol candies.
Excessive weight loss can be a serious problem with treatment. A well-balanced diet is an important part of maintaining overall health during treatment. Most patients notice weight changes during treatment. Unfortunately, weight loss can be associated with side effects of therapy and loss of muscle tissue. Exercise, like a balanced diet, is important because it increases muscle mass, stimulates appetite, and reduces depression and anxiety.
Causes of weight loss must be identified and corrected by your doctor.
Tips for preventing weight loss:
- Consult a dietitian regarding food choices.
- Choose foods that are high in calories and protein.
- Drink juices in addition to water.
- Add to your diet regular consumption of milk, milkshakes, milk soups, eggs, mashed potatoes, baked goods.
Skin and hair
Antiviral therapy can lead to excessive hair loss (baldness) as well as changes in hair texture. Such changes can occur throughout the body, not just on the head. One in three patients taking antiviral therapy is worried about brittle hair and hair loss, hair color becomes dull.
Hair loss can also be a symptom of a malfunctioning thyroid gland, and all patients who complain of this symptom should have a thyroid function test. Major hair loss / changes in hair structure occur more frequently after 3-4 months of treatment.Hair usually falls out little by little, rather than profusely as with chemotherapy. After the end of the therapy, your hair will begin to grow slowly and will regain its original thickness. It is important to know that minoxidil (contained in VICHI shampoos) does not have the desired effect on interferon-induced hair loss. In fact, minoxidil can cause irritation and dryness of the skin, which are undesirable during therapy.
- Do not wash your hair too often.
- Wear a hat.
- Use a wide-toothed combs or soft brush, do not brush your hair too often.
- Do not blow dry your hair, tie your hair tightly, and avoid chemical dyes and permanents.
- Use less gels, sprays, hair sprays, hair mousses, especially those containing alcohol.
Use mild shampoos.
- Sleep on a satin pillowcase to reduce friction.
- Do not use medications for hair loss – they are not effective for hair loss associated with taking interferon
Changes to nails
Antiviral therapy can affect the structure of your nails, they can become dry and brittle.
Tips for nail care:
Keep your feet short.
Use hand lotions and creams as often as possible, especially after your hands have been in water.
Wear gloves to protect your hands when washing dishes, cleaning, gardening, doing laundry, or working with chemicals.
Before going to bed, grease your hands with greasy cream, wear special cotton gloves.
Use custom manicure supplies.
If you use the services of nail salons, remember not only about your own safety, but also about the safety of other clients.
Skin rashes, especially on the limbs and trunk, are often the result of ribavirin. This rash tends to come and go during the treatment period.
- Take a cool bath, use moisturizing soaps and lotions.
- For dry skin, use a shampoo containing selenium.
- Protect your skin from sun damage, which can exacerbate rashes.
- Avoid taking hot showers, baths.
- If the use of lotions and creams does not improve the condition, consult your doctor.
Local reactions in the area of injection
Redness and spots may appear at the injection sites. Your condition will improve in a few days after the end of the course of treatment.
If you are self-administering the drug, follow the rules for administering the drug.
If you experience pain, swelling, or irritation at the injection sites, consult your doctor immediately.
Tips for safe injections:
Wash your hands with soap and water before injecting to prevent infection.
Check that the drug is at room temperature.
Treat the injection site, the skin must be dry.
Change injection sites constantly.
Do not massage the injection site.
Apply cold to problem areas.
Talk to your doctor about using hydrocortisone cream for itching.
Clothing can irritate the skin at the injection site; therefore, dress and linen made from natural materials should be worn respectfully.
Needles and syringes should not be reused.
The use of cosmetic creams may help with minor irritations.
Chest pain is a common side effect of therapy. The hepatitis C virus affects the entire body – from muscles to joints, lungs and digestive system. Your esophagus, lungs, chest muscles, ribs, and heart can trigger a variety of chest symptoms that feel like chest pain.But if the pain appears during therapy, especially if it is significant, differs from the pain that was previously present, or appears during the ascent or descent of stairs, you should seek medical help, because perhaps the pain is associated with problems of the cardiovascular system and requires special therapy.
Seek medical help, as only a doctor can decide what your problem is.
Shortness of breath
During treatment, many patients notice the appearance of shortness of breath.This phenomenon is associated with a decrease in red blood cells (anemia) while taking ribavirin. Seek medical attention immediately if shortness of breath occurs. Shortness of breath can make you feel anxious. A doctor can help rule out bronchial asthma or another lung disease that requires special treatment.
Pay attention, after which shortness of breath occurs, inform your doctor. It is necessary to undergo additional examinations to exclude heart and lung diseases.
Visual impairment may be associated with impairment of visual clarity. If they do occur, you should see an ophthalmologist to rule out other causes of visual impairment.
Visit your ophthalmologist prior to treatment to know your baseline vision readings.
Describe to the doctor the time of the appearance of visual impairments (night, in bright light, the usual time of day), how they appear (blurred objects, inability to look with one or two eyes, pain).
If vision impairment is noticeable (sudden loss of vision, sudden change in vision in one eye), seek medical attention within 24 hours.
The thyroid gland is located on the front of the neck and is the size of an apricot. It controls many functions of the body: it affects appetite, weight, concentration. Pegillated interferon can decrease and increase the activity of the thyroid gland.Thyroid function should be carefully checked before treatment, and then checked every three months of treatment. In most patients, interferon does not cause thyroid dysfunction. If any changes occur, they should be discussed with your doctor.
Tell your doctor about the changes that worry you, the doctor will prescribe you additional blood tests.
Before starting antiviral therapy and during treatment, it is necessary to regularly, at least once every two weeks, monitor the indicators of a general blood test, including indicators of erythrocytes, platelets and leukocytes.
Taking ribavirin often leads to anemia (a decrease in the number of red blood cells), which leads to chronic fatigue and can cause heart pain, shortness of breath, or even a heart attack. Anemia is diagnosed using two tests: determining the amount of hemoglobin and hematocrit.
There are two approaches to the treatment of ribavirin-induced anemia: dose reduction of ribavirin and the use of erythropoietin-beta, which stimulates red blood cell production. Some medical experts believe that dose reduction of ribavirin should be avoided, especially during the first 12 weeks of treatment, as adequate doses of ribavirin help prevent relapse and increase the chances of achieving a sustained virologic response (SVR).
The main function of leukocytes is to fight infection. There are several types of white blood cells: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Neutropenia is characterized by an abnormally low number of neutrophils. Neutropenia is a common side effect of both conventional and pegylated interferons. Clinical studies have shown that in more than 95% of patients with antiviral therapy, there was a decrease in the number of neutrophils. The vast majority of patients who develop interferon-induced neutropenia do not develop serious infections. However, despite this, it is very important that patients are timely (at least once every 14 days) monitored blood counts in order to prevent serious complications of neutropenia. Neutropenia is usually corrected by dose reduction
90,000 Medical nutrition for acute hepatitis
Nutritional therapy for patients with hepatitis is the most important component of the overall complex of measures aimed at healing the patient.
The diet should be mechanically and chemically gentle.
Products in the diet must be included in such and such a ratio so that the activity of liver cells is normalized and its functions are restored, writes Chronicle.info with reference to healthinfo.
It is allowed to eat boiled, stewed and baked dishes. Food is served warm 4-5 times a day. Spicy, salty and fried foods, pickles, garlic, radish, radish, chocolate, cakes are strictly prohibited. Do not eat pork, canned food and hard-to-digest fats.The amount of liquid you drink should be increased to 1.5–2 liters per day. We recommend weak tea, fruit and berry juices, rosehip decoction as drinks. Canned juices and alcoholic beverages are contraindicated.
It is useful to include in the diet foods containing dietary fiber, which contain nutrients such as alcohols and polysaccharides. Their sources are grains, fruits and vegetables. Alcohols and polysaccharides are not degraded in the small intestine; bacterial fermentation occurs with them in the large intestine.
Based on these recommendations, dietitians have developed various diets for patients with hepatitis. The so-called table number 5 is optimal for patients with moderate and severe course of the disease. It contains from 90 to 100 g of proteins, from 80 to 100 g of fat and from 350 to 400 g of carbohydrates. The amount of vitamin A is 2-3 mg, B – 4 mg, C – 100 mg, PP – 15 mg. Energy value – from 2800 to 3000 kcal. All dishes are served pureed and with a small amount of table salt, only 10-15 g.
Even short-term fasting is contraindicated in patients, since it has an extremely unfavorable effect on the development of the disease. For those patients who have no appetite or cannot eat due to constant vomiting, doctors prescribe the so-called parenteral nutrition, in which all the food components necessary for the body are introduced in liquid form into a vein using a dropper.
List of recommended and not recommended products and dishes
From flour products, we recommend wheat bread made from flour of the 1st and 2nd grade, rye bread from sifted and peeled flour of yesterday’s baking, uncooked pastries with boiled meat and fish, as well as cottage cheese and apples.Lingering biscuits, dry biscuit.
Very fresh bread, pastries made from puff pastry and pastry, fried pies are not recommended.
Vegetable soups, vegetable broth with cereals, dairy soups with pasta, fruit, vegetarian borscht and cabbage soup, beetroot soup are recommended. Do not fry flour and vegetables for dressing in oil, but dry them.
Meat, fish and mushroom broths, okroshka, green cabbage soup are not recommended.
From meat and poultry, beef, lean young lamb, lean pork, rabbit, chicken, turkey, dairy sausages are recommended.Products should be eaten boiled and baked after boiling in a whole piece or chopped. You can make stuffed cabbage rolls or pilaf with boiled meat. Cook meat without ligaments and tendons, poultry without skin.
Fatty meat, duck, goose, liver, kidneys, brains, smoked meats, most sausages, canned food are not recommended.
Low-fat and moderately fatty fish are recommended. Cook boiled and baked after boiling. Can be whole or in the form of dumplings, meatballs and soufflés.
Fatty fish, smoked and salted fish, canned food are not recommended.
Milk, kefir, acidophilus, curdled milk are recommended from dairy products; sour cream as a seasoning for dishes; low-fat and semi-fat cottage cheese and casseroles made from it, lazy dumplings, puddings and other dishes. Mild and low-fat cheese.
Limit the consumption of cream, milk of 6% fat, fermented baked milk, fat cottage cheese, salted and fat cheese.
We recommend baked protein omelet, 1 yolk per day as part of the dish and, with normal tolerance, one soft-boiled egg or in the form of an omelet.
Hard-boiled and fried eggs are not recommended.
Any of the cereals are recommended, especially buckwheat and oatmeal. You can cook pilaf with dried fruits and carrots, puddings with carrots and cottage cheese, cereals. Boiled pasta is also recommended.
Legumes are not recommended.
All vegetables are recommended except spinach, sorrel, radish, radish, green onion, garlic, pickled vegetables and mushrooms. Eat raw, boiled and stewed.
Only sweet fruits and berries are recommended. Take for food raw, dry, boiled or baked. You can make compotes, jelly, jelly, mousse, sambuca.
From sweets, meringues, snowballs, marmalade, non-chocolate candies, marshmallows, honey, jam are recommended. Partially replace sugar with sorbitol.
Chocolate, cream products, ice cream are not recommended.
Sour cream, dairy, vegetable, sweet fruit sauces are recommended. From spices – dill, parsley; vanillin, cinnamon.Do not brown flour for sauces.
Mustard, pepper, hot ketchup are not recommended.
From drinks we recommend tea, coffee with milk, fruit, berry and vegetable juices, decoctions of rosehip and wheat bran.
Strong black coffee, cocoa, cold drinks are not recommended.
From fats we recommend natural butter in the dish, soft margarines, refined vegetable oils.
Pork, beef and lamb fat, cooking fats are not recommended.
Diet options for viral hepatitis
Here is a sample menu of a traditional diet for acute viral hepatitis.
1st breakfast: steamed curd soufflé, mashed milk rice porridge, tea.
2nd breakfast: baked apple.