Alcoholic hepatitis is an inflammatory condition of the liver caused by heavy alcohol consumption over an extended period of time. Ongoing alcohol use and binge drinking can both aggravate this condition.

If you develop this condition, it’s important that you consider stopping alcohol use gradually. Continued drinking can lead to additional health conditions, such as cirrhosis, excessive bleeding, or even liver failure.

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

Although heavy alcohol use can lead to alcoholic hepatitis, experts aren’t entirely sure why the condition develops in some people but not in others.

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 use alcohol only moderately.

Because alcoholic hepatitis doesn’t occur in all people who heavily use alcohol, other factors may influence the development of this condition.

Risk factors include:

  • having genetic factors that affect how the body processes alcohol
  • living with liver infections or other liver disorders, such as hepatitis B, hepatitis C, and hemochromatosis
  • malnutrition
  • having a higher body weight
  • timing of drinking in relation to eating (drinking during mealtimes lowers the risk of developing alcoholic hepatitis)

Women typically have a greater risk of developing alcoholic hepatitis. This may be due to the differences in how their bodies absorb and break down alcohol.

The symptoms of alcoholic hepatitis can vary, depending on the amount of damage to your liver. If you have a mild case of the condition, you may not experience any symptoms.

As more damage occurs, you may begin to experience:

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. They’ll also perform a physical exam to help determine if you have an enlarged liver or spleen.

They may decide to order tests to help confirm the diagnosis. These tests could include:

Your doctor may order a liver biopsy to confirm a diagnosis of alcoholic hepatitis. A liver biopsy requires your doctor to remove a tissue sample from the liver. It’s an invasive procedure with certain inherent risks, but biopsy results can show the severity and type of liver condition.

Alcohol use both causes and worsens alcoholic hepatitis, so a diagnosis of alcoholic hepatitis means you may want to consider stopping drinking gradually. Quitting drinking can help reduce symptoms and prevent further damage to your liver.

In the early stages of the condition, avoiding alcohol may even help reverse liver damage. Once more significant damage has occurred, the changes to your liver may become permanent.

Even if the damage is too severe to reverse, quitting drinking could prevent further harm to your liver.

  • According to 2017 research, people with permanent liver damage due to heavy alcohol use who continued drinking had a 30 percent decrease in survival rate, compared to people who stopped drinking.

Other treatment options might include:

  • Getting support for quitting drinking. If you have an alcohol addiction and need help to stop drinking, talk with your doctor about the different treatment options for addiction. Hospitals and clinic facilities can offer inpatient and outpatient support for alcohol detoxification and recovery.
  • Taking medication. Your doctor may prescribe medications such as corticosteroids or pentoxifylline to help reduce inflammation in your liver and improve liver function. In a small 2018 study, the muscle relaxer baclofen also showed promise for helping people with advanced liver disease reduce alcohol use and maintain sobriety, but the FDA has yet to approve it for this use.
  • Trying vitamin and nutrient supplements. If you’re malnourished, adding more nutrients to your diet can improve your health and recovery. A feeding tube can help you get enough nutrients, even when you’re having trouble eating, by passing nutrient-rich liquids directly into your digestive system.
  • A liver transplant. A liver transplant may be an option if your liver is severely damaged. To qualify for a transplant, you must show a commitment to staying sober after receiving a new liver. You’ll also need to stop drinking at least 6 months before the transplant.
  • Counseling. Your doctor may also recommend counseling as part of treatment. Support from a therapist can’t address your physical symptoms, but it can go a long way toward improving emotional well-being and helping you learn new coping skills to overcome alcohol cravings and avoid drinking.

Alcoholic hepatitis can lead to severe and lasting liver damage, which can, in turn, cause serious health complications. In some cases, these complications can be life threatening.

Cirrhosis of the liver

Cirrhosis happens when scar tissue permanently replaces the healthy tissue of your liver. Scar tissue affects the normal function of your liver and can eventually cause it to fail.

If you develop cirrhosis as a result of heavy alcohol use, alcoholic hepatitis can get worse. Cirrhosis can also raise your risk of liver cancer.

Esophageal bleeding

Scar tissue slows down the flow of blood in your liver, raising overall blood pressure within your liver and weakening surrounding blood vessels in your stomach and esophagus.

The blood vessels here aren’t meant to carry the blood that can’t pass through your liver, so they can swell until they split and leak into your esophagus.

Ascites

This condition involves a buildup of fluid in your abdomen. You might notice a tender or swollen abdomen, pain or discomfort, and trouble breathing.

Spontaneous bacterial peritonitis

The fluid that builds up in your abdomen can get infected. When this happens, it’s known as spontaneous bacterial peritonitis, which is a medical emergency. Getting treatment when you first notice symptoms of ascites can help reduce your risk.

Hepatic encephalopathy

This condition occurs when the toxins typically filtered out by your liver remain in your bloodstream. These toxins can cause brain injury and lead to a coma.

Organ failure

Over time, alcoholic hepatitis can damage your kidneys as well as your liver. Without treatment, these organs may fail.

Other complications

A few other potential complications include:

Your outlook depends on three main factors:

  • severity of your symptoms
  • amount of damage to your liver
  • whether you stop drinking alcohol

Generally speaking, if your symptoms are mild and you stop drinking gradually, your outlook is often good. In fact, research suggests mild cases could be reversed if you avoid alcohol entirely.

If you continue drinking, your symptoms will eventually get worse, which will negatively affect your chances for recovery.

Severe alcoholic hepatitis is fatal within about 6 months for 40 percent of people who develop the condition. Complications like hepatic encephalopathy can also worsen this outlook.

The best way to prevent alcoholic hepatitis is to avoid alcohol or drink only in moderation. Moderate drinking is defined as less than two drinks per day for men and less than one drink per day for women.

You can also reduce your risk by taking steps to protect yourself from hepatitis B and hepatitis C. The bloodborne viruses that cause these conditions can be transmitted in several ways, including shared needles or razors and through body fluids during sex. Currently, vaccines are available for hepatitis B, but not for hepatitis C.

Your healthcare team may also recommend certain lifestyle changes based on your specific symptoms and health needs.

For example:

  • eating a balanced diet low in salt
  • drinking enough water
  • adding more protein to your diet
  • getting regular physical activity, such as walking, if you’re able to exercise

Following these recommendations can improve symptoms and make a difference in your outlook.

Alcoholic hepatitis can be serious, but it’s treatable. Quitting drinking gradually and getting medical care right away can go a long way toward improving your outlook.

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