What is Hepatitis B and what are the side effects?

Hepatitis B is an infection of your liver caused by a noncytopathic virus called HBV which can cause scarring, liver failure and cancer. The virus does not directly cause damage to the liver; however, it results in the immune system reacting aggressively to the virus leading to inflammation and damage to the liver.

HBV is highly contagious and can spread when people come into contact with bodily fluids of someone who has the virus, blood or open sores. It does not spread through food or water, sharing eating utensils, breast-feeding, hugging, kissing, cough or sneezing. The virus can actually live outside the body for at least 7 days and still be potentially infectious.

In most cases, the disease does not last for a long time as the body fights it off within a few months, and your body will become immune for the rest of your life.


When infected, the warning signs include jaundice, light-coloured poop or dark urine, fever, fatigue that persists for weeks or months, joint and/or muscle pain, abdominal pain around the liver, nausea, loss of appetite or vomiting. If an acute HBV is not resolved within 6 months, it will become chronic and people who are contracted with chronic hepatitis B does not experience symptoms unless the liver becomes severely damaged.

The effects of these symptoms are not consistent with every individual. Some people with chronic hepatitis B experience occasional symptoms while others experience symptoms that becomes permanent.

If Hepatitis B is left untreated, it can leave to serious live damage such as liver cancer or cirrhosis. In addition to fatigue, there may be muscle weakness, bruising, poor appetite, nausea, weight loss, itchy skin, cola-coloured urine, grey-coloured stool, jaundice and fluid accumulation in the lower extremities.

Managing Common Symptoms

Symptoms of viral hepatitis, whether acute or chronic, should always be brought to the attention of a health care provider. Bed rest may be recommended during hepatitis B’s acute phase. If you have symptoms from cirrhosis, your health care provider will discuss a plan to manage these. Do not attempt to manage these symptoms on your own.


Appetite loss: Be sure to discuss this with your health care provider. If you are experiencing significant weight loss, you may be referred to a nutritionist or dietitian. Here are some tips to help with your appetite:

  • Eat small, frequent meals of nutritious, high-calorie foods such as peanut butter, nuts, avocados, protein shakes and smoothies.
  • Select a variety of foods. Vary the colour, temperature, texture and type of food you eat.
  • Try new foods or ones that you might not have liked in the past.
  • Experiment with seasonings and spices.
  • Choose foods that are high in calories and protein.
  • Add powdered milk or protein powder to regular milk, milkshakes, casseroles, soups, eggs, mashed potatoes, hot cereal and puddings.
  • Spread peanut butter or other nut butters on bread, tortillas, waffles, pancakes, fruit and celery.
  • Add cooked beans or hard-boiled eggs to soups, casseroles and pasta.
  • Try products designed to promote weight gain, such as nutritional supplements, canned formulas, protein powders, instant breakfast drinks, power bars and high-calorie puddings.


Fatigue: In the acute phase, bed rest and low physical exertion may be advised. In the chronic phase, your medical provider will likely rule out other medical conditions that may contribute to fatigue, such as depression, insomnia, pain, sleep apnea and thyroid problems. Here are some tips to help with fatigue:

  • Get enough sleep. The National Sleep Foundation recommends seven to nine hours of sleep per night for adults. If sleep is a problem, discuss this with your health care provider.
  • If you have chronic hep B with mild fatigue, light exercise is a good remedy. Pick an activity and do it for 10 to 15-minute intervals, two to three times daily. If you are not accustomed to physical activity, start with five-minute intervals and increase gradually. Sample activities include walking, biking, swimming, dancing, gardening, yoga and tai chi.
  • Vary your activities—do not sit or stand too long.
  • Drink plenty of water. According to the Institute of Medicine, men need about 13 cups (3 litres) of total beverages a day; women need about 9 cups (2.2 litres) daily. If you are drinking enough liquids, your urine will be pale yellow or colourless.
  • Reduce stress and find ways to relax.
  • Take short naps of 20 minutes or less. Don’t nap close to bedtime.
  • Use caffeine. Coffee and tea may give you a lift, plus coffee may protect the liver. Do not drink caffeinated drinks late in the day, as this may interfere with sleep. 


Gastrointestinal complaints: Some people feel discomfort in the right upper part of the abdomen around the liver area. Always discuss pain with your medical provider, particularly when pain is constant, severe or interferes with your quality of life. Call your medical provider if you have severe or chronic stomach pain. Eat small, frequent meals, as stomach pain may be caused or worsened by hunger.If you feel nauseous, try to eat a small portion of food at regular intervals. Hunger can intensify nausea, so try eating a cracker or other small piece of food every hour or two. Ginger helps with mild to moderate nausea. Peppermint, chamomile or raspberry leaf tea may also alleviate nausea.

Muscle and joint aches are common symptoms of hepatitis B; pain is not. Both require medical evaluation. Research tells us that moderate exercise and staying active are the best way to manage physical discomfort. Other tips that may provide relief are:

  • Hot baths
  • Stretching
  • Massage, whether done by a friend, a professional or yourself
  • Avoid prolonged sitting or reclining.

(Section: Managing Common Symptoms is adopted from www.hepmag.com)

You do not wish to rely on symptoms to appear before deciding to check on your liver. You can now have a peace of mind after making sure you do not have the virus in your body by doing your annual health check-ups.

For more information on health screening and liver function tests, you may contact Integrated Wellness Pte Ltd at 6250 7623 or send an email to appointments@iwell.sg. Our friendly nurses and staff will be glad to assist you in your queries.