Are Hepatitis C and Liver Cirrhosis Similar?

Here’s an alarming fact: 20% to 30% of people with chronic hepatitis C will develop liver cirrhosis within 20 years. Thankfully, with advancements in medicine and newer antiviral drugs, hepatitis C can now be cured with treatment in 90% to 100% of cases.

What are Hepatitis C and Liver Cirrhosis? 

Hepatitis C refers to liver inflammation caused by infection from the hepatitis C virus. Around 30% of people with the infection recover without treatment within six months. However, if not treated, almost 70% of people infected with hepatitis C will develop chronic illnesses that predispose them to liver cirrhosis and even liver cancer. 

Liver cirrhosis refers to scarring of the liver caused by long-term liver damage. If not treated, it usually progresses to liver failure or cancer. Apart from a hepatitis C infection, liver cirrhosis also occurs due to excessive consumption of alcohol over many years and excessive fat deposition in the liver. 

Symptoms Associated with Hepatitis C  

An acute hepatitis C infection rarely causes symptoms and often goes undetected. Some patients may experience discolouration of the eyes and skin (jaundice), nausea, fever and muscle aches. If detected in time, it responds well to antiviral therapy. 

Chronic hepatitis C generally remains asymptomatic or silent for years until the liver damage is bad enough to cause signs and symptoms. Patients with a chronic hepatitis C infection easily bruise and bleed, tire quickly, have a poor appetite and show yellowish discolouration of the eyes. There may be fluid build-up in the abdomen, leg swelling, and weight loss. In severe cases, a person may become confused, drowsy and disoriented.

What TCM Says About Hepatitis C 

Real Health Medical Chief TCM Physician Chu I Ta suggests following a healthy lifestyle to prevent an infection of the hepatitis C virus. “According to Traditional Chinese Medicine (TCM) tenets, we recommend eating bland, nutritious, easy-to-digest food. Stay away from cold, cool, difficult-to-digest food that may easily damage Spleen yang. Avoid hot, spicy and fried food that may easily generate Damp-Heat as well as rough and hard food that may easily damage the blood collaterals,” he advises.

He also recommends a low-sodium diet, as salt thickens water Dampness. People with swelling in the lower limbs and low urine output should avoid salt at all costs.

Keeping a peaceful mind and avoiding overexerting oneself also helps to reduce the risk of hepatitis. According to Physician Chu, irregular emotions, especially anger and pensiveness, can damage the Liver and Spleen and aggravate the pathogenic condition of Qi-Fire. This can damage blood collaterals or even result in life-threatening situations.

Keeping warm, supplementing anti-pathogenic qi and preventing infection with pathogens help to stay healthy. “Don’t delay treatment if you contract an infection,” he cautions. 

Treatment of Hepatitis C

The prognosis for hepatitis C patients has improved considerably compared to the past. With new antiviral treatments, almost 90% of patients can be completely cured. Besides Western medicine, TCM can be used as a supportive therapy, especially for relief from fluid in the abdomen, a common symptom of the condition. 

According to Physician Chu, tympanites or collection of fluid or gas in the abdomen is caused due to impairment of the Liver, Spleen, and Kidneys. Common syndromes are retention of Qi Stagnation, Blood Stasis and Water-Dampness. Tympanites mainly involve the Liver and Spleen at an early stage, affecting the Kidneys later.

Gastric and abdominal distention occurs during the initial stage of tympanites, especially after eating. The abdomen may appear visibly distended, and bluish blood vessels may appear on the abdominal wall at a later stage like ascites (a condition where fluid collects in spaces in the abdomen). In severe cases, the umbilicus may project outwards. 

Herbal remedies 

TCM treats patients based on syndrome identification.

Qi Stagnation and Dampness 

Patients have symptoms such as abdominal distension without palpable hardness, fullness or distension and pain below the ribs. The principle of treatment in these cases is to regulate Liver-qi, strengthen the Spleen and remove Dampness. Physician Chu recommends the herbal formulas Chai Hu Shu Gan San (柴胡疏肝散) and Wei Ling Tang (胃苓汤). 

Water-Dampness obstructing the Spleen 

Patients usually have an enlarged abdomen with fullness and distension, a feeling like there’s a water-filled sack upon palpation or even facial puffiness. Symptoms such as swelling in the lower limbs and gastric and abdominal stuffiness might also show. Physician Chu recommends the herbal formula Shi Pi Yin (实脾饮) to warm the middle jiao (焦), strengthen the Spleen, promote qi flow and induce diuresis.

Dampness-Heat 

Symptoms include an enlarged abdomen with hardness and fullness, gastric and abdominal distension. A combination of Zhong Man Fen Xiao Wan (中满分消丸) and Yin Chen Hao Tang (茵陈蒿汤) is recommended. It clears Heat, resolves Dampness, induces urine production and removes water retention. 

Blood Stasis and water retention 

Physician Chu usually prescribes the formula Tiao Ying Yin (调营饮). These patients typically have stomach and abdominal hardness and fullness, bluish vessels on the abdomen, and masses below the ribs with needle-pricking pain. The formula helps circulate blood, resolve Stasis, promote qi flow and induce diuresis.

Yang Deficiency 

Patients with water retention due to Yang Deficiency are recommended the formulas Fu Zi Wei Ling Tang (附子胃苓汤) or Ji Sheng Shen Qi Wan (济生肾气丸). These help warm and supplement the Spleen and Kidneys, transform qi and induce diuresis.

Yin Deficiency 

Patients with water retention due to Yin Deficiency experience an enlarged abdomen with fullness and distension, a dry throat, and restlessness. To nourish the Kidneys, soothe the Liver, nourish yin and induce diuresis, Physician Chu recommends a combination of Liu Wei Di Huang Wan (六味地黄丸) and Yi Guan Jian (一贯煎). 

Acupuncture 

Physician Chu emphasises the effectiveness of acupuncture when administered by a licensed practitioner. He suggests the acupoints tai chong (LR3), yin ling quan (SP9, 阴陵泉), di ji (SP8, 地机), san yin jiao (SP6, 三阴交), guan yuan (CVRV4, 关元), zhong ji (CV3, 中极), ri yue (GB24, 日月), and zhang men (LR13, 章门) for treatment in the early stage of liver diseases. 

Prevention of Hepatitis C 

Unfortunately, unlike hepatitis B, there isn’t a vaccine available against a hepatitis C infection. The best way to prevent it is to avoid behaviours that expose you to the virus.

The hepatitis C virus spreads through blood. A person can get infected through contaminated needles, syringes, blood, and blood products. Avoid using illicit drugs, especially if they’re injected. Also, be careful about body piercing and tattooing, and choose a reputable salon with good hygiene practices. 

Until a vaccine for hepatitis C is found, Western and traditional medicine will continue giving patients hope of recovery and good clinical outcomes. Share this article with someone whom you think may find this information useful.