saudigastro.com/patients/pediatric-hepatitis
Category
Serious
Red flags
5
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Hepatitis ("hep-uh-TIE-tis") means the liver is inflamed. The liver cleans the blood, makes proteins that help blood clot, and stores energy. When it is inflamed, liver blood tests rise and the child may feel unwell or become yellow (jaundiced). Hepatitis can be short-lived (acute) or last more than six months (chronic). It is a broad term, and the treatment depends entirely on the cause.
How common is it?
Mild liver inflammation is not unusual in children, especially with common viral infections. Serious or long-term hepatitis is much less common. Vaccination has made hepatitis A and B much less frequent in countries with good immunisation programmes.
Why does it happen?
Causes include viruses (hepatitis A, B, C, E and others such as EBV or CMV), autoimmune hepatitis where the body attacks the liver, medicines and toxins (including overdose of common painkillers or herbal products), fatty liver linked to excess weight, inherited conditions such as Wilson disease or alpha-1 antitrypsin deficiency, and sometimes no cause is found. Hepatitis A and E usually spread through contaminated food or water; hepatitis B and C spread through blood or from mother to baby.
Symptoms
- Tiredness, low energy, and poor appetite
- Nausea, vomiting, or belly discomfort
- Yellow skin and eyes (jaundice)
- Dark urine and pale stools
- Itching
- Low fever and joint aches
- Often no symptoms at all, found on a blood test done for another reason
Red flags — seek urgent medical care
Confusion, unusual sleepiness, personality change, or difficulty waking
May mean the liver is failing and affecting the brain. This is an emergency; go to the emergency department now.
Bleeding easily, nosebleeds that will not stop, blood in vomit or stool, or large bruises
The liver may not be making enough clotting proteins. Seek emergency care.
Deepening yellow colour with repeated vomiting and inability to drink
Risk of dehydration and worsening liver injury. Your child needs to be seen immediately.
Swollen belly, swollen legs, or a rapidly growing belly
May indicate advanced liver disease with fluid collection. See a doctor urgently.
Any child who has swallowed too much paracetamol or an unknown medicine or mushroom
Go to the emergency department immediately, even if the child seems well. Do not wait for symptoms.
How is it diagnosed?
The doctor examines your child, asks about medicines, travel, family history and exposures, and sends blood tests to measure liver enzymes, bilirubin, clotting, and tests for viruses and autoimmune markers. An ultrasound of the liver is common. Some children need further blood tests for inherited conditions or a liver biopsy (a small tissue sample taken with a needle under sedation or anaesthetic) to find the cause. A paediatric liver specialist guides this process.
Outlook — what to expect
The outlook depends on the cause. Hepatitis A and many other short-lived viral infections usually clear completely. Hepatitis B and C, autoimmune hepatitis, and inherited liver diseases need long-term specialist care, and treatment can prevent serious damage. A small number of children develop liver failure and need urgent specialist care, sometimes including a liver transplant.
Treatment
Habits & Lifestyle
Rest, hygiene and careful medicine use protect the liver and others.
- Let your child rest as needed and return to school when well enough and the doctor agrees.
- Wash hands well after using the toilet and before eating to prevent spreading hepatitis A and E.
- Do not share toothbrushes, razors or items that may carry blood.
- Make sure vaccinations (including hepatitis A and B) are up to date.
- Keep medicines and chemicals locked away from children.
Diet
There is no special diet that cures hepatitis, but good nutrition supports recovery.
- Offer small, frequent, balanced meals while appetite is low, with plenty of fluids.
- Do not give herbal products, supplements or traditional remedies without asking the doctor, as some can harm the liver.
- Children with fatty liver benefit from healthy eating, regular activity and less sugary drinks; avoid crash diets.
- Ensure food and water are safe and well cooked, especially when travelling.
Medications
Treatment depends on the cause. Many viral hepatitis illnesses need only supportive care.
- Do not give any medicine, including paracetamol or herbal remedies, without checking the dose and safety with your doctor, because the liver processes many medicines.
- Chronic hepatitis B, hepatitis C and autoimmune hepatitis have specific treatments chosen by a paediatric liver specialist.
- Treatment for inherited or metabolic liver disease is specific to the condition.
- The doctor decides every medicine, dose and duration. Never stop treatment without advice.
Procedures & Surgery
Procedures are used for diagnosis or complications.
- Liver ultrasound or elastography may be used to look at the liver.
- A liver biopsy may be needed to make an accurate diagnosis.
- Children with liver failure are cared for in a specialist centre, and a liver transplant is considered only in selected cases.
Living with the condition
- Tell the school about your child's condition if needed, and explain that some forms of hepatitis are not spread by ordinary contact.
- Family members and close contacts may need testing or vaccination; ask your doctor.
- Keep regular follow-up for long-term types of hepatitis, as treatment works best with close monitoring.
In the Saudi context
Routine childhood vaccination in the Kingdom includes hepatitis B. Keep your child's vaccination record up to date and ask your doctor about hepatitis A vaccination and about travel or Hajj and Umrah health advice.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- What is causing my child's hepatitis?
- Is it contagious, and do we or others need testing or vaccines?
- Which medicines are safe for my child now?
- When can my child return to school and activities?
- How often will we need blood tests and follow-up?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide