Alcoholic Hepatitis

What is alcoholic hepatitis?

The liver is a large organ that lies up under the ribs on the right side of the belly (abdomen). It helps filter waste from the body. It also makes bile to help digest food, and stores sugar that the body uses for energy.

Hepatitis is inflammation of the liver that leads to liver cell damage and cell death.

What causes alcoholic hepatitis?

Alcoholic hepatitis is caused by drinking too much alcohol. The liver breaks down alcohol. Over time, if you drink more alcohol than the liver can process, it can become seriously damaged. Obese patients and tobacco smokers are at higher risk of alcoholic hepatitis, or a more complicated course.

What are the symptoms of alcoholic hepatitis?

These are the most common symptoms of alcoholic hepatitis:

  • Belly (abdomen) tenderness or pain over the liver
  • Nausea
  • Vomiting blood or material that looks like coffee groundsĀ 
  • Poor appetite
  • Yellowing of the skin and eyes (jaundice)
  • Weight loss
  • Tiredness and weakness
  • Fever

Alcoholic hepatitis usually develops over time with continued drinking. But severe alcoholic hepatitis can develop suddenly. It can quickly lead to liver failure and death. You can get alcoholic hepatitis from drinking even if you don't have cirrhosis (permanent scarring of the liver).

The symptoms of alcoholic hepatitis may look like other health conditions or problems. Always see a doctor for a diagnosis.

How is alcoholic hepatitis diagnosed?

Your healthcare provider will take a complete health history and do a physical exam. You may need tests, including:

Blood tests

These include:

  • Liver function studies
  • Blood cell counts
  • Bleeding times
  • Electrolyte tests
  • Tests for other chemicals in the body

Ultrasound of the abdomen

This imaging uses sound waves to show internal structures. It does not involve radiation.

CT scan

This imaging test uses X-rays and a computer to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the liver. CT scans are more detailed than general X-rays.

MRI

MRI (magnetic resonance imaging uses a magnetic field, radio frequency pulses, and a computer to make detailed pictures of internal body structures. Dye is injected to make organs visible.

Liver biopsy

For this test, a small tissue sample is taken from the liver with a needle or during surgery. These samples are checked under a microscope to find out the type of liver disease.

How is alcoholic hepatitis treated?

The goal of treatment is to restore some or all normal functioning to the liver.

You will need to stop drinking alcohol. To do this, you may need to be in an alcohol treatment program. Sometimes you may also need to change your diet. If scarring of the liver occurs, it is permanent. But, if caught early, the liver is often able to repair some of the damage caused by alcohol so you can live a normal life.

You may be admitted to the hospital or treated on an outpatient basis. There is no medicine to cure alcoholic hepatitis. Treatment involves easing the symptoms and keeping the disease from getting worse.

Because malnutrition is usually present, you will be treated with vitamins and attention to your food intake.

Ask your healthcare provider about recommended vaccines. These include vaccines for viruses that can cause liver disease.

What are possible complications of alcoholic hepatitis?

Alcoholic hepatitis makes it more likely that you will have gallstones. It also increases your risk for liver cancer.

If you continue to drink alcohol, the liver will continue to be damaged. Over time, cirrhosis will develop. Cirrhosis can cause the pressure in the liver blood vessels to increase which can lead to life-threatening bleeding in the stomach and esophagus. It can also affect the blood flow to your kidneys, causing damage to them. If the liver is not functioning properly, toxins can build up in your body which can damage your brain, and lead to coma and death.

Key points about alcoholic hepatitis

  • Hepatitis is inflammation of the liver that leads to liver cell damage and cell death.
  • Alcoholic hepatitis is caused by drinking too much alcohol. The liver breaks down alcohol and if, over time, you drink more alcohol than the liver can process, it can become seriously damaged.
  • Alcoholic hepatitis usually develops over time with continued drinking. Severe alcoholic hepatitis can develop suddenly and quickly lead to liver failure and death.
  • You must completely stop drinking alcohol and may need an alcohol treatment program. Sometimes diet changes are recommended, too. Treatment involves reducing the symptoms and halting the progression of the disease.
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