Alcoholic hepatitis is a diseased, inflammatory condition of the liver caused by heavy alcohol consumption over an extended period of time. It’s also aggravated by binge drinking and ongoing alcohol use.
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 alcohol use leads to alcoholic hepatitis, doctors aren’t entirely sure why the condition develops. Alcoholic hepatitis develops in a minority of people who heavily use alcohol — no more than 35 percent according to the American Liver Foundation. It can also develop in people who moderately use alcohol.
Because alcoholic hepatitis doesn’t occur in all people who excessively use alcohol, other factors may influence the development of this condition. These include:
- genetic factors that affect how the body processes alcohol
- the presence of liver infections or other liver disorders, such as hepatitis B, hepatitis C, and hemochromatosis
- being overweight
- timing of drinking in relation to eating (drinking during mealtimes lowers the risk of developing alcoholic hepatitis)
Women are at a greater risk of developing alcoholic hepatitis. This may be due to the differences in how the bodies of men and women absorb and break down alcohol.
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
- jaundice, or yellowing of the skin or eyes
- changes in your mental state, including confusion
- easy bleeding or bruising
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.
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 so they can confirm your diagnosis. These tests could include:
- complete blood count (CBC)
- liver function test
- blood clotting tests
- abdominal CT scan
- ultrasound of the liver
Your doctor may order a liver biopsy if needed to confirm a diagnosis of alcoholic hepatitis. A liver biopsy is an invasive procedure with certain inherent risks. It requires your doctor to remove a tissue sample from the liver. A liver biopsy will show the severity and type of liver disease.
Alcoholic hepatitis is a condition that’s caused and aggravated by alcohol use. 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 in the early stages of the disease. Once more significant damage has occurred, the changes within the liver become permanent. Significant damage can lead to conditions such as cirrhosis, blood clotting problems, and high levels of bilirubin.
Even if the damage is too severe to reverse, you should still quit drinking to prevent further harm to your liver. In people with permanent liver damage due to alcohol, there’s a 30 percent increase in survival rate among those who stop drinking compared to those who continue to drink.
There’s always a benefit to quitting drinking. If you have an alcohol addiction and need help to stop drinking, talk to your doctor about the different treatment options for addiction. There are many excellent hospitals and clinic facilities that specialize in alcohol detoxification and recovery.
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 need to be provided through a feeding tube if you’re having trouble eating. Feeding tubes pass nutrient-rich liquids directly into to your digestive system through a variety of methods.
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’ll also need to abstain from alcohol for at least six months prior to the transplant. In some cases, you may need to seek counseling as well.
The best way to prevent alcoholic hepatitis is to avoid alcohol or, if you drink, to do so only in moderation. This is defined as less than two drinks per day for men and less than one drink per day for women.
You can also prevent alcoholic hepatitis through maintaining a healthy weight and by protecting yourself from hepatitis B and hepatitis C. Hepatitis B and C are bloodborne diseases. They’re transmitted by sharing needles and other equipment for drug use or through some body fluids by having unprotected sex. Currently, vaccines are only available for hepatitis B, but not for hepatitis C.
Your outlook depends on the severity of your symptoms and the amount of damage to your liver. It also depends on whether you stop drinking. If your symptoms are mild and you stop drinking, your outlook is often 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 bloodstream. These toxins can cause brain damage and lead to a coma.
Your outlook may worsen if you develop cirrhosis as a result of excessive alcohol use. Bleeding complications, anemia, and liver failure can become life-threatening.
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 doctor may order. In general, blood work will test serum magnesium, and replacements will occur if indicated. Vitamins such as thiamine and folic acid will need to be supplemented. In addition, the doctor 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, PsyD, CAADC, CARN-AP, MACAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.