Autoimmune Hepatitis (what is it?)

So the results are in.

Unfortunately for me, they aren’t the best results in the world. Following months of blood tests, a scan and a biopsy, a Hepatologist has now diagnosed me with Autoimmune Hepatitis.  What on earth is that? I hear you ask. Well let me explain…

Hepatitis is the sciency word for inflammation of the liver and there are many ways of contracting Hepatitis including alcohol abuse or a viral infection. Autoimmune Hepatitis (commonly referred to as AIH) is when the body’s immune system turns against the liver’s cells (hepatocytes) and starts to destroy it. Yes my dear Itisites, the body tells itself to attack, even though the mighty liver has done no wrong!  The cause of this disease is unclear but genetics and environment can play a key factor; I guess my immune system is currently playing top trumps with my insides.


Is Autoimmune Hepatitis curable?

AIH is a suppressible, manageable but not curable disease. There is medication to keep it from progressing and causing real damage. If AIH is left untreated, it can develop into cirrohsis of the liver. Cirrohsis, which can take years to develop, is when the liver is so badly scarred that it is no longer functions as it should and at this point you are likely to need a liver transplant. Thankfully, although my liver is inflamed and slightly scarred, my doctor has suggested that this hasn’t developed into cirrohsis, but the scarring suggests my liver has been under attack for some time.  So we found it out at an early stage!

How am I treating my Autoimmune Hepatitis?

To stop the progression of the inflammation and scarring I have been prescribed a corticosteroid called budesonide. It’s designed to target the colon, not the stomach and this is where it slowly releases and is then absorbed by the liver – it treats both my Ulcerative Colitis and the Autoimmune Hepatitis. Here’s a really cool Youtube video which shows the process of absorption by the body.

I’ll be back to see my Hepatology doctor in a month where we’ll talk about tapering down my steriod and putting me on to Azathioprine which is an immunosuppressant oral drug. My research suggests will treat my Ankylosing Spondilitis, Ulcerative Colitis and Autoimmune Hepatitis…say that with a mouth full of marshmallows!

How am I handling it? 

Well I’m honestly incredibly peeved and angry at my body for being so feeble and for a while I’ll need the space to just wallow in my own misery and shake my fist at the world. But I know that over time, with more rational thought I’ll start to feel gratitude for the fact that I’ve caught this bastard thing early enough that I can kick its sorry ass. Also, if you throw a slice of lime in a small glass of water it sure as heck looks like a gin and tonic.



My Ulcerative Colitis story

With my diagnosis of Ankylosing Spondilitis (AS) three years ago, came the first of the prescribed medicines. My Rheumatologist started me off on Naproxen, although unfortunately I can’t be 100 per cent sure on the dosage. After doing a little bit of digging I discovered that Naproxen isn’t a drug that’s specific to AS. It’s a simple anti-inflammatory which is prescribed for various things. Here in the UK, medicine is unjustifiably expensive, and I’ve come to the realisation that you’re always given the cheapest drug first before you’re moved on up to the stuff that actually works and that also come with a price tag!

I took Naproxen for no more than a month and then started to get pains in my stomach. This developed into seeing spots of blood in my stool. Convinced that the Naproxen was not agreeing with me, I stopped taking the medication immediately.  As time went on, every once in a while I’d notice signs of blood and this continued for a year until it started to take a turn for the worst.

I was sent for a colonoscopy, on my birthday, which was probably up there with one of the worst presents you could ask for, and the results showed that there was a presence of ulcers on the left and right side of my colon. For this I was prescribed Pentasa which is a mesalazine. Strangely, not long afterwards, I started to get an increase in my symptoms.  My older brother too had been diagnosed with Ulcerative Colitis many years ago so I knew the signs:

What is Ulcerative Colitis?

Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon (the large bowel). In UC, tiny ulcers develop on the surface of the lining and these may bleed and produce pus.

The inflammation usually begins in the rectum and lower colon, but it may affect the entire colon. If UC only affects the rectum, it is called proctitis, while if it affects the whole colon it may be called total colitis or pancolitis.

It’s one of the two main forms of Inflammatory Bowel Disease (IBD). The other is Crohn’s Disease.

Ulcerative Colitis is a chronic condition. This means that it is ongoing and life-long, although you may have periods of good health (remission), as well as times when symptoms are more active (relapses or flare-ups).


So, it looked just like it was described above. I’ll refrain from repeating the gruesome details, but let’s just say within a week or two the frequency of me passing a stool went from 4 times a day to 13! I was in total denial. I thought it would go back to normal eventually, that this would pass (excuse the pun). But I was fooling myself. I work as a Primary School Teacher and at the time, was fortunate that I had an adult in the room so I could make regular mad dashes across the hall to the toilet but it was embarrassing and I was confused about what was happening to my body.

When I called my Gastroenterologist doctor the next day, he told me to go down to the A&E, my notes would be there waiting and I would be immediately examined. My notes weren’t there. It wasn’t immediate. But I was examined and kept in for 5 days on a fluid drip and steroid drip. Both of which had me feeling much better by the end of the stay as an inpatient. I was sent home and signed off work for 3 weeks to recover. The effects of the medication et al. I will discuss in another blog. But this is the story of how I came to have two inflammatory diseases.

Image: Ciesielski