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Alcoholic Hepatitis: Symptoms, Causes, Diagnosis, and Treatment

Alcoholic hepatitis can be described as an inflammatory condition of the liver that is attributed to regular and heavy drinking of alcohol. Consumption of quantity alcohol harms the liver cells as they become swollen and develop scar tissue.

The condition ranges from moderate to severe. In worst affected individuals, the liver might be damaged beyond repair and one might need a liver transplant if they did not seek treatment early enough or have not stopped taking alcohol.

This blog investigates the connection of alcohol to the liver, the signs and causes of AH, and the potential treatments available.

What is Alcoholic Hepatitis?

Alcoholic hepatitis is a type of alcoholic liver disease whereby a person’s drinking exceeds the recommended liver tolerance limit. The Alcoholic Hepatitis Consortia describes alcoholic hepatitis as a condition characterized by the sudden onset of symptoms and liver inflammation brought about by the excessive consumption of alcohol.

The liver is the second largest organ in the body and is located in the abdominal area. It is situated on the right side of the torso just below the ribcage. Its primary function is to turn the ingested foods and drinks into forms that the body can easily utilize. The liver also helps remove toxins and other substances that could be damaging to the body, such as alcohol, from the blood.

The liver is able to metabolize alcohol for detoxification and removal from the body. However, alcohol is toxic hence its ability to cause destruction of the liver cells, and the liver can only metabolize alcohol up to a certain quantity. This excess alcohol floats in the bloodstream and goes to all parts of the body. This in turn means that consuming alcohol beyond a specific limit may result in injury or severe damage to the liver.

What is the Cause of Alcoholic Hepatitis?

If the alcohol gets metabolized in the liver it forms highly toxic substances. These chemicals can cause harm to the liver cells which are involved in the detoxification process. This injury can progress to inflammation and consequently cause alcoholic hepatitis.

While it is well understood that alcoholic hepatitis is precipitated by heavy alcohol consumption, there is still some ambiguity about why some people are susceptible to this condition and why others are not. Alcoholic hepatitis occurs in a small percentage of alcohol consumers who indulge in alcohol up to the 35 percent mark, as per the American Liver Foundation. It may also manifest in individuals who moderately consume alcohol.

What are the Symptoms of Alcoholic Hepatitis?

Alcoholic hepatitis has only one typical symptom that is related to jaundice or the yellowing of the skin and the whites of the eyes. The change in the color of the skin might be less conspicuous in people with Black and brown skin tones.

Other symptoms include:

  • Loss of appetite.
  • Nausea and vomiting.
  • Belly tenderness.
  • Fever, often low grade.
  • Tiredness and weakness.

Patients with alcoholic hepatitis are also likely to be, nutrient-deficient. Intoxication also drowns the feeling of hunger in people and this is associated to excessive intake of alcohol. Moreover, the most of calories consumed by heavy drinkers come from alcohol.

Other symptoms that happen with severe alcoholic hepatitis include:

  • Swelling of the abdomen due to excessive accumulation of fluids in it is known as ascites.
  • Being confused and giddy due to the accumulation of toxins. In the healthy condition, this organ is in a position to metabolize these toxins and excrete them.
  • Kidney and liver failure.

How is Alcoholic Hepatitis Diagnosed?

An initial assessment begins with questions about the patient’s medical history which includes alcohol consumption. If they think you have an alcohol use disorder they will check for signs of alcohol damage on your internal organs. This may involve several tests, including:

  • Blood tests: A complete blood count (CBC) provides results of several conditions, while liver function tests determine whether the liver’s enzymes are up or not. This includes Blood alcohol level – phosphatidyl ethanol and Urine alcohol test – urine ethyl glucuronide are coming into practice.
  • Imaging test: Various imaging tests can be used to observe the liver for indications of inflammation and injury, including ultrasound, FibroScan® (if accessible), CT scan, or MRI.
  • Liver biopsy. In some cases, your healthcare provider may want to take some samples of your liver tissue for analysis. To get the sample, they will insert a hollow needle through your liver.

How is Alcoholic Hepatitis Treated? 

Alcohol-induced hepatitis cannot be directly treated as there is no specific medication that can cure this condition. The only cure that has been described is to stop alcohol consumption. But ideally, it should be done under medical advice and supervision. Trying to quit cold turkey may cause withdrawal symptoms and possibly fatal side effects.

Primary care physicians and other doctors can provide alcohol withdrawal treatment and also recommend other options for managing alcohol dependence or alcohol use disorder. They can also help treat some of the complications that result from alcohol use as well as hepatitis.

Goals are to bring the function of the liver to near-normal levels if possible. Some options may include:

  • Dietary changes: An example of how a doctor may intervene is to suggest a change in the person’s diet. Vitamin supplements or a focused diet plan might work at reviving the balance of nutrients within the body, should a person undergo malnourishment as a regular drinker of alcohol.
  • Medication: In treatment, physicians may use corticosteroids and pentoxifylline to decrease inflammation of the liver.
  • Liver transplant: In certain advanced stages, the only hope for the patient is indeed a liver transplant. But of course, the process is rather long, and not always easy to find a donor.

Also Read – Hepatitis C Treatment Cost in India

A doctor may also recommend other ways of altering the lifestyle that can help in enhancing liver health. This may include:

  • maintaining a healthy weight
  • getting regular exercise
  • exclusion of toxins and illegal drugs
  • practicing safe sex and using of a condom or other barrier method during sexual intercourse
  • receiving vaccinations.

Furthermore, there is never a shortage of research in discovering other forms of cures referred to as ‘alternative medicine’. For instance, there is an indication that cannabidiol could aid in the reduction of inflammation related to alcohol-induced liver damage. However, more research is still needed in this field.

Physicians will likely continue the notion that the way to be cured is to know the potential symptoms and signs of the disease and to decrease or eliminate the use of alcohol before the pathology worsens.

Take Away

Alcohol-induced hepatitis can start without any noticeable symptoms. A lot of individuals are unaware of the harm that excessive and prolonged alcohol consumption can cause to their livers. However, early detection is crucial in order to identify and reverse the effects of alcohol-induced hepatitis. If you have a history of heavy alcohol consumption and/or are experiencing symptoms of liver disease, it is important to contact your healthcare provider. They will examine your liver, evaluate any potential damage, and assist you in making lifestyle changes to improve your future health.

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