Alcoholic hepatitis is a disease caused by drinking alcohol. The disease causes fat to build up in the liver cells, as well as inflammation and even scarring of the liver.
The condition occurs most often in heavy drinkers. Those who have drunk heavily for several years and have poisonous levels of alcohol in their bodies are most at risk.
Alcohol and the liver
Ethyl alcohol or ethanol is an ingredient found in beer, wine, and liquor that can cause intoxication. Alcohol affects every organ in the body as well as the central nervous system. The effect of alcohol on a person depends directly on the amount they consume.
Drinking excessive amounts of alcohol can lead to a variety of health problems. It can result in serious health problems including:
- Inflammation of the pancreas
- High blood pressure
- Psychological disorders
- Alcohol abuse or dependence
In pregnant women, alcohol can harm the fetus or increase the chances of sudden infant death syndrome. Being reckless with alcohol can also lead to unintentional motor accidents and violence.
Alcoholic hepatitis and the liver
The liver is the second largest organ in the body. It is located on the right side of the body under the rib cage. The liver is responsible for processing what people eat and drink into nutrients that can be used readily by the body.
It is also responsible for removing harmful substances from the blood. Alcohol can damage and even destroy the body’s liver cells. The liver breaks down alcohol so that it can be removed from the body.
The liver processes alcohol, but it can only do so in small doses. Any excess alcohol is left to circulate throughout the body. Drinking more alcohol than the body can process may cause injury or serious damage to the liver.
Symptoms of alcoholic hepatitis
One of the most common signs of alcoholic hepatitis is jaundice, which causes yellowing of the skin and eyes. Additional symptoms that can occur include:
- Loss of appetite
- Stomach pain
- Tiredness and weakness
- Weight loss
Alcoholic hepatitis is generally defined as either mild or severe. Mild alcoholic hepatitis can sometimes be reversed by giving up alcohol.
Severe alcoholic hepatitis can occur without warning. It can lead to serious complications such as liver failure and even death. The signs and symptoms of severe alcoholic hepatitis include:
- Buildup of fluid in the upper body
- Confusion and behavior changes caused by a buildup of poisons in the body that are normally broken down and removed by the liver
- Liver and kidney failure
Signs and symptoms vary from person to person. They also change depending on the severity of the disease and after recent periods of heavy drinking.
Causes and risk factors
The main cause of alcoholic hepatitis is excessive drinking over an extended period of time. The poisonous chemicals released by the breakdown of alcohol cause inflammation that can destroy liver cells.
Over time, scars begin to replace healthy liver tissue in the body, interfering with how the liver works. Irreversible scarring or cirrhosis is the final stage of alcoholic liver disease.
Once cirrhosis has developed, it can quickly progress to liver failure. A damaged liver can also affect the flow of blood to the kidneys, which can result in damage and kidney failure.
Some factors can contribute to alcoholic hepatitis. People with other types of hepatitis are at an increased risk and should not drink. Inadequate absorption of nutrients from the intestine can also be a problem.
Most people who suffer from alcoholic hepatitis are malnourished because drinking significant amounts of alcohol suppresses the appetite. As a result, most heavy drinkers get the majority of their daily calories from alcohol. Malnutrition can also contribute to liver disease.
Other risk factors include:
- Sex: Women may have a higher risk of developing alcoholic hepatitis
- Genetic factors
- Race and ethnicity: African American and Hispanics may be at higher risk of developing alcoholic hepatitis.
- Binge drinking: Consuming five or more alcoholic drinks at one time can increase the risk of alcoholic hepatitis
Diagnosis of alcoholic hepatitis
Some people may not show any symptoms of alcoholic hepatitis until the disease has become advanced. Doctors start with a complete medical history and physical examination. During this exam, the doctor will also ask the patient about their history of alcohol consumption and to describe their drinking habits.
Blood tests to determine alcohol hepatitis include:
- Liver studies
- Cellular blood counts
- Bleeding times
- Electrolyte tests
- Tests for other chemicals in the body
An ultrasound, CT, or MRI scan of the liver is also used to show a more detailed view. If other tests fail to provide a clear answer, a liver biopsy may be carried out.
During this test, a small tissue sample is taken from the liver either using a needle or during surgery. The sample is then examined under a microscope to help determine the type of liver disease.
Treatment of alcoholic hepatitis
The main treatment involves stopping drinking alcohol completely. There is no exact medicine that can cure alcoholic hepatitis. The goal of treatment is to reduce or eliminate the symptoms and halt the progress of the disease.
Scarring of the liver is permanent, but the liver can repair some of the alcohol damage so that the person can lead a normal life. The hope for treatment is to restore all or some of the normal function to the liver.
Doctors may recommend alcohol treatment programs for some patients. There are inpatient and outpatient programs available depending on the needs of the patient. These cessation programs can be very helpful in helping excessive drinkers such as alcoholics.
Alcoholics Anonymous is a popular group found in most areas that can be helpful in becoming sober. The National Drug and Alcohol Treatment Referral Routing Service can also be helpful in helping a person to locate their nearest treatment program or talk to a specialist about alcohol problems.
Diet changes are also recommended. Vitamins or a special diet may be ordered for malnourished patients to help correct the problem.
People who have severe alcoholic hepatitis may be prescribed medicines such as corticosteroids and pentoxifylline to help reduce liver inflammation. A liver transplant may be the only chance for survival for some severe alcoholic hepatitis patients, but there is often a long list and donor process.
Written by Brian Wu