DEAR DR. DONOHUE: I am very worried about my 50-year-old daughter. She’s hospitalized with hepatitis, which I thought always came from an infection. My daughter’s hepatitis didn’t come from an infection. It’s immune hepatitis.

Please tell me what this is and what it involves. Is it deadly? My daughter is the single mother of three children. Her husband died in an auto accident three years ago. I don’t know how I can take care of these children. I am 85. — M.M.

ANSWER: When people hear “hepatitis,” they immediately think of viral infections of the liver — hepatitis A, B and C. “Hepatitis” indicates liver inflammation and liver cell death. Autoimmune hepatitis isn’t an infection.

The body’s immune system suddenly targets the liver as though it were a foreign invader and needs to be put out of commission. Why this happens isn’t clear. The immune system is one of our chief protections against invading germs and materials that do us harm. Here, it has gone rogue and is bent on destroying the liver.

The signs and symptoms of autoimmune hepatitis are similar to hepatitis from infections and from other causes. The person feels quite ill and must go to bed. Jaundice is common. Jaundice is a yellowing of the skin and the whites of the eyes. It indicates that the liver isn’t functioning.

Untreated, the mortality rate from autoimmune hepatitis is quite appalling. It’s as high as 40 percent. Treatment makes it a much less dangerous illness. The 10-year survival rate of treated patients approaches 90 percent. Your daughter’s chances of living a long life are quite good.

The cortisone drugs prednisone and prednisolone are the medicines used for controlling this malady, and they work well. They calm the inflamed liver and put an end to its destruction. Other medicines that rein in a misbehaving immune system are also available. Your daughter’s chances for surviving and remaining her children’s caretaker are very high.

DEAR DR. DONOHUE: I have had a urinary tract infection for longer than a year. I have taken antibiotic after antibiotic, without any improvement. I have pain in my bladder area, and I must run to the bathroom many, many times throughout the day. I’m afraid to leave my home.

Have you ever heard of a urinary tract infection lasting for longer than a year? — A.P.

ANSWER: I haven’t, unless there are very special circumstances. You have none of those.

You need to get proof of infection. That can be done with a simple urinalysis and with a culture of the urine for bacteria. Without such proof, the diagnosis of infection is on shaky grounds.

Your story has all the markings of interstitial cystitis, a bladder condition that is frequently mistaken as an infection and for which antibiotics have no effect. You need to see a gynecologist, a urogynecologist or a urologist. Specifically ask the doctor about interstitial cystitis. Treatment for it is quite different from that of an infection.

The booklet on urinary tract infections describes the symptoms of kidney and bladder infections and their treatment. To order a copy, write: Dr. Donohue — No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am confused about medicine-taking.

When the directions say to take the medicine every six hours, does that mean exactly every six hours, or can it be spaced out during the waking hours? I usually get eight hours of sleep. — N.D.

ANSWER: If the doctor has explicitly emphasized the need to take a particular medicine as close to every six hours as humanly possible, those directions should be followed.

For many medicines, every six hours can be interpreted as four times a day during your waking hours.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

Copy the Story Link