Alcoholic Hepatitis


What is alcoholic hepatitis?

Key points

  1. Alcoholic hepatitis is an inflammatory condition of the liver. It’s caused by excessive alcohol consumption over an extended period of time.
  2. Genetics, other liver disorders, and malnutrition may also contribute to alcoholic hepatitis.
  3. If you have alcoholic hepatitis, it’s crucial you quit alcohol.

Alcoholic hepatitis is a diseased, inflammatory condition of the liver caused by excessive alcohol consumption over an extended period of time. If you develop this condition, you must stop drinking alcohol. Continued drinking can lead to additional health problems, such as cirrhosis (permanent scarring) of the liver, or even liver failure.



What causes alcoholic hepatitis?

When alcohol gets processed in the liver, it produces highly toxic chemicals. These chemicals can injure the liver cells. This injury then leads to inflammation, and alcoholic hepatitis.

Although heavy drinking causes alcoholic hepatitis, doctors are not entirely sure why the condition develops. Alcoholic hepatitis only develops in a minority of heavy drinkers. It can also develop in people who are only moderate drinkers.

Because alcoholic hepatitis doesn’t occur in all heavy drinkers, other factors may influence the development of this condition. These include:

  • genetic factors that affect how the body processes alcohol
  • the presence of other liver disorders, such as hepatitis C
  • malnutrition
  • concurrent consumption of food (drinking outside of meal times triples the risk of getting alcoholic hepatitis)

Women are at a greater risk (twice as likely as men) of developing alcoholic hepatitis. This may be due to the differences in how the bodies of men and women absorb and break down alcohol.


What are the symptoms of alcoholic hepatitis?

The symptoms of alcoholic hepatitis vary depending on the amount of damage to the liver. If you have a mild case of the disease, you may not experience any symptoms. However, as more damage occurs, you may begin to experience:

  • changes in appetite
  • dry mouth
  • weight loss
  • nausea and vomiting
  • pain or swelling in the abdomen
  • yellowing of the skin or eyes (jaundice, icterus)
  • fever
  • changes in your mental state, including confusion
  • fatigue

The symptoms of alcoholic hepatitis are similar to those caused by other health conditions. If you develop any of these symptoms, you should contact your doctor to get a proper diagnosis and begin treatment.



How is alcoholic hepatitis diagnosed?

If you have symptoms of alcoholic hepatitis, your doctor will ask you about your health history and alcohol consumption. Your doctor will also perform a physical exam to see if you have an enlarged liver or spleen. They may decide to order tests to confirm your diagnosis. These could include:

  • complete blood count (CBC)
  • liver function test
  • abdominal computerized tomography (CT) scan
  • ultrasound of the liver

Your doctor may order a liver biopsy if these tests can’t confirm a diagnosis. A liver biopsy is an invasive procedure (with certain inherent risks) that requires your doctor to remove a tissue sample from the liver. A liver biopsy will show if you have liver disease. This test will also show whether or not you have alcoholic hepatitis.


Treatment options for alcoholic hepatitis

You need to stop drinking if you receive an alcoholic hepatitis diagnosis. You may be able to reverse the damage to your liver by avoiding alcohol.

Even if the damage is too severe to reverse, you should still quit drinking to prevent further harm to your liver. You might need help to stop drinking, especially if you’re struggling with alcohol addiction. Be sure to talk to your doctor about the different treatment options for addiction. There are many excellent hospitals and clinic facilities that specialize in alcohol detoxification.

Treatment for alcoholic hepatitis may include medications that reduce inflammation in your liver and improve liver function.

Your doctor may also prescribe vitamin and nutrient supplements if you’re malnourished. These nutrients may be provided through a feeding tube if you’re having trouble eating. A feeding tube passes from your nose or mouth into your stomach, allowing nutrient-rich liquids to enter your body.

Your doctor may recommend a liver transplant if your liver is severely damaged. To qualify for a transplant, you must demonstrate that you won’t continue drinking if you receive a new liver. You will also need to abstain from alcohol for at least six months. In some cases, you may need to seek counseling as well.



How can you prevent alcoholic hepatitis?

The best way to prevent alcoholic hepatitis is to avoid alcohol or, if you drink, to do so only in moderation. You can also prevent alcoholic hepatitis through proper nutrition and by protecting yourself from hepatitis C. Hepatitis C is a blood-borne disease that spreads by sharing needles and other equipment for drug use, or by having unprotected sex.



Long-Term outlook for alcoholic hepatitis

Your outlook depends on the severity of your symptoms and the amount of damage to your liver. Your outlook also depends on whether you’re able to stop drinking. If your symptoms are mild and you stop drinking, your prognosis is typically good.

If you don’t stop drinking and your condition worsens, your overall outcome and chances for recovery will worsen as well. Alcoholic hepatitis can lead to hepatic encephalopathy. This condition occurs when the toxins typically filtered out by your liver remain in the blood. These toxins can cause brain damage and lead to a coma. Your outlook may worsen if you develop scarring of the liver (cirrhosis) as a result of your drinking.



Diet and nutrition

  • What nutrition advice can you provide for people recovering from alcohol addiction?
  • This depends on the individual and the results of laboratory tests that their physician may order. In general, blood work will test serum magnesium, and replacements will occur if indicated. In general, vitamins such as thiamine and folic acid will need to be supplemented. In addition, the physician may add a daily multiple vitamin. The person should also try to eat three well-balanced meals per day and drink enough water to remain hydrated.

    - Timothy J. Legg, PhD, CARN-AP, CASAC, MAC
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