How can hepatitis A be treated ?

Hepatitis A treatment

Hepatitis A treatment , Hepatitis treatment

Hepatitis A treatment is now usually carried out in a hospital infection, but given that hepatitis A in most cases are mild and practically is neither malignant forms or chronic hepatitis, and hepatitis A treatment can be carried out at home. In epidemiological terms, patients at the time of hospitalization is no longer dangerous to others, as they usually are hospitalized with the appearance of jaundice, when the concentration of viral antigen in faeces sharply reduced or disappears completely.It should be noted that in many foreign countries with hepatitis A are treated almost exclusively at home. Complex therapeutic interventions recommended for the hepatitis A treatment in recent years has undergone significant changes. Virtually all hepatology centers prevailed principle restrained therapy, involving the protection of the diseased liver, the full guard her from additional energy costs, as well as protection from drugs with questionable or unproven efficacy. Optimal hepatitis A treatment is considered to be the appointment of so-called basic hepatitis A treatment, including rational motoring, health food, cholagogue preparations, mineral oxen, multivitamins.

Motor mode with hepatitis A treatment

Patients with hepatitis A should observe sparing regimen throughout the disease. Degree of limitation in motor mode should depend on the severity of the symptoms of intoxication, being patient and the severity of the disease. When worn out, and in most cases anicteric - milder forms mode can be obtained from the first bed days jaundice period.Patients were allowed to eat at the table, use the basin, WC. Especially in moderate and severe forms assigned bed rest during the period of intoxication - usually within the first 3-5 days of jaundice period. Along with the reduction of intoxication patients transferred to the floor bed rest. Criteria for the expansion mode and are feeling better appetite, decrease jaundice. It is important to emphasize that too strict restriction of active movements Bostrom period of illness may adversely affect the emotional and muscle tone and promotes healing. However, it is known that in a horizontal position substantially increases blood flow to the liver, as well as more favorable conditions. For its regeneration. We can assume that the motor activity of hepatitis A should be determined by the patient, depending on the state of health, degree of intoxication.Increasing physical activity should be individualized and appropriate to the nature of the pathological process, the degree of functional recovery of the liver, the presence of residual symptoms, age of the patient, his premorbid background.

What are drugs used in hepatitis A treatment ?

It is believed that the majority of patients with hepatitis A is not needed any medication assignment. Gentle motoring, health food, optimal admission that preclude superinfection, especially other viral hepatitis, provide a smooth course of the disease and complete clinical recovery. Not shown for hepatitis A and glucocorticosteroid hormones. Now generally recognized that prescribe in viral hepatitis need with great caution, since their utilization and excretion in the damaged liver conditions are very difficult, especially when simultaneous use of multiple drugs, excluding Compatibility. It should be emphasized, however, that negative attitudes towards polypharmacy does not exclude the possibility of selective assignment of certain medications.Phosphatidylcholine is the main structural component of the biological membranes of phospholipid layer and acts like a "membrane glue", restoring the structure and function of the damaged hepatocyte membranes, thereby preventing the loss of cells, and other enzymes active substance, normalizes the protein, lipid and fat metabolism, antitoxic function of the liver restores suppresses connective tissue synthesis in the liver, reduces the risk of hepatic fibrosis and cirrhosis. Sodium glycyrrhizinate has anti-inflammatory, inhibits the virus replication in the liver and other organs by stimulating the production of interferon-y, increase of phagocytosis, increase the activity of natural killer cells, etc. Phosphogliv prescribed for children under 3 years - 0.5 capsules, 3 to 7 years - 1 capsule, from 7 to 10 years - 1.5 capsules, over 10 years and adults - 2 capsules 2-3 times day.Pathogenetically justified in hepatitis A and vitamin B complex assignment. Recently, as is known, is a coenzyme of metabolic transformations of providing normal course of metabolic processes in the body, usually administered Troupe vitamins (B1, B2, B6). and C and PP in the conventional age inwardly dosing regimen. In said complex can include vitamin A (retinol) and E (tocopherol) and rutin. Hepatitis A treatment vitamins held no more than 10-15 days, while it is not recommended to resort to parenteral administration of vitamins.. Noting the positive effects of vitamins on the metabolic processes, it should still be emphasized that the question of the undisputed effectiveness of hepatitis A can not be considered as finally settled.In recent years, is widely believed that the vitamins in liver disease at least ineffective or even contraindicated. In any case excessive introduction of the more vitamins and certain vitamins can not be considered valid since it can lead to disruption of the dynamic equilibrium of cellular metabolism and the displacement of the other components of the hepatic cells, as necessary for their functioning. It therefore should be cautioned against excessive use of vitamins, but they are still physiological doses shown. The accumulated clinical experience suggests that patients with hepatitis A do not require infusion therapy aimed, as you know, detoxification, restoration of homeostasis and partially - to provide parenteral nutrition. However, hepatitis A symptoms of intoxication are usually short-lived and expressed moderately, insignificant changes in homeostasis, and eating disorders are uncommon.

Out of hospital treatment

Extract from the hospital performed as recovery. Criteria for discharge are satisfactory overall condition, disappearance of jaundice, liver size reduction to normal or close to normal levels, normalization of serum bilirubin, decreased activity of hepatic cellular enzymes to normal or close to normal values. It is important to emphasize that these criteria should be considered indicative. The patient can be discharged with residual hepatomegaly, dysproteinemia and even in the absence of full normalization of pigment metabolism. Regulated by the order of the Ministry of Health calendar dates and discharge criteria must be understood only as conditional.Terms extract must be determined individually! considering premorbid state, the home environment, the level of outpatient services, etc.In milder forms of hepatitis A statement should be made on the 15-20th day of the disease, and under appropriate conditions and treatment can be performed at home.Our experience of early discharge from hospital (15-20th day of illness) shows that in these cases more quickly restored liver function, rarely residual effects and faster recovery period ends.In protracted course of hepatitis A patients are discharged as the stabilization of the pathological process and identify trends to improve.

Clinical supervision

After discharge from the hospital all convalescents are subject to compulsory medical check-ups. Clinical examination is best done in a special cabinet, organized with the hospital. 
When you can not organize such a study should conduct medical examinations of infectious diseases.
The first examination and inspection conducted after 15-30 days after discharge from the hospital, repeated - 3 months. In the absence of residual clinical phenomena and full normalization of liver function tests convalescents derecognised, in those cases where there are any residual effects, clinical supervision is carried out until complete recovery.
Clinical examination of convalescents, in rural areas, performed with infectious wards of central district hospitals and clinics.

Rehabilitation of convalescents

In the process of clinical supervision is necessary to solve complex problems related to rehabilitation.

After discharge from the hospital to conduct drug therapy is usually not required. In some cases, convalescents can receive cholagogue preparations, multivitamins with mineral water and others question of extending the physical load hook well as the lifting of restrictions in clinical nutrition should be decided strictly individually and in full accordance with the general condition and the rate of recovery of functions Liver.
Offer some authors to conduct follow-up care hepatitis A rehabilitation offices or specialized sanatoriums needs further study. Anyway, the best results for the rehabilitation of convalescents hepatitis A is not possible to achieve in the departments for follow-up care, where it is difficult to avoid further their infection, and at home with the organization of individual care and hepatitis A treatment .