Heavy alcohol use can lead to a condition called alcoholic hepatitis. Hepatitis is inflammation of the liver, and regular use of alcohol can lead to the development of alcohol-induced hepatitis, also called alcoholic hepatitis.
This inflammation disrupts the liver’s normal functions and can lead to several distressing and potentially deadly symptoms. One study shows that people who had been hospitalized for alcoholic hepatitis only had a 31.8% chance of living for five or more years.
While the medical community does not fully understand how someone gets hepatitis from drinking, this alcohol-related disease has existed for several centuries. While alcoholic hepatitis may be reversible, it can also lead to permanent scarring of the liver, causing a lasting condition called alcoholic cirrhosis.
Symptoms of Alcoholic Hepatitis
The inflammation that is caused by alcoholic hepatitis can lead to several symptoms, many of which can be dangerous. Some cases of acute alcoholic hepatitis may not cause symptoms, and people who are developing alcoholic hepatitis may not know that they have it until it becomes more advanced.
Alcoholic hepatitis symptoms occur because inflammation has impaired the liver’s normal functioning. These symptoms may include:
- Confusion, due to the build-up of a toxin called ammonia
- Swelling in the abdomen caused when the liver does not make enough of a protein called albumin
- Bleeding that may be severe because the liver does not make enough of the proteins needed for blood clotting
- Bleeding in the throat caused by weakened blood vessels that occur with hepatitis
- Yellowing of the skin and whites of the eyes also called jaundice, that occurs when the liver cannot break down a substance called bilirubin
Many of these symptoms have the potential to become deadly under the wrong conditions and contribute to the high fatality rate of this disease. If someone experiences any of these symptoms they should seek immediate medical care by dialing 911 or going to the nearest hospital.
The jaundice alcoholic hepatitis causes is not dangerous in the way that many of the other symptoms are, as all it does is turn the skin yellow. Jaundice, however, is one of the earlier signs that the other symptoms may develop, and people who experience jaundice should still seek immediate medical care.
Causes of Alcoholic Hepatitis
Scientists are not entirely certain what it is about alcohol that causes alcoholic hepatitis. Several factors are being considered as research on this hepatitis continues.
- Alcohol is known to be toxic to liver cells and the membranes of cells. The liver must also work much harder to process large amounts of alcohol, and this could cause the liver cells to become worn out.
- People who frequently use alcohol are more likely to be malnourished, and this lack of nutrition may negatively affect the liver.
- The byproducts of alcohol use that the body creates may also cause liver inflammation.
Alcoholic Hepatitis Risk Factors
The key risk factor for alcoholic hepatitis is chronic, heavy alcohol use. Without alcohol use, there is essentially no risk at all for developing alcoholic hepatitis. Even when alcohol use is stopped, the inflammation from alcoholic hepatitis may eventually go away completely.
While alcohol use is the key risk factor for developing alcoholic hepatitis, several other risk factors may, when combined with alcohol misuse, make the risk of developing alcoholic hepatitis greater. These risk factors include:
- Poor nutrition
- Immune system disorders or diseases
- Viral illnesses, especially hepatitis B or hepatitis C
- Use of Tylenol, especially over a prolonged period of time
- Age over 55
- Female gender
Additionally, there may be some additional risk for developing alcoholic hepatitis based on genetics. There is still some debate about this risk factor, and the role that it plays seems, at this point, to be more minor if it is a risk factor.
Preventing Alcoholic Hepatitis
Preventing alcoholic hepatitis depends primarily upon one factor: stopping the consumption of alcohol. Alcohol is what causes the inflammation of the liver, and as long as there is regular alcohol use, the inflammation of the liver will likely continue to worsen.
One of the more common questions physicians receive about alcoholic hepatitis is, “Is alcoholic hepatitis reversible?” The good news is that, over time, the inflammation of the liver can subside once alcohol use is stopped.
Unfortunately, the inflammation can sometimes lead to scarring, also called alcoholic cirrhosis. This scarring cannot be reversed and will have more permanent, long-term effects. More severe cases of alcoholic hepatitis also may not be reversible, even if alcoholic cirrhosis has not developed. The key to reversing alcoholic hepatitis is to stop drinking as soon as possible before the scarring of the liver occurs.
Alcoholic Hepatitis Treatment
Ceasing Alcohol Use
Alcoholic hepatitis treatment involves stopping the use of alcohol that causes the inflammation and supporting the liver as it heals. Alcohol cessation is the key part of the initial treatment because as long as alcohol is used, there will be more inflammation.
Medications may be used to stop or reduce inflammation. The main medication used to treat alcoholic hepatitis is steroids. These medications reduce inflammation and suppress the body’s immune system. Steroids may help to reduce alcoholic hepatitis recovery time.
While malnutrition plays a smaller role in alcoholic hepatitis, following a healthy and nutritious diet while maintaining a healthy weight has been shown sometimes to improve the symptoms of alcoholic hepatitis.
In severe cases where the liver inflammation has caused permanent and potentially deadly damage, a liver transplant may be needed. Transplants are rarely done and typically require a significant period without alcohol to ensure that the new liver will not experience the same damage that was initially caused.
Key Points: Alcoholic Hepatitis
Alcoholic hepatitis can be dangerous and even deadly. Some of the key points to remember about alcoholic hepatitis are:
- Alcoholic hepatitis is an inflammation of the liver caused by alcohol use
- Alcoholic hepatitis can lead to bleeding, confusion, jaundice, and swelling
- While there are factors that will increase your risk of alcoholic hepatitis, alcohol use is the main risk factor
- The only way to treat alcoholic hepatitis is to stop alcohol use
Alcoholic hepatitis is often deadly, and the only way to treat it is to stop using alcohol.
If you or a loved one struggle with alcohol addiction or use alcohol even though you may be at risk for alcoholic hepatitis, consider getting professional help. The Recovery Village has a proven track record of helping people with addiction begin recovery. Contact us to speak with an understanding team member about the struggles of addiction and about how we can help you to achieve recovery.
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Heuman, Douglas. “Alcoholic Hepatitis.” Medscape, 2017. Accessed April 23, 2019.
Potts, J. R. et al. “Determinants of Long-Term Outcome in Severe Alcoholic Hepatitis.” Alimentary Pharmacology and Therapeutics, 2013. Accessed April 23, 2019.
National Organization for Rare Disorders. “Hepatic Encephalopathy.” 2011. Accessed April 23, 2019.
Herrine, Steven K. “Ascites.” Merck Manual, 2018. Accessed April 23, 2019.
Blonski, W., Siropaides, T., & Reddy, K. R. “Coagulopathy in Liver Disease.” Current Treatment Options in Gastroenterology, 2007. Accessed April 23, 2019.
Mallet, Maxime; Rudler, Marika; & Thabut, Dominique. “Variceal Bleeding in Cirrhotic Patients.” Gastroenterology Report, 2017. Accessed April 23, 2019.
Herrine, Steven K. “Jaundice.” Merck Manual, 2018. Accessed April 23, 2019.
Orfanidis, Nicholas T. “Alcoholic Liver Disease.” Merck Manual, 2017. Accessed April 23, 2019.