Liver, Pancreas and Biliary Diseases Resources & FAQs

Hepatitis is inflammation of the liver, usually caused by one of six known hepatitis viruses: A, B, C, D, E and G. There is both an acute and a chronic form. Acute hepatitis is of shorter duration, lasting a few days to a few weeks. Chronic hepatitis lasts longer, six months to 30 years or more. Acute hepatitis can progress to chronic hepatitis.

Hepatitis is usually caused by one of the six hepatitis viruses: A, B, C, D, E and G. However, it also can be caused by other factors, including excessive alcohol use, a traumatic injury to the liver, certain medications, an immune disorder, other viral infections and insufficient blood supply to the liver.

Hepatitis B and C may be passed from an infected individual to another individual through bodily fluids such as blood, and may be transmitted through sharing of needles and through unprotected sex. The virus also may also be passed by sharing razors or toothbrushes, or from anything that causes direct contact with infected blood. It cannot be passed by shaking hands, coughing, sneezing, touching a doorknob, sharing a drinking glass, being in crowds or using public toilets.

Hepatitis A is one of six hepatitis viruses that causes inflammation of the liver. This virus is commonly passed through fecal contamination: from food handlers who do not wash their hands thoroughly after a bowel movement; from fecal contamination of food and water; from fecal contamination of a diaper-changing area; anal sex; and from eating contaminated (with hepatitis A virus) raw or undercooked shellfish. Adults who contract hepatitis A may suddenly become ill with nausea, vomiting and fever.

Hepatitis B is one of six hepatitis viruses that causes inflammation of the liver. A hepatitis B infection can be spread through contact with the blood or body fluids (semen, vaginal fluids and saliva) of a person who has the virus. Chronic infections can cause permanent liver damage. 

Hepatitis C is one of six hepatitis viruses that causes inflammation of the liver. Many people are unaware of the disease until they are diagnosed with liver damage. This can take many years. Many people infected with the virus develop long-term, or chronic, hepatitis C. Chronic hepatitis C causes tiny scars and inflammation in your liver which can lead to cirrhosis. 

Infection with any one of the hepatitis viruses causes inflammation of the liver, which results in the liver malfunctioning. One of the liver's functions is to filter waste products from the bloodstream. When this process doesn't occur, bilirubin—a waste product in blood from the normal breakdown of red blood cells—backs up in blood and tissues. Symptoms can include jaundice (yellow skin and eyes), itching, fever and nausea.

Symptoms can include: 

• Fatigue 
• Nausea
• Skin rashes
• Swelling of the ankles
• Abdominal distention or swelling due to fluid build-up
• Abdominal pain on the right side of the body where the liver is located
• Jaundice (yellowing of the skin and eyes)
• Dark urine

Hepatitis is diagnosed through a blood test. A biopsy (sample) of liver tissue also may be performed to determine the extent of liver damage.

Hepatitis is treated with medications, lifestyle changes and, in cases in which the liver is severely compromised, a liver transplant.

Yes. If you have hepatitis B, you are at a higher risk of contracting hepatitis D. Hepatitis D only develops in individuals who already have hepatitis B. If you have hepatitis C you are at a higher risk of contracting hepatitis A and B.

Yes, because individuals with hepatitis have an increased risk of developing cirrhosis (scarring) of the liver, which can lead to liver cancer.

Vaccines are available for hepatitis A and B, but not for hepatitis C.

The best preventive measure is to take precautions against risky behaviors that can cause an infection and follow your doctor’s recommendations for getting vaccinated for hepatitis A and B.

According to the Centers for Disease Control and Prevention, liver and bile duct cancers are the fifth most common cause of cancer death in men and women. Liver cancer is closely associated with hepatitis virus infections, especially hepatitis B. 

According to the National Cancer Institute, risk factors for liver cancer, also called hepatocellular carcinoma, include chronic liver infection (hepatitis), cirrhosis, aflatoxin (a toxin produced by a fungus or mold), gender, a family history of liver cancer and age. A recent study reported in the Journal of Cancer Prevention found that the risk of developing hepatobiliary (liver and bile duct) and pancreatic cancers is higher in people with gallstones and swelling of the gallbladder.

While symptoms may vary depending on how far the cancer has spread, some common symptoms include nausea, vomiting, weight loss, pain in the abdominal area, loss of appetite, weakness, fever and jaundice (yellowing of skin and eyes).

Unfortunately, many people are diagnosed with liver cancer at advanced stages when symptoms may first appear. However, some people are candidates for a liver transplant, which offers the best chance for a cure.

Gallstones are typically small, hard masses that may form in the gallbladder. They may cause no symptoms. However, if they cause blockage, it can be very painful. If bile duct stones develop, they may result in inflammation of the gallbladder, called cholecystitis. A gallstone or bile stone in the common bile duct may block the pancreatic duct, causing painful inflammation of the pancreas or pancreatitis.

The most common symptom is upper abdominal pain on the right side of the body, where the liver and gallbladder are situated. The pain may start suddenly and be intense. Or it may be a slow, dull pain or occur intermittently. The pain may shift from the abdominal area to the upper back or shoulder. When blockage occurs, other symptoms may include nausea, fever, chills, jaundice, dark urine, itching, fatigue, weight loss, night sweats, loss of appetite and greasy or light-colored stools.

Diagnosis may involve blood tests, abdominal ultrasound or CT scan, and endoscopic retrograde cholangiopancreatography, or ERCP, with or without ultrasound.

A number of effective treatments are available, including removing the stones endoscopically, medications and extracorporeal shock wave lithotripsy, which uses sound waves to break up the stones. In some cases the gallbladder will be removed, either by conventional or laparoscopic surgery.

People who develop gallstones have a slightly increased risk of developing gallbladder cancer, called cholangiocarcinoma. However, this is a rare disease and most people with gallstones do not develop cancer.

A pseudocyst is a fluid-filled sac containing pancreatic enzymes. They are common cysts found on and within the pancreas. Most do not cause symptoms nor are they cancerous. They often are discovered incidentally when people undergo imaging tests such as a CT scan or abdominal ultrasound for other reasons.

Most pseudocysts have no known cause, but some develop after a bout of pancreatitis, which may damage areas within the pancreas. Pseudocysts also may develop as a result of trauma to the abdomen or from hereditary conditions.

Not all pseudocysts cause symptoms. When they do, symptoms can include abdominal pain (from pressing on organs) that may radiate to the chest and upper back, nausea and vomiting, and the presence of a growth that can be felt within the upper abdomen.

A pseudocyst can become infected and cause intense abdominal pain, fever and a rapid pulse. A cyst also may burst and release pancreatic enzymes all at once. When this situation occurs, the enzymes can damage blood vessels and cause internal bleeding. Both infected and ruptured pseudocysts are medical emergencies that should be seen in the emergency department at once.

Pseudocysts are diagnosed with blood tests and imaging studies that include abdominal ultrasound, abdominal CT scan or MRI, ERCP with endoscopic ultrasound, or MRCP. Your gastroenterologist also can take a sample of cystic fluid with a fine needle passed through the ERCP. Pseudocyst fluid is tested for the presence of cancer cells and proteins produced by cancer cells.

Most pseudocysts cause no symptoms and are not treated. However, when imaging studies have determined a pseudocyst's size and location, your gastroenterologist may request that you have regular follow-up scans performed to monitor its growth. If a pseudocyst is causing symptoms it can be drained or surgically removed.

In addition to its diagnostic role, endoscopic retrograde cholangiopancreatography (ERCP) is used therapeutically to treat disorders of the biliary tract, including pseudocysts. Once the pancreas is visualized - usually with a contrast dye that produces x-ray images viewed on a monitor - miniaturized surgical instruments are passed through the ERCP. The pseudocyst is then drained or surgically removed.

Pseudocysts can develop again if you have recurring pancreatitis. Acute and chronic pancreatitis are risk factors for the development of pseudocysts.