If you have hepatitis B, can you not even eat normally?

This is the 3115th article of Da Yi Xiao Hu

These days, Brother Hua's "stomach" has been feeling a bit depressed and listless. He complained to his "liver", "It's all your fault. I got infected with the hepatitis B virus, which has caused Brother Hua to be afraid of this and that these days. He dares not eat anything, and eats plain soup every day, like a monk who has left home. If this continues, I won't have any oil or water left. What's the point of living!"

The liver, which was blamed, felt very aggrieved. "It's not my fault that I got infected with the virus. Hua's mother was a carrier of the hepatitis B virus. During the birth process, the hepatitis B virus in her blood entered Hua's body through the tiny wound caused by the forceps. Because the immune system of a newborn is not fully developed and cannot identify and eliminate foreign viruses, these hateful invaders traveled straight into my body through the bloodstream and settled here. So, I am also a victim."

The stomach felt that what it said was a bit too much, so it comforted the liver, "I'm not blaming you, it's just that Brother Hua is too afraid of this virus. Is it necessary for him to live so cautiously? Even we think it's too much."

The kindhearted man spoke for his master again, "In fact, Hua has been living with the virus for more than 20 years, but he didn't know it. During the last physical examination at the company, it was found that his liver function was abnormal. Further examination revealed that he was infected with the hepatitis B virus. The doctor said that his immune system has now begun to recognize the virus and fight the virus. He needs to cooperate well in his life to help the immune system win the battle, including getting enough sleep, eating a healthy diet, quitting smoking and drinking, not staying up late, and not overworking. Therefore, Hua lives so cautiously. He actually wants to help the immune system win the battle and drive the virus out of the body."

His stomach started complaining again. "I understand wanting to win the battle, but this isn't the way to do it. Brother Hua used to have a strong taste for meat, and he loved spicy food. Now, he only eats vegetables, radishes, rice, and steamed buns every day, and he hardly eats any meat. He only puts salt in his dishes, and no other seasonings. Isn't this going from one extreme to another?"

The liver understands its owner. It knows the deeper reasons why the owner suddenly changed so much. Hua Ge's uncle had liver cancer and died not long ago. When Hua Ge went to the hospital for treatment, he told the doctor about this situation. The doctor warned Hua Ge to be especially careful because liver cancer is also prone to family aggregation like hepatitis B virus; he not only has hepatitis B, but also fatty liver. If fatty liver is not taken seriously, it will increase the risk of poor prognosis of hepatitis B patients; the doctor asked him to pay attention to controlling weight through exercise and diet, avoiding greasy food, taking medicine on time, regular check-ups, and maintaining a healthy lifestyle. Since then, Hua Ge's lifestyle has changed dramatically, like a different person.

In the past, Brother Hua liked to hang out with friends, smoke, drink, play cards, stay up late, and eat meat, and he loved smoked, steamed, boiled, and grilled meat. Now he is completely different. He has gradually distanced himself from his friends, saying that he was afraid of infecting others with the hepatitis B virus. He has become a self-discipline maniac, going to bed early and getting up early, running in the community in the morning, not drinking a drop of alcohol, and has quit smoking. He pays more attention to his diet, cooks at home, and never eats out anymore. He only eats vegetarian food, and does not eat any meat. His family can't stand it, and his wife and children are dissatisfied with it.

As for the stomach, it actually felt very sorry for Brother Hua. "I know that the master is right to attach so much importance to this. I actually admire Brother Hua's self-discipline. He has developed a good and healthy lifestyle, which is good for all of us. The problem is that Brother Hua's way of eating is not very scientific. If he has hepatitis B, can he not even eat normally?"

Gan also agreed, "Yeah, I don't agree with his diet either. In fact, after I first learned that we were infected with the hepatitis B virus, I was negative for a while, but then I was influenced by Brother Hua, and my mentality gradually changed. I realized that the right attitude towards the virus is to take it seriously but not to be afraid of it."

The stomach nodded, "Yes, as Hua's stomach, I used to be overwhelmed. Hua's heavy taste and love of greasy food are also a burden to me. As one of his essential organs, I actually prefer a healthy diet, which is beneficial to all of us."

"Me too, I have been thinking about how to stay healthy, especially after being infected with the hepatitis B virus. What kind of diet and lifestyle should I maintain to be reasonable and scientific? Regarding this issue, I have recently looked up some information and done some research."

My stomach couldn't wait. "Then tell me, how should patients infected with hepatitis B virus eat rationally and scientifically? We should help Brother Hua correct some of his bad eating habits."

Gan said, "The food that the human body consumes every day includes several categories: carbohydrates, proteins, fats and vitamins. A reasonable and scientific diet should be a combination of meat and vegetables, and carbohydrates (sugars), high-quality proteins, fats and vitamins are indispensable. The diet of patients infected with hepatitis B virus should vary depending on the condition of the disease."

My stomach urged, "Then tell me more about it."

"If you are a virus carrier whose liver function has always been normal, or a patient with active hepatitis and early cirrhosis, and your liver function remains basically normal after active treatment and you have no complications, your diet is exactly the same as that of a normal person. Carbohydrates, which are commonly known as staple foods, include rice, noodles, cereals and potatoes, about 250-400g a day, and pay attention to the combination of coarse and fine. The second is protein, including meat and eggs, 150-200g a day, and dairy products 300g a day. Then there are fat foods, which should not exceed 30g a day. Finally, there are fresh vegetables and fruits, which contain various vitamins and trace elements. Vegetables should be consumed about 300-500g a day, and fruits should be consumed 200-400g a day."

Wei listened carefully, "I understand. The problem with Hua's current diet is that it only contains carbohydrates and vitamins, but lacks protein and fat."

Gan continued, "If the disease has developed to the decompensated stage of liver cirrhosis and is combined with various complications such as gastrointestinal bleeding and hepatic encephalopathy, the patient's diet should be paid special attention to."

The stomach is impatient, "Are there some foods that I can't eat?"

"Yes, at this time, the following aspects of diet should be noted: First, the protein intake should be appropriately limited to about 1-2g/kg/day. If the blood ammonia is high and hepatic encephalopathy has occurred, the protein intake is recommended to be 0.5-1g/kg/day to prevent excessive protein from producing excessive ammonia in the intestines and being absorbed into the blood, which may induce hepatic encephalopathy; second, the cooking methods of diet should be steamed, boiled, stewed, and boiled to make the food soft and easy to digest. It is advisable to chew slowly when eating to prevent rough, dry and hard food from entering the esophagus and stomach and scratching the varicose esophageal and gastric veins, inducing gastrointestinal bleeding; third, the nature of the diet should be mild, and spicy and irritating foods should be avoided to prevent increasing the burden on the liver and damaging the gastric mucosa to induce bleeding; fourth, eating should be small and frequent meals, 4-6 times a day is easy, and it is recommended to add a moderate amount of snacks before going to bed."

Wei nodded, thinking, "Then can I drink alcohol after being infected with the hepatitis B virus?"

"After being absorbed into the blood through the gastrointestinal tract, alcohol must be detoxified by the liver, which will increase the burden on the liver and induce alcoholic fatty hepatitis, alcoholic cirrhosis and even liver cancer. Drinking is of no benefit to healthy people who are not infected with the virus, and this is even more true for hepatitis B patients. Of course, they should quit drinking."

"Can I smoke?"

"It's the same with smoking. Nicotine and other toxic substances in tobacco need to be detoxified by the liver after entering the human body, which will increase the burden on the liver, so you have to quit smoking. Of course, it's not a big deal to smoke occasionally when you're having fun with friends."

"So staying up late is not allowed at all?"

"It depends on the condition. If the condition is active, liver function is obviously abnormal, or has developed into cirrhosis with obvious complications, then you definitely can't stay up late. For chronic hepatitis patients whose condition is stable or whose liver function remains normal after treatment, if you really need to stay up late for work, it is recommended that you try to make up for the sleep time during the day, because lack of sleep will affect your health."

"Then if we interact with friends normally, will Brother Hua infect his friends with the virus?"

"Of course not. The reason why people are so afraid of hepatitis B patients is because they lack basic knowledge about hepatitis B. Normal study, work and life, eating, talking and shaking hands together will not transmit hepatitis B; maintaining normal interpersonal communication is also beneficial to physical health, so there is no need for Brother Hua to stop all social activities."

"Is there anything else I need to pay attention to in life?"

"Other precautions include maintaining a stable mood, an optimistic attitude, doing appropriate exercise according to your condition, taking medicine on time, and going to the hospital for regular checkups, etc."

"I understand. Brother Hua is a chronic hepatitis B patient whose condition has stabilized after treatment. The dietary and lifestyle precautions are exactly the same as those of normal people. Scientific and reasonable precautions are the most important. The question is how can we make Brother Hua understand this?"

"Don't worry! I have compiled a popular science article about the life and diet precautions of hepatitis B patients. "Hepatitis B patients, can't they even eat normally?" It was published in the most authoritative liver science magazine "Liver Science". I will open the magazine to this article, mark the title of the article with a red pen, and then put the magazine next to Brother Hua's computer. Doesn't he go online every day after get off work?"

"Well, that's a good idea. For Hua Ge's health, and for the health of all of us, we must get him to change his unreasonable lifestyle as soon as possible."

In the evening, Brother Hua went home after get off work. His stomach and liver had been paying attention to his movements. They saw Brother Hua open the magazine and read it for a long time, then leaned back in his chair and went into a state of deep thought.

The stomach and liver smiled at each other. They believed that Brother Hua would eventually move towards a scientific and reasonable way of life and eating.

Author: Wang Fang, Department of Hepatology II, Shenzhen Third People's Hospital