Alcoholic Hepatitis

Alcoholic hepatitis is inflammation of the liver caused by years of heavy drinking. The disease can occur in people who drink heavily for less than a year. Most of the time, alcoholic hepatitis is reversible. However, it can be life-threatening if left untreated.
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The word hepatitis refers to inflammation of the liver. Hepatitis can be caused by viruses, such as hepatitis A, hepatitis B or hepatitis C, or by substance abuse. Alcoholic hepatitis describes liver inflammation caused by alcohol.

Unlike hepatitis that’s caused by a virus, alcoholic hepatitis is not contagious.

Liver disease is one of the most common diseases caused by heavy alcohol use. Alcoholic hepatitis is one of three categories of liver damage caused by alcohol. The other categories include a mild condition called fatty liver and a serious condition called alcoholic cirrhosis.

Prognosis for Alcoholic Hepatitis

The prognosis for alcoholic hepatitis is more serious than the prognosis for fatty liver but not quite as concerning as that of cirrhosis, which is usually life-threatening.

Although the likelihood of recovery and survival from alcoholic hepatitis is usually optimistic, it is a serious condition that can be fatal if it isn’t diagnosed and treated. Drinking alcohol can drastically increase the risk of liver failure and death.

A 2008 study published in the Archives of Internal Medicine found that 6.6 percent of patients admitted to the hospital for acute alcoholic hepatitis died of the disease from 1988 to 2004. The mortality rate for chronic alcoholic hepatitis with cirrhosis was 13.6 percent.

Another study found that 6.8 percent of patients admitted to a U.S. hospital with acute alcoholic hepatitis in 2007 died during hospitalization. That research was published in the Journal of Clinical Gastroenterology in 2011.

Acute vs. Chronic Alcoholic Hepatitis

Hepatitis caused by alcohol consumption is usually an acute or short-term condition. Lifestyle changes, such as reduced alcohol consumption, may be the only treatment for acute cases of alcoholic hepatitis. Medications may be prescribed for severe cases.

When people return to heavy drinking after recovering from acute alcoholic hepatitis, they increase their risk of developing chronic alcoholic hepatitis. Chronic alcoholic hepatitis is reoccurring liver inflammation that can lead to cirrhosis, or scarring, of the liver.

What Causes Alcoholic Hepatitis?

Heavy drinking for prolonged periods of time is the main cause of alcoholic hepatitis, but some heavy drinkers never develop the condition.

People who develop alcoholic hepatitis have usually been drinking heavily for years. Some studies on alcoholic hepatitis have defined heavy drinking as consuming 80 grams of alcohol per day, and others have defined it as 100 grams of alcohol per day.

A standard drink contains about 14 grams of alcohol, so the risk of alcoholic hepatitis may increase after drinking between five and seven standard drinks per day for multiple years. One standard drink is about 12 ounces of regular beer, five ounces of wine or 1.5 ounces of liquor, according to the National Institute on Alcohol Abuse and Alcoholism.

In addition to heavy drinking, risk factors for alcoholic hepatitis include:

Biological sex
Women are more likely to develop alcoholic hepatitis than men.
Weight
People who are obese are more likely to have liver problems associated with alcohol.
Genetics
Some people are biologically more vulnerable than others.
Ethnicity
African-Americans and Hispanics may have a higher risk of developing the condition.
Binge drinking
Consuming a lot of alcohol in a short period of time increases the risk of liver inflammation.

A 2011 article in the World Journal of Hepatology described the typical alcoholic hepatitis patient as someone between the ages of 40 and 60 who drank alcohol heavily for more than five years. However, people as young as 20 and as old as 80 have been diagnosed with the condition.

Symptoms & Side Effects of Alcoholic Hepatitis

Symptoms of alcoholic hepatitis may be mild or severe. Jaundice, a condition that causes a yellow coloring of the skin or eyes, is one of the most common symptoms of alcoholic hepatitis.

Other common symptoms of alcoholic hepatitis include:

  • Fever
  • Stomach pain
  • Nausea
  • Vomiting
  • Appetite loss
  • Dark urine

Liver problems are associated with several side effects and complications. In addition to the symptoms caused by alcoholic hepatitis, major health problems are associated with the condition.

Health problems related to alcoholic hepatitis include:

High blood pressure
This condition is also known as hypertension.
Hepatomegaly
This is the medical term for enlarged liver.
Ascites
This condition involves the accumulation of protein-containing fluids in the abdomen.
Spider angiomas
Swollen blood vessels near the skin can cause red spots on the skin.
Hepatic encephalopathy
Brain damage can occur when the liver fails to remove toxins from the blood.
Cirrhosis
Scarring of the liver can lead to liver failure.
Kidney failure
Damage to the liver can disrupt blood flow to the kidneys.

When complications related to alcoholic hepatitis aren’t treated, they can be life-threatening. If the complications are detected early, most are reversible. However, a person may require a major procedure or lifelong treatment for complications such as encephalopathy, cirrhosis or kidney failure.

Is Alcoholic Hepatitis Reversible?

Alcoholic hepatitis is sometimes reversible. If the condition isn’t severe, individuals can recover from liver damage caused by alcohol abuse. It is clear that the condition will continue to worsen if a person continues to drink. Drinking alcohol also increases the risk of developing cirrhosis, a liver condition that can be deadly.

Medical conditions that commonly occur alongside alcoholic hepatitis, such as infections, pneumonia, tuberculosis, internal bleeding, diabetes, pancreatitis and cancer, may be irreversible.

Alcohol addiction is a common contributor to alcoholic hepatitis. Alcoholics, the common term for people with alcoholism, usually have to receive treatment for alcoholism to increase the likelihood of successfully reversing alcoholic hepatitis.

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Treatment for Alcoholic Hepatitis

Alcohol rehab is often required to help people who are addicted to alcohol stay sober. They have to quit drinking alcohol to recover from alcoholic hepatitis.

In addition to abstinence, treatments for alcoholic hepatitis include:

  • Corticosteroid medications to reduce inflammation
  • Pentoxifylline (Trental) to improve kidney function
  • Nutritional support to reverse health problems caused by malnutrition

In severe cases, feeding tubes may be necessary to ensure a person receives proper nutrition because many patients with alcoholic hepatitis have low appetite.

Other treatments that address complications associated with alcoholic hepatitis:

  • Ascites can be treated by reducing salt consumption in the diet and taking diuretic medications.
  • Hepatic encephalopathy may be treated with a medication called lactulose and antibiotics that remove toxins from the gut.
  • Kidney failure caused by a condition called hepatorenal syndrome may be treated with a medication called Albumin and drugs that constrict blood vessels, such as terlipressin, midodrine and octreotide, or norepinephrine.

In severe cases, a liver transplant may be necessary. However, many liver transplant centers require six months of abstinence from alcohol before a patient becomes eligible for a transplant.

Alcoholic hepatitis is a serious condition caused by years of heavy drinking. Alcoholic hepatitis is often reversible if a person quits drinking alcohol. Many people need help overcoming alcoholism before they’re able to recover from alcoholic hepatitis.

Author
Chris Elkins, MA
Senior Content Writer, DrugRehab.com
Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication.
@ChrisTheCritic9
Editor
Joey Rosenberg
Joey Rosenberg,
Editor, DrugRehab.com
Medical Reviewer
Ashraf Ali
Psychiatrist, Los Angeles County Department of Mental Health

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