Alcoholic hepatitis is the inflammation of the liver that leads to liver cell damage and liver cell death. Alcoholic hepatitis occurs from drinking alcohol. This takes place after years of heavy drinking.
However, not every person who drinks heavily ends up with alcoholic hepatitis. A person diagnosed with alcoholic hepatitis should stop drinking alcohol to decrease any further deterioration of the liver. There is a very high risk of serious liver damage and death for people that continue to drink.
Signs And Symptoms Of Alcoholic Hepatitis
Alcoholic hepatitis symptoms may look like symptoms caused by other health problems. If a person starts showing any signs or symptoms they should contact a medical professional for proper diagnosis.
The symptoms of alcoholic hepatitis include:
- jaundice—yellowing of the skin and/or eyes
- abdominal pain or swelling
- fluid accumulation in the abdomen (ascites)
- vomiting blood—may look similar to coffee grounds
- weight loss
- change in appetite
- changes in mental state
- easy bruising or bleeding
- kidney or liver failure
The standard for diagnosing alcoholic hepatitis is a liver biopsy. However, because the procedure is expensive, invasive, and not easily accessible, there is a lack of agreement within the medical community regarding the liver biopsy.
Medical professionals may order liver function tests and blood tests to see how well the liver is functioning.
Long-Term Effects Of Alcoholic Hepatitis
Being diagnosed with alcoholic hepatitis means a person should stop drinking immediately. Liver function will continue to deteriorate if alcohol consumption continues.
When the liver has to continually break down alcohol over a long period of time, it becomes inflamed. Long-term liver inflammation leads to scarring on the liver.
Scar tissue negatively impacts liver function and interrupts proper blood flow. Other organ systems are affected by this and developing cirrhosis becomes probable.
Many individuals with alcoholic hepatitis are at a higher risk for jaundice, kidney failure, liver cancer, and gallstones. Alcoholic hepatitis is a very serious disease with significant short-term mortality.
Those with severe alcoholic hepatitis may need a liver transplant. However, transplant centers usually require at least six months of abstinence from alcohol and many of those diagnosed with severe alcoholic hepatitis won’t be eligible for urgent liver transplants due to this requirement.
Who Is At Risk For Alcoholic Hepatitis?
The biggest risk factor for alcoholic hepatitis is the amount of alcohol a person consumes. A person who is considered a heavy drinker would certainly be at risk for alcoholic liver disease.
Heavy drinking is considered more than seven drinks per week for women, or more than 14 drinks per week for men.
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One study of people diagnosed with alcoholic hepatitis had a history of drinking more than seven drinks per day for 20 years. However, individuals who have drank significantly less for a shorter amount of time have been diagnosed with alcoholic hepatitis.
Other risk factors for alcoholic hepatitis are:
- ethnicity — the mortality rate is higher among Hispanics, Native American, and native Alaskans origin
- genetics — genetic components were found to be related to alcohol-induced liver disease in some studies. It is challenging to separate what is genetic and what is environmental
- binge drinking — having more than four to five drinks in two hours
- sex — males are at high risk since they generally consume more alcohol than women. Yet many women who are heavy drinkers are at risk as they are more susceptible to alcohol hepatotoxicity.
- obesity — overweight heavy drinkers are more likely to develop alcoholic hepatitis and progress from alcoholic hepatitis to liver cirrhosis
Stages Of Alcoholic Liver Disease
Alcohol-related liver disease, also called alcoholic liver disease (ALD), is liver damage from the overconsumption of alcohol. The liver becomes inflamed, built up with fats, and scarring occurs.
There are different stages of alcoholic liver disease, but the three main stages are:
- alcoholic fatty liver disease
- alcoholic hepatitis
Alcoholic Fatty Liver Disease
The beginning stage of alcoholic liver disease is called alcoholic fatty liver disease. An inflamed, enlarged liver that had build-ups of fatty tissue indicates fatty liver disease.
This can occur after heavy drinking over a few days, and is typically reversible when a person stops drinking alcohol.
Alcoholic fatty liver disease usually does not have symptoms, but it is an indication that a person is drinking too much alcohol.
Long-term alcohol abuse can lead to the development of alcoholic hepatitis, the second stage of alcoholic liver disease.
For some people, this is the stage they commonly discover that they have liver disease.
There is potential to reverse symptoms as long as the person stops drinking and adheres to the doctor’s instructions. However, severe alcoholic hepatitis can be life-threatening.
Cirrhosis is the final stage of alcoholic liver disease and is life-threatening. The liver is incredibly scarred at this stage and struggles to function.
A liver transplant may be needed at the point that alcoholic liver disease progresses to cirrhosis. If the person continues to drink alcohol, a transplant will not be approved.
When a person continues to drink once they reach the final stages of alcoholic liver disease, they have less than a 50 percent chance of living more than five years.
Additionally, those with liver cirrhosis are at high risk for hepatic encephalopathy. Also called portosystemic encephalopathy, hepatic encephalopathy causes impaired brain function.
Hepatic encephalopathy is a result of the liver not being able to filter out toxins, and they accumulate in the brain, leading to physical and mental side effects.
Is There Treatment For Alcoholic Liver Disease?
People that develop any stage of alcoholic liver disease need to focus on removing alcohol from their life. Early stages of ALD can be reversed if a person stops drinking.
Cognitive behavioral therapy can also help a person with alcohol dependence. Inpatient rehabilitation facilities may also help a person with severe alcohol dependency.
Individuals diagnosed with acute alcoholic hepatitis may be given corticosteroids or pentoxifylline to reduce the inflammation of the liver while receiving treatment in a hospital.
In the advanced stages of alcoholic liver disease, a person may develop liver failure. If this happens, a liver transplant is the only option for survival. People must demonstrate sobriety by going at least six months of abstaining from alcohol to be considered for a liver transplantation.
The best way for a person to reduce the risks of alcoholic liver disease is to monitor their alcohol intake and get help for alcohol abuse. People with any stage of alcoholic liver disease need to stop drinking completely to increase their chance of slowing or possibly reversing the disease.
Treatment Options For Alcoholism
Severe alcoholism is a disease, and often needs the assistance of addiction treatment specialists. Seeking treatment for an alcohol use disorder while attempting to manage medical issues can be overwhelming.
Treating addiction and alcoholic liver disease at the same time is an option that will help your recovery to be as successful as possible. Please reach out to our qualified and helpful staff so we can help explore substance abuse treatment options with you.
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- American Association for the Study of Liver Diseases—Prediction of histologic alcoholic hepatitis based on clinical presentation limits the need for liver biopsy
- American Liver Foundation—Hepatic Encephalopathy Information Center
- American Liver Foundation—Cirrhosis of the Liver
- American Liver Foundation—Alcohol-Related Liver Disease
- World Journal of Gastroenterology—Is liver biopsy necessary in the management of alcoholic hepatitis?