What's to know about alcoholic hepatitis?
The infection can be mild or severe. The person may need a liver transplant if they do not receive treatment or stop consuming alcohol during the early stages.
This article explores the relationship between alcohol and the liver, the symptoms and causes of alcoholic hepatitis and possible treatments.
What is alcoholic hepatitis?
Hepatitis is a liver disease that can result from drinking too much alcohol too often.
Alcoholic hepatitis occurs when a person consumes more alcohol than the liver can process.
The liver is the second largest organ in the body. It is on the right side of the torso, under the rib cage.
Its role is to convert food and drink into nutrients that the body can use easily.
The liver also filters poisons and harmful substances — including alcohol — from the blood.
Alcohol can damage and destroy liver cells. The liver breaks down alcohol for removal from the body.
The liver can only process alcohol in small doses. Any excess alcohol circulates throughout the body. Drinking more alcohol than the body can process may cause injury or serious damage to the liver.
Alcohol and the liver
Ethyl alcohol or ethanol is an ingredient in beer, wine, and liquor that causes intoxication. Alcohol affects every organ in the body and the central nervous system.
The way a person experiences the effects of alcohol depends directly on the amount they consume.
Excessive alcohol consumption can lead to a variety of health problems, including:
- cirrhosis, or scarring of the liver
- inflammation of the pancreas
- high blood pressure
- psychological disorders
- alcohol dependence
Alcohol can harm a fetus during pregnancy and increase the risk of sudden infant death syndrome. It can also lead to unintentional motor accidents and violence.
Liver damage can progress over time if a person consumes more alcohol than is healthful for them.
One of the most common signs of alcoholic hepatitis is jaundice, or yellowing of the skin and eyes.
Additional symptoms include:
Alcoholic hepatitis can be either mild or severe. It is possible to reverse the condition by ceasing to drink alcohol.
Severe alcoholic hepatitis can occur without warning, leading to life-threatening complications, such as liver failure.
Once the condition becomes severe, symptoms include:
- a buildup of fluid in the upper body
- confusion and behavior changes
- liver and kidney failure
Signs and symptoms vary between people and depend on the severity of the disease. They can also flare up after consuming alcohol.
Causes and risk factors
The main cause of alcoholic hepatitis is heavy drinking over an extended period.
The process of breaking down alcohol in the liver causes inflammation that can destroy liver cells.
Over time, scars begin to replace functional liver tissue in the body. This interferes with how the liver works. Irreversible scarring — or cirrhosis — is the final stage of alcoholic liver disease.
Cirrhosis can quickly progress to liver failure once it develops. A damaged liver can also interfere with blood flow to the kidneys. This can result in damage and kidney failure.
Other factors can contribute to alcoholic hepatitis. People with other types of hepatitis have a higher risk. They should not drink alcohol.
A person with alcoholic hepatitis may experience malnourishment. Drinking significant amounts of alcohol can suppress the appetite. Alcohol may become the main source of calories for an individual.
Malnutrition can also contribute to liver disease.
Other possible risk factors include:
- sex, as women may have a higher risk of developing alcoholic hepatitis
- genetic factors
- race and ethnicity, as African-American and Hispanic people may face a higher risk of developing alcoholic hepatitis
Some people may not show symptoms until the disease has reached a severe stage.
A doctor will:
- take a complete medical history
- carry out a physical examination
- ask the person about their history of alcohol consumption and their drinking habits
Blood tests to determine alcoholic hepatitis include:
- liver function studies
- cellular blood counts
- measuring bleeding times
- electrolyte tests
- tests for other chemicals in the body
If other tests do not provide a clear answer, the doctor may conduct a liver biopsy.
This involves taking a small tissue sample from the liver using either a needle or through surgery for testing in a laboratory. The results will help to determine the type and scale of the problem.
The main treatment for alcoholic hepatitis is to stop consuming alcohol.
There is no cure for alcoholic hepatitis, but treatment will aim to reduce or eliminate symptoms and stop the progression of the disease.
Scarring of the liver is permanent, but the liver can repair some of the damage. Treatment aims to restore as much normal function to the liver as possible.
Dietary changes: A doctor may also recommend dietary changes. Vitamin supplements or a focused diet plan may help to correct the balance of nutrients in the body if a person has malnourishment after regular alcohol use.
Medication: Doctors may prescribe medicines including corticosteroids and pentoxifylline to help reduce liver inflammation.
Liver transplant: In severe cases, a liver transplant may be the only chance for survival. However, the process of finding a donor can be long and complicated.
The best hope of recovery is to be aware of the possible signs and symptoms and to reduce, manage, or stop alcohol consumption before the condition progresses.
Treatment programs and support
Doctors may recommend alcohol treatment programs for people who find it difficult to cut out alcohol. Programs are available both in and out of hospital, depending on the severity of the dependence.
These programs can help people to reduce and eventually stop consuming alcohol.
Here are some examples:
- Substance Abuse and Mental Health Services Administration (SAMHSA) provide help and information for those looking for help for themselves or others
- Alcoholics Anonymous (AA) offers help and support for those seeking to reduce alcohol dependence, with meetings locally around the world
- The National Institute on Alcohol Abuse and Alcoholism (NIAAA) website can help people locate their nearest treatment program or alcohol cessation specialist.
Drinking too much alcohol on a regular basis can lead to a range of diseases, including alcoholic hepatitis. Consuming in moderation can reduce this risk.
Not everyone who consumes large amounts of alcohol will develop alcoholic hepatitis.
More research is necessary to confirm why some people who drink in excess develop the disease while others do not.
It is also important to note that alcoholic hepatitis can also occur in moderate drinkers, although the risk is far lower.
According to the Liver Foundation, up to 35 percent of people who consume alcohol heavily develop alcoholic hepatitis. Of these, 55 percent already have cirrhosis.
Alcohol can have a wide range of harmful effects on the body. People who consume alcohol should do so in moderation.
Alcoholic hepatitis is a liver infection that mainly occurs due to heavy alcohol use on a regular basis.
Alcohol can damage the liver by causing fat to build up. This may eventually lead to irreversible liver scarring, known as cirrhosis.
Ceasing to drink alcohol will often reverse the condition in its early stages. However, the symptoms may not always be clear until the later stages.
There is no direct treatment for alcoholic hepatitis, but treatment can help to manage the symptoms. If liver damage is extensive, a transplant may be necessary.
It is important always to drink alcohol in moderation and to know the early signs that a person is drinking too much.
I have a family member who is struggling with alcohol dependence. What can I do to connect them with treatment?
The best way to help your family member is to connect them with treatment.
Offer options to get into a medically supervised detox treatment, a comprehensive rehabilitation program, and ongoing therapy to help them maintain sobriety.
If you do not already have information on how to approach this problem, contact the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services.
They have a National Helpline, also known as the Treatment Referral Routing Service. The number is 1-800-662-HELP (4357).
1-800-487-4889 is another confidential, free, information service, available 24/7 in English and Spanish.Debra Sullivan, PhD, MSN, RN, CNE, COI Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.