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 severely damaged. Obese people 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 soreness or pain over the liver

• Upset stomach (nausea)

• Vomiting blood or material that looks like coffee grounds 

• 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 permanent scarring of the liver (cirrhosis).

Many of these symptoms may be caused by other health problems. Always see a healthcare provider 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 doesn't use radiation.

CT scan

This imaging test uses X-rays and a computer to make horizontal (axial) images 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. Contrast 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'll 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's permanent. But if it's caught early, the liver can often fix 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'll be treated with vitamins and attention to your food intake.

Ask your healthcare provider about advised 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'll 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 occur. Cirrhosis can cause the pressure in the liver blood vessels to increase. This 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 isn't working correctly, toxins can build up in your body. This 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. If, over time, you drink more alcohol than the liver can process, it can become severely damaged.

• Alcoholic hepatitis usually develops over time with continued drinking.

• Severe alcoholic hepatitis can occur 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 advised, too.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.