Alcoholic hepatitis is an inflammation of the liver caused by drinking alcohol. People who have been drinking heavily for many years are more likely to have alcoholic hepatitis. However, the relationship between alcoholism and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis and the disease can occur in people who drink only somewhat.
If you are diagnosed with alcoholic hepatitis, you must discontinue drinking alcohol. People who continue to drink alcohol have a higher risk of severe liver damage and death.
Symptoms of Alcoholic Hepatitis
The most common symptom of alcoholic hepatitis is yellowing of the skin also whites of the eyes (jaundice).
Other signs and symptoms include:
- Loss of appetite
- Abdominal tenderness
- Nausea and vomiting
- Fatigue and weakness
- Fever, often low grade
Malnutrition is common among people with alcoholic hepatitis. Drinking huge amounts of alcohol suppresses appetite and heavy drinkers get most of their calories from alcohol.
Additional signs and symptoms that occur with serious alcoholic hepatitis involve:
- Fluid accumulation in your abdomen (ascites)
- Kidney and liver failure
- Confusion and behavior changes due to a build-up of toxins normally broken down and eliminated by the liver
Causes of Alcoholic Hepatitis
Alcoholic hepatitis develops when the alcohol you drink damages your liver. Just how alcohol damages the liver — and why it does so only in some heavy alcoholics — isn’t clear.
These factors are known to play a part in alcoholic hepatitis:
- The body’s process for breaking down alcohol produces largely toxic chemicals.
- Over time, scars replace healthy liver tissue, snooping with liver function.
- These chemicals spark inflammation that destroys liver cells.
- This unrecoverable scarring (cirrhosis) is the final stage of alcoholic liver disease.
Other factors that can contribute to alcoholic hepatitis involve:
- Other types of hepatitis. If you have hepatitis C and also drink — indeed moderately — you’re more likely to develop cirrhosis than if you do not drink.
- Malnutrition. Many people who drink heavily are malnourished because they eat badly or because alcohol and its byproducts prevent the body from properly absorbing nutrients. Lack of nutrients contributes to liver cell harm.
The main risk factor for alcoholic hepatitis is the amount of alcohol you drink. You do not know how much alcohol you are at risk for alcoholic hepatitis. But most people with the disease have a history of drinking 3.5 ounces (100 grams) – the equivalent of seven glasses of wine, seven beers or seven shots of spirits – every day for at least 20 years.
However, those who drink less may develop alcoholic hepatitis and have a variety of risk factors.
Other risk factors include:
- Your sex. Women seem to have a higher risk of developing alcoholic hepatitis conceivably because of differences in the way alcohol is processed in females.
- Binge drinking. Having five or more drinks within two hours for men and four or further for women might increase your risk of alcoholic hepatitis.
- Obesity. Heavy drinkers who are obese might be likelier to develop alcoholic hepatitis and progress from that condition to cirrhosis.
- Blacks and Hispanics may be at higher risk of alcoholic hepatitis.
- Genetic factors. Studies recommend there may be a genetic component in alcohol-induced liver disease although it’s difficult to separate genetic and environmental factors.
Complications of alcoholic hepatitis, which result from severe liver harm, relate to scar tissue. Scar tissue can slow blood flow through your liver, increasing stress in a major blood vessel (portal vein), and the buildup of toxins. Complications involve:
- Enlarged veins (varices). Blood that can’t roll freely through the portal vein can back up into other blood vessels in the stomach and esophagus. These blood vessels have thin walls and are likely to bleed if filled with too major blood. Heavy bleeding in the upper stomach or esophagus is life-threatening and requires instant medical care.
- Ascites. Fluid that accumulates in the abdomen might become infected and need treatment with antibiotics. Ascites isn’t life-threatening but are generally a sign of advanced alcoholic hepatitis or cirrhosis.
- Confusion, drowsiness and blurred speech (hepatic encephalopathy). A damaged liver is a problem in removing toxins from your body. Accumulation of toxins can damage your brain. serious hepatic encephalopathy can lead to coma. hepatic encephalopathy can lead to coma.
- Kidney failure. A damaged liver can affect blood flow to the kidneys, resulting in harm to those organs.
- Cirrhosis. This scarring of the liver can lead to liver failures.
Prevention of Alcoholic Hepatitis
You might lessen your risk of alcoholic hepatitis if you:
Drink alcohol in moderation, if at all. For healthy adults, moderate drinking means up to one drink a day for women of all ages and men older than 65, and over to two drinks a day for men age 65 and younger. The only certain way to help alcoholic hepatitis is to avoid all alcohol.
Protect yourself from hepatitis C. Hepatitis C is an contagious liver disease caused by a virus. Untreated, it can lead to cirrhosis. If you have hepatitis C and drink alcohol, you are far more likely to develop cirrhosis than if you didn’t drink.
Check before mixing medications and alcohol. Ask your doctor if it’s alright to drink alcohol when taking your prescription medications. Read the warning labels on over-the-counter medications. Do not drink alcohol when taking medications that warn of complications when associated with alcohol — especially pain relievers such as acetaminophen (Tylenol, others).
Diagnosis of Alcoholic Hepatitis
Your doctor will conduct a physical exam and ask about your current and past alcohol use. It’s significant to be truthful about your drinking habits. Your doctor might ask your authorization to interview family members about your drinking.
To test for liver disease, your doctor might advise:
- Liver function tests
- Blood tests
- An ultrasound, CT or MRI scan of the liver
- A liver biopsy, if other tests and imaging don’t provide a clear diagnosis or if you are at risk of different causes of hepatitis
Treatment of Alcoholic Hepatitis
Treatment for alcoholic hepatitis involves quitting drinking and therapies to ease the signs and symptoms of liver harm.
If you’ve been diagnosed with alcoholic hepatitis, you must break off drinking alcohol and never drink alcohol again. This is probably the only way to reverse liver damage or prevent the disease from getting worse. Those who do not stop drinking can have life-threatening health problems.
If you are addicted to alcohol and want to stop drinking, your doctor may recommend a therapy tailored to your needs. Quitting alcohol suddenly can be dangerous, accordingly be sure to discuss a plan with your doctor if you are dependent.
Treatment might include:
- Alcoholics Anonymous or other support groups
- Outpatient or residential treatment program
Treatment for malnutrition
Your doctor may recommend a special diet to correct the nutritional problem. You may be referred to a dietitian who can recommend ways to increase your deficiency of vitamins and nutrients.
If you have trouble eating, your doctor may recommend tube feeding. A tube is passed down your throat or through your side and into your stomach. A special nutrient-rich liquid diet is also passed through the tube.
Medications to reduce liver inflammation
If you have severe alcoholic hepatitis, your doctor might suggest:
- Corticosteroids. These medications have shown some short-term advantage in increasing the survival of certain people with severe alcoholic hepatitis. However, corticosteroids have serious side effects and usually aren’t prescribed if you have failing kidneys, gastrointestinal bleeding or an infection.
- Pentoxifylline.Your doctor might suggest this anti-inflammatory medication if you can not take corticosteroids. The advantage of pentoxifylline (Pentoxil) for alcoholic hepatitis is not clear. Study results are inconsistent.