Alcoholic hepatitis is a serious condition that is related to drinking alcohol. You can think of it as a warning from your liver that it has had enough abuse. Alcoholic hepatitis symptoms will most commonly be associated with those who have been drinking heavily for many years. Often, alcoholic liver disease is what will cause a family to intervene on a loved one’s drinking.
Alcoholic hepatitis refers to a diseased, inflamed liver that is specifically caused by heavy drinking for a long time. If your doctor diagnoses you with alcoholic hepatitis, you have a chance to stop and live a normal life. If you don’t heed to the alcoholic hepatitis symptoms and stop drinking, you risk the development cirrhosis, a disease that up to 20% of heavy drinkers develop. This is when you end up with permanent scarring to the liver. Scarring of the liver will stay with you for life. While your liver may potentially be able to repair some damage caused by alcohol consumption, you may never be the same.
The fact is, your liver is an essential part of feeling good and maintaining a healthy body. It processes your food and drinks, turning it into nutrients and energy your body needs to run properly. The liver is also responsible for detoxing the blood from harmful substances. It is responsible for bile formation and secretion; eliminates toxins and creates products the body needs to clot blood. Your liver has an amazing ability to maintain it’s functions despite being abused but it can only handle so much. When you overtax your liver with alcohol abuse and lack of good diet, you may suffer heavy consequences that are irreversible, including liver failure.
What Causes Alcoholic Hepatitis?
Heavy alcohol consumption is the main cause of alcoholic hepatitis. The ethyl alcohol or ethanol, an ingredient found in alcohol, is the cause of intoxication to the liver. Alcohol negatively effects every organ in the body, including your central nervous system. While there are many reasons to quit drinking alcohol, liver damage and disease is one of the main reasons.
When alcohol processes in the liver, it produces toxic chemicals which injure the cells in the liver. This can cause the liver to become inflamed and alcoholic hepatitis is the result. Doctors aren’t quite certain why heavy drinking causes alcoholic hepatitis symptoms to occur. It is a small amount of heavy drinkers that develop this disease and it can sometimes develop in those who drink moderately.
Factors that have been shown to influence whether you develop alcoholic hepatitis include:
- Lack of nutrition
- Pre-disposed genetic factors that affect how your body processes alcohol
- You have liver disorders, like hepatitis C
- Drinking without eating, this triples your risks of getting alcoholic hepatitis
- Whether you’re male or female. As a woman, you are twice as likely as a man to develop alcoholic hepatitis. This is likely attributed to how your body absorbs and breaks down alcohol.
Diagnosing Alcoholic Hepatitis
Some people who drink heavily will not show alcoholic hepatitis symptoms until the disease has hit advanced stages. When a doctor is examining you based on these symptoms, which can be an indication of a few health issues, they will ask you to give them details of your drinking habits. If they suspect you have alcoholic hepatitis, they will give you blood tests which include:
- Liver studies
- Blood cell counts
- Bleeding times
- Testing your electrolytes
- Testing for other chemicals in the body
Past blood tests, an ultrasound, CT, or MRI scan of the liver can give doctors a more detailed view. If all else fails, a liver biopsy may be performed. The test includes a small tissue sample which is taken from your liver by surgery or using a needle. The sample is then looked at in order to figure out what is specifically wrong with the liver.
Alcoholic Hepatitis Symptoms and Complications
Alcoholic hepatitis symptoms are variable depending on how much damage has been done to your liver. If your case is mild, you may not even know you have it. The more damage there is, the more you’ll experience these initial symptoms:
- A loss of appetite
- Dry mouth
- Pain/swelling in the abdomen
- Jaundice or icterus which is the yellowing of skin or eyes
- Negative changes in mental state, including confusion
Complications of Alcoholic Hepatitis
Alcoholic hepatitis can cause many complications within your body as the liver has so many functions. When the liver doesn’t work properly, the symptoms can turn into scary health issues. These complications can be life threatening or at the very least, quite uncomfortable. Portal hypertension is one of the complications associated with liver damage, which can cause symptoms like:
- Fluid build up in the abdomen
- Confusion or changes in behavior caused by a poison build up in the body that would normally be broken down or removed by the liver
- Bleeding within the esophagus or stomach
- The spleen enlarges
- Liver or kidney failure
Further complications can arise such as multi-organ conditions that are non-liver conditions.
Alcohol hepatitis can lead to hepatic encephalopathy where toxins filtered out by the liver stay in your blood. These toxins can cause brain damage and possibly lead to a coma. Alcohol hepatitis symptoms are sometimes not present for a long time which can lead to complications such as liver failure or death. The symptoms will vary for each person and will change during periods of heavy drinking if the disease is severe.
Alcoholic Hepatitis Treatment
Once you’re diagnosed with alcoholic liver disease, the main alcoholic hepatitis treatment the doctor will prescribe is that you stop drinking immediately. Alcoholic hepatitis is defined as mild or severe but in either case, the ability to reverse damage can only occur by giving up alcohol. Even if the damage to your liver is severe and can’t be reversed, you can prevent further progress of the disease. You may still stand a chance in eliminating some of the alcoholic hepatitis symptoms so you can live comfortably.
There is no medication that will cure for the effects of liver damage so the goal of the alcoholic hepatitis treatment will be to reduce or eliminate symptoms as well as stop the progress of the disease. If your condition is severe, you may be given prescription medication to help ease symptoms of alcoholic hepatitis. This includes corticosteroids and pentoxifylline which will help reduce the inflammation in your liver and improve the function of the liver.
When the condition of your liver is beyond repair, sometimes the only hope for survival in severe alcoholic hepatitis is a liver transplant. There is often a long list and a donor process for a liver transplant so you could be waiting for a long time. Regardless of how severe your alcoholic hepatitis is, quitting drinking is the one step you can take to prevent more damage to your liver. To increase your chances of getting a liver transplant when there are no other options includes being qualified.
With such long waiting lists, there are requirements you must meet. This includes proving that you won’t abuse your new liver as you had previously done. If you’ve destroyed your liver through years of alcohol abuse, you need to demonstrate that you won’t continue to drink. This includes abstinence from alcohol for a minimum of six months. You may also need to prove that you sought out counseling. This may include such things as finding a good rehab center where you can get individual or group therapy.
Understandably, it might be easier said than done to stop drinking. The challenge to stop drinking immediately may seem like something you can’t possibly manage on your own. Sometimes, people don’t think they have a problem with alcohol until the day comes that they must stop. Treatment clinics for alcohol addiction are widely available and they’re designed to help you stop drinking for good. Heavy drinking for many years is traditionally what causes alcoholic hepatitis so you may need an inpatient or outpatient program to help you get through detox and rehabilitation.
Another way of helping the liver is to offer your body nourishment. A healthy lifestyle that includes natural foods without too much fat will greatly help the liver and all other organs. Drinking a lot of alcohol has poisoned your body so that’s one of the problems. Furthermore, your body is likely malnourished from days that you didn’t eat at all.
Many times, heavy drinkers with alcoholic hepatitis are malnourished because when you drink a lot, the alcohol suppresses your appetite. You end up getting the majority of your calories from alcohol so your body doesn’t demand sustenance. Not only are you poisoning your liver with excessive alcohol consumption but malnutrition from not eating can also contribute to alcoholic liver disease.
When your body is in serious need of nourishment, your doctor will administer nutrients into you immediately. Either they prescribe vitamins and nutrient supplements or they feed it to you through a feeding tube in liquid form. Scarring of the liver is permanent but through a healthy diet, better lifestyle and sober living, you can repair some of the damage caused by alcohol and live a normal life.
Alcoholic Fatty Liver Disease vs Alcoholic Hepatitis vs Cirrhosis
There are three stages that define liver damage from alcohol. The first stage is alcoholic fatty liver disease. The second is alcoholic hepatitis and the third stage is cirrhosis. This will give you a glimpse of the process your body goes through before the liver stops functioning properly.
Alcoholic fatty liver disease
The first stage is known as alcoholic fatty liver disease which occurs from deposition of fat in your liver cells. It is an alcohol-related liver disease and the symptoms are so slight, they will often go unnoticed or can be mistaken for something else. You may experience fatigue, weakness or discomfort in your upper right abdomen. If you get tested for liver function, the results will often show up as normal. A large majority of heavy drinkers have fatty liver disease but it’s possible to reverse the damage by abstaining from alcohol use.
The second stage of alcoholic liver damage is diagnosed as alcoholic hepatitis. It is characterized by inflammation, mild scarring, and fat deposition in liver cells. Alcoholic hepatitis symptoms become more intense such as nausea, vomiting, abdominal pain, fever, and jaundice. When tested, liver enzymes are elevated and liver function will show to be abnormal. Up to 35% of heavy drinkers will develop this disease. Of those, 55% will already have cirrhosis. The difference of alcoholic hepatitis vs cirrhosis is the amount of damage done to the liver. You still have the chance to live a normal life when you stop drinking after being diagnosed with alcoholic hepatitis symptoms.
Alcoholic cirrhosis is the most advanced type of liver injury that is related to alcohol. It’s characterized by severe scarring that causes many severe symptoms. At the stage of cirrhosis, your liver will be disrupted and the structure of the liver will be abnormal. This includes the loss of soft healthy tissue which is replaced by hard tissue. Cirrhosis vs. severe alcoholic hepatitis symptoms can be similar but cirrhosis can’t be reversed by abstinence of alcohol. Abstinence can still improve the symptoms and signs of liver disease and prevent any further damage to the liver.
Cirrhosis is a pattern of damage to the liver that results in long-term injury from chronic hepatitis and chronic bile duct obstruction. As cells are damaged in the liver, they are replaced with fibrous tissues that cause scarring. The scarring causes liver cells to regenerate in an abnormal way, leaving clumps or nodules. The scar tissue and nodules alter your blood flow through the liver which can cause major complications. You can’t reverse the pattern of damage but by stopping alcohol use, you can stop further damage.
Early signs of cirrhosis are much like that of alcoholic hepatitis but also include more serious symptoms such as:
- Spider angiomas which will be seen on the skin as pin head sized red spots on the upper body and arms,
- Fluid accumulation in the abdomen and legs
- Loss of muscle bulk
- Loss of body hair
- Varicose vein formation in the esophagus and stomach. This can lead to ruptures which can cause significant blood loss and possibly cause death.
- Portal hypertension which can cause spleen enlargement. When this happens, it can trap white blood cells and platelets (these cells aid in clotting). If you experience bruising easily, this may be the cause.
- Possible mental impairments which can cause you to forget things or struggle to concentrate. Associated with this is the possibility of going into a coma, or potentially a sudden death.
At the time you experience alcoholic hepatitis symptoms, your body is essentially giving you warning signs of a more serious condition. If you couldn’t stop drinking before, it’s time to seek out inpatient or outpatient treatment to stop further damage.
How Much Alcohol Abuse Causes Alcoholic Hepatitis?
Currently, the exact amount of alcohol needed to cause alcoholic hepatitis is not known. The Mayo Clinic reported that the average person with alcoholic hepatitis would drink 3.4 ounces daily. This is equal to seven glasses of wine, seven beers, or seven shots of spirits for a minimum of 20 years. For those that drink heavily for a long time, alcoholic hepatitis and cirrhosis is much more likely when compared to people living healthy lifestyles.
It’s important to note that the time varies from individual to individual and females are more susceptible to developing symptoms compared to men when they consume the same amount of alcohol. Just because symptoms don’t become apparent for many years, heavy drinkers will eventually develop fatty liver. It has been proven that 100% of heavy drinkers will end up with the first stage of alcoholic liver disease. If you choose to seek out treatment and create a healthier lifestyle at this stage, symptoms are reversible.
It’s not just heavy alcoholics who are at risk. In fact, not all heavy drinkers will develop alcoholic hepatitis. Regular or social drinkers can be at risk of developing some form of alcoholic liver damage that could lead to serious conditions.
As your liver breaks down toxins like alcohol and the amount of alcohol is too high, the liver is overworked which causes cells to become damaged. If you continue to drink excessively once you develop fatty liver, there’s a 30% chance that you’ll develop alcoholic hepatitis.
Health authorities recommend not exceeding 3-4 units of alcohol per day, which should help reduce the risk of alcohol-related liver damage. You may not realize that this rate of heavy drinking per day is one of the major signs of alcohol addiction.
If you’ve been heavily drinking for a long time and you’re diagnosed with a form of alcoholic liver disease, you’ll need to stop drinking right away in order to live a healthy life. If you can’t manage stopping on your own after years of drinking daily, alcohol detox is a good first step. From there, ongoing support and further rehabilitation will likely be necessary. You do have the chance to have a normal life if you commit to a healthier lifestyle.