The topic Diet and Hepatitis is really very vast! First of all, it is necessary to explain what hepatitis is (to dispel myths and false beliefs), then we will analyze how it is possible to contract hepatitis through diet; finally, we will see how to prevent it and structure a correct diet as a support to treatment.
Hepatitis - What Does It Mean?
The term hepatitis indicates an "inflammation of the liver.
The liver is an organ with glandular function located in the upper abdominal cavity (right hypochondrium and epigastrium), between the stomach and the transverse colon.
The liver performs many functions, such as glycemic support (essential for the brain), the synthesis of plasma proteins (of different types, which also have the purpose of maintaining oncotic pressure) and the metabolization of toxic substances and drugs. Obviously, in conditions of hepatitis the liver is not able to carry out its duties with normal effectiveness and efficiency, even if the severity of the disorder depends on many factors, for example: etiopathological causes, age of the subject, treatments, complications, comorbidities, etc. . Sometimes, due to hepatitis, there is also an anatomical and histological alteration of the liver.
Causes of hepatitis include: alcoholism, abuse or adverse drug reactions, ingestion of poisons, fungal toxins, viral infections, bacterial infections, parasitic infestations, iron overload, autoimmunity, etc. They can be acute or chronic and, among all, the only ones to be contagious are the infectious forms, therefore induced by pathogens (usually viral).
The complications of hepatitis can be remarkably different according to the causes of origin of the disease, even if, more than anything else, they vary according to the severity of the hepatitis. In the most serious cases, there is an alteration of the cyto-histological component tissue typical of fibrosis; worsening, in some cases the fibrosis can evolve into cirrhosis, with liver failure and increased risk of neoplasms.
Contract Hepatitis with Diet
DIET can be a primary cause of hepatitis. Among all the various forms, foodborne hepatitis can be divided into infectious (and infested), and non-infectious.
The infectious are essentially of the type: viral (virus HAV for hepatitis A), bacterial (Salmonella typhi for typhoid fever, Leptospire for leptospirosis) and parasitic (Entamoeba histolytica or Entamoeba dispar for hepatic amoebiasis, usually secondary to intestinal entry).
Dietary hepatitis that does not depend on infectious agents are basically the following: alcoholic steatohepatitis (alcoholic steatohepatitis), steatohepatitis due to indiscriminate food abuse (especially carbohydrates and fats - food steatohepatitis) and mycotoxin intoxication (Phalloid syndrome, certain types of Amanita or Lepiota, and aflatoxin intoxication from Aspergillus flavus).
On the other hand, we exclude hepatitis caused by chemical agents and drugs which, while passing through the digestive tract, are not contracted in order to feed themselves.
NB. Also some algal toxins, namely those of Cyanobacteria (Cyanobacteria, once called blue algae) have hepatotoxic capacity but, due to their modest epidemiological importance, they will not be dealt with in the following paragraphs.
Of all the aforementioned, the contagious forms, of the viral, bacterial and parasitic type, are transmitted above all by ORO-FECAL contamination, ie by ingesting food or water contaminated by the responsible agent.
Viral hepatitis with diet
This form of hepatitis is contracted by consuming raw water or RAW foods containing the HAV virus. Like all viruses, this too is thermolabile and can be annihilated by cooking food or boiling water. The foods typically involved in the spread of foodborne viral hepatitis are raw molluscs, especially bivalves and gastropods; less frequent vegetables and fruit with raw peel. There are cases of hepatitis A caused by the ingestion of torrential water or wells. , as, even in the cases already mentioned, the virus is often present suspended in the water (sea water for molluscs or irrigation in internal courses). Obviously, the chances that the virus is present at high concentrations in the water increase exponentially in the presence of illegal sewage discharges; this applies both to those that enter fresh water courses or into the sea, and to those on land that contaminate the underground aquifers.
Last but not least, the sources of direct viral spread for: manipulation of an infected and hygienically incorrect operator, incorrect slaughter, cross-contamination, contamination by insects and small animals (e.g. flies that transfer the virus from faeces to food). Hepatitis A has an acute course and often heals spontaneously within a couple of months.
Bacterial hepatitis with diet
This form of hepatitis is secondary to the contagion of Salmonella typhi or of Species belonging to the Genus Leptospira.
Unlike salmonellosis, typhoid fever is systemic since bacteria cross the intestinal mucosa without damaging it to enter the circulation; it affects many organs and among these also the liver, even if a real hepatitis does not always originate. The conditions of expansion and diffusion of the bacterium Salmonella typhi they are the same as virus A, that is the fecal-oral contamination of water and / or food. Furthermore, the bacterium is thermolabile and should perish at around 60 ° C. Typhoid fever tends to be acute and rarely chronic. The curative treatment consists of antibiotics.
Leptospirosis is a zoonosis, that is a pathology transmitted from animals (mammals, birds and reptiles) to man. There are different types, respectively spread by different organisms. Leptospirosis is systemic and has different forms of diffusion; fecal, leptospires can be excreted with urine and saliva. Ultimately, it is possible to contract leptospirosis both with the feces, but also with the saliva and urine of animals (such as pigeons and rats) that come into contact with food. Also in this case, slaughtering is a process that is extremely affected by the spread of the pathogen. The severity of the correlated hepatitis depends on the species and the strain in question, but also on the availability of antibiotics (little present in the most widespread areas, ie the third world); it too has a tendentially acute course and rarely becomes chronic. The resulting hepatitis seems to be caused by the edema of the hepatic capillaries which causes cell necrosis.
Parasitic hepatitis with diet
An example of this disease is the contraction of amoebiasis. Again, the Entamoeba histolytica or the Entamoeba dispar they are already present in the waters and, from here, they can end up on food (both directly and via the fecal-oral route). This organism easily perishes with the use of heat and its presence in food at the time of consumption is allowed by the crudity of the food or by post-cooking contamination. The therapy consists of amebicidal drugs; once again the course tends to be acute but can become chronic even primarily. Very often, the amoebas reach the liver only after having affected the intestine.
Fatty, alcoholic and alimentary steatohepatitis
Steatohepatitis is characterized by the "volumetric increase of the liver due to an increase in lipid storage and, to a lesser extent, of glycogen inside it. In practice, the liver accumulates an excess of fat, which causes it to swell and become inflamed. This is mainly due to it. the "immoderate increase in blood sugar and triglycerides in the blood, in turn induced by the abuse of ethyl alcohol (always converted into fatty acids by the liver) and / or by a generally too abundant diet with excessive portions of high-content foods of carbohydrates. Lipid excess also seems to be involved in the onset of fatty steatohepatitis, but mainly in diets characterized by high frequency of consumption of junk foods (in which the lipids are saturated, hydrogenated and with high percentages of fatty acids in configuration trans). In any case, the fundamental requirement for the onset of fatty steatohepatitis is ALWAYS THE CALORIC and / or ALCOHOLIC EXCESS!
Generally, this form of hepatitis is diagnosed during check-ups, perhaps following the detection of altered blood parameters (transaminases, triglycerides, glycaemia, cholesterol) or the manifestation of discomfort, swelling or pain in the abdominal area of the right hypochondrium. The dietary one is often associated with overweight (mainly visceral), insulin resistance, hypertriglyceridemia or, more generally, metabolic syndrome. In the long term and if neglected, it can evolve into very serious conditions; unfortunately, that with a purely alimentary etiology seems more subtle than to alcohol, as it is almost ALWAYS asymptomatic. Usually, after diagnosis, to obtain a fairly rapid remission it is sufficient to abolish alcohol, use specific prescription drugs, start a balanced low-calorie diet, increase physical activity and, possibly, consume food supplements aimed at improving the liver health. Com "it is presumable, it is a basically chronic pathological form even if, in certain cases of alcoholic abuse, real manifestations of acuteness occur.
Dietary mycotoxin hepatitis
Mycotoxins are toxins released by organisms belonging to the kingdom of fungi; in the case of hepatitis, fungi belonging to the Division are mainly involved Basidiomycota and those of the Phylum Ascomycota. The former are taken voluntarily with the diet, mistaken for edible mushrooms; the latter, on the other hand, some of which are completely unwanted, are better known as molds.
The most harmful mycotoxins for the liver, capable of originating a "hepatitis from Falloid Syndrome, belong to some species of the genera Amanita And Lepiota. These mushrooms, if taken with the diet, are able to poison the organism in a rather long period, which almost always determines the inability to intervene at the (late) moment of diagnosis. Phalloid syndrome is one of the leading causes of death worldwide and, already in the third of the four clinical phases, causes a violent increase in hepatic markers for hepatocyte destruction. If from that moment the intoxication does not undergo a rapid reversal, it evolves into the fourth phase and causes (from the initial hepatitis) a severe hepatic insufficiency followed by death. The treatment can be constituted by: gastric lavage, administration of activated charcoal capable to absorb poisonous molecules, forced diuresis, hemodialysis, plasmapheresis and drugs.This is an acute course and often requires liver transplantation.
Less lethal, but still dangerous, the mycotoxins belonging to the aflatoxin type produced by the fungus Aspergillus flavus. These microorganisms, which germinate on grains, are eaten in the diet through the consumption of poorly preserved grains; this condition is typical of the less developed areas of the third world but, in Italy, there is a certain risk linked to food imports. Very high doses of aflatoxins can therefore cause a form of acute hepatitis; on the other hand, less dangerous, even if more difficult to detect, is the secondary contamination by aflatoxins in cow's milk. It has also been shown that systematic exposure to low concentrations of aflatoxins significantly increases (similarly to certain chronic viral hepatitis) the chances of liver cancer. The cure is not yet well defined.
CONTINUE: Diet in the treatment of "Hepatitis"
