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.
Excessive alcohol consumption could result in fatty liver disease or steatosis, alcoholic hepatitis (AH), and eventually cirrhosis. Alcoholic hepatitis usually progresses to cirrhosis if drinking is continued. For those who discontinue alcohol, hepatitis returns to normal within a few months but the cirrhosis that has already occurred does not reverse. A survey of liver transplant programs conducted in 2015 revealed only 27% of the programs offer a transplant to AH patients. Of the 3,290 liver transplants performed 1.37% were on AH patients.
Causes of Alcoholic Hepatitis
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.
Alcoholic Hepatitis Risk Factors
Because alcoholic hepatitis doesn’t occur in all people who heavily use alcohol, other factors may influence the development of this condition.
Risk factors of alcoholic hepatitis 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
- Having a higher body weight
- Timing of drinking in relation to eating (drinking during mealtimes lowers the riskTrusted Source 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.
Alcoholic Hepatitis Symptoms
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:
- Jaundice, or yellowing of the skin or eyes
- Changes in your mental state, including confusion
- Easy bleeding or bruising
- Changes in appetite
- Dry mouth
- Weight loss
- Nausea and vomiting
- Pain or swelling in the abdomen
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.
How is alcoholic hepatitis diagnosed?
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:
- Complete blood count (CBC)
- Liver function test
- Blood clotting tests
- Abdominal CT scan
- Ultrasound of the liver
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.
Alcoholic Hepatitis Treatments
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.
Possible Complications of Alcoholic Hepatitis
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 alcoholic cirrhosis as a result of heavy alcohol use, alcoholic hepatitis can get worse. Cirrhosis can also raise your risk of liver cancer.
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.
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.
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.
Over time, alcoholic hepatitis can damage your kidneys as well as your liver. Without treatment, these organs may fail.
A few other potential complications include:
- Problems with blood clotting
- Low blood platelet count
- Iron overload
- High levels of bilirubin
Long-term outlook for alcoholic hepatitis
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. 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 of 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.
How Can You Prevent Alcoholic Hepatitis?
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 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.
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.
Symptoms of Alcoholism
As stated by the National Institute on Alcohol Abuse and Alcoholism, these are the signs to be aware of in terms of this condition:
- Appearing intoxicated more regularly
- Appearing tired, unwell or irritable
- An inability to say no to alcohol
- Becoming secretive or dishonest
- Drinking more, or longer than one intended
- Wanting to cut down or stop drinking, or tried to, but haven’t been able to do so
- Spending a lot of time drinking, being sick or getting over the aftereffects
- Experiencing craving, a strong need, or urge to drink
- Founding that drinking, or being sick from drinking, often interferes with taking care of your home or family, job troubles or school problems
- Continuing drinking even though it was causing trouble with family or friends
- Giving up or cutting back on activities that are important or interesting to you, in order to drink
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)
- Continuing to drink even though it was making you feel depressed, anxious, or adding to another health problem, or after having had a memory blackout
- Having to drink much more than you once did to get the effect you want. Or finding that your usual number of drinks have much less effect than before
- Finding that when the effects of alcohol are wearing off, you have withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating.
Treatment for alcoholism
When it comes to Alcoholism treatment, it is normal to think of 12-step programs or 28-day inpatient rehab, but it becomes difficult to think of more options of treatment for this condition. There are a variety of treatment methods currently available. According to the National Institute on Alcohol Abuse and Alcoholism, there are three types of treatment:
- Behavioral Treatments for alcoholism: are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.
- Medications for alcoholism: Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.
- Peer-Support Groups for alcoholism: Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.
Reclaim Your Life From Alcoholic Hepatitis by Treating Alcoholism
You may be able to reverse the damage to your liver by avoiding alcohol in the early stages of the 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.
If you suffer from alcoholism, stopping drinking may be a challenge, even if that involves your own wellbeing. We Level Up Washington can provide you, or someone you love, the tools to recover from alcoholism with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.