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Drinking alcohol, as pleasant as the media and advertising make it sound, can be one of the most dangerous pastime activities in the world. Excessive consumption of alcohol can lead to a variety of maladies and illnesses. Most notably, damage to the liver is one of the most serious and common side-effects of alcohol abuse, alcohol addiction, and alcoholism.

In this post, we will discuss without judgment what happens to the liver when too much alcohol is consumed, and the effects this damaging cycle can have on the body. Hepatitis is a condition that is not normally associated with drinking alcohol – but in this post, we will debunk all the myths surrounding this disease.

What is Hepatitis?

Hepatitis is when the liver tissue becomes inflamed, which can have several root causes. Viral hepatitis is the most common kind suffered by people with substance abuse disorders and can come in several common varieties known as hepatitis A, B, and D (HAV, HBV, HDV). [1]

The disease is spread through blood, so it is possible to have multiple forms of hepatitis at the same time. These types of hepatitis can form through excessive drinking and are many times fatal if it is not treated.

Below is a breakdown of the various types of hepatitis that is affecting the world today:

  • Hepatitis B – the ninth leading cause of death globally. It can be contracted by unprotected sex, contaminated needles (including tattoo and piercing needles), and mothers can infect their babies
  • Hepatitis C – spread via intravenous drug use and contact with contaminated sexual fluids
  • Hepatitis D – can only be contracted if you have Hepatitis B, though they can be contracted from the same source

What is Alcoholic Hepatitis, and What Causes It?

Simply put, alcoholic hepatitis is an inflammation of the liver which is caused by drinking too much. Those who have been diagnosed with this condition must stop drinking immediately, to curb the damage done to the liver and allow it to naturally repair itself.

Alcohol is a toxin processed through the liver, and excessive consumption can damage the tissue causing alcoholic hepatitis. It does not result in all people or every case of excessive alcohol use, and medical professionals are uncertain why this is the case.

It is caused when too much alcohol cannot be adequately filtered by the liver into the blood, as the liver can only filter small doses of alcohol (ethanol) at once. This then contributes to excess fat building up around the liver – and this can lead to liver scarring.

Here are four key points to remember about alcoholic hepatitis:

  1. Hepatitis is an inflammatory response that causes tissue damage or even death
  2. To treat the symptoms, all alcohol drinking will need to stop, and sometimes further alcohol treatment programs are necessary
  3. The damage to the liver tissue caused by alcohol hepatitis happens when you drink so much alcohol that it overloads your liver, and the organ is no longer able to process the toxin
  4. Alcoholic hepatitis happens due to accrued damage from long term drinking. However, severe alcoholic hepatitis is sudden and can take place very quickly. This is often fatal if left untreated

What are the Risk Factors for Alcoholic Hepatitis?

There is a difference in alcohol breakdown between genders and races. Females are at a higher risk of developing alcohol hepatitis. There are genetic, environmental, and biological risk factors for developing it. Below are some of the most common factors:

  • Genetic predispositions that determine how your body processes alcohol
  • Having a liver infection or disorders such as other forms of hepatitis or hemochromatosis
  • Being over the recommended weight
  • Drinking on an empty stomach

Symptoms of Alcoholic Hepatitis

The symptoms are dependent on the stage of liver damage. If you have only mild liver damage, there may be no outward signs. [2] However, once it progresses, these are some symptoms you can expect to see:

  • Lack of appetite and noticeable weight loss
  • Nausea
  • Vomiting
  • Pain in the abdomen
  • Confusion
  • Lethargy
  • Trouble concentrating
  • Dry mouth
  • Fever
  • Unusually prevalent bruising or bleeding from minor injuries
  • Jaundiced colour around eyes or on skin

Complications Associated With Alcoholic Hepatitis

Below are some of the most prominent complications associated with alcoholic hepatitis:

Enlarged veins can happen if there is a backup of red blood cells that cause the vein walls to fail, leading to internal bleeding.

If bleeding takes place in the esophagus or abdomen, then it can be fatal if not treated quickly enough.

Ascites, a fluid buildup in the stomach, is usually noticed as tenderness, pain, or swelling of the abdomen.

This fluid can become infected, causing significant health complications if not treated though it is not life-threatening. Ascites is very common among people who have alcoholic hepatitis.

Hepatic encephalopathy is manifested as slowed or slurred speech, tiredness, and lethargy. These are signs that there is a significant amount of toxins in your body, and left untreated can lead to coma or even death.

Cirrhosis, scarring of the liver, is guaranteed to happen if AH is left to run its course without treatment. Liver failure may also result from the abuse sustained alcohol abuse can wreak on the vital organ.

Diagnosing Alcoholic Hepatitis

If a medical assessment determines you may be suffering from alcoholic hepatitis, several testing measures can be utilized to make a final determination. These include:

1. Blood tests

The blood tests that can determine if alcoholic hepatitis is present include liver function studies, electrolyte tests, and looking for other tale-tell chemicals that may be present in the body. They will usually check blood cell counts and bleeding times.

2. Ultrasound of the abdomen

They will do an ultrasound check to see if there are any physical abnormalities. These include any nodules on the surface of the liver (indicative of the septa found in liver cirrhosis) the size of the lymph nodes, and how coarse the parenchyma is.

They will also test how well the flow of blood is inside the arteries and veins, the size of the spleen, and if there are any ascites found. These may sound intimidating but this test is non-invasive and is generally low cost.

3. MRI

Medical professionals will inject dye into the liver and then image it to show any signs of problem areas. This falls under the category of ‘liver imaging’ which has seen many advancements in recent years.

4. Liver biopsy

This is the most invasive type of treatment to determine alcoholic hepatitis. A sample of liver tissue is removed and then studied for signs of hepatitis. Although a minor surgical procedure that is done in your local hospital, risks for those who do have cirrhosis include uncontrollable post-surgery bleeding.

Due to liver damage, the blood cannot clot and stop from flowing. This procedure only takes minutes but patients who are suspected of having alcoholic hepatitis are asked to remain in the hospital for 4-6 hours, lying on their right side to stop any potential bleeding.

5. CT scan

These are detailed x-rays showing details of the liver to see if any areas of concern or signs of inflammation are readily visible. This option is generally to see the extent or stage of liver damage.

Can Alcoholic Hepatitis Be Reversed?

Mild liver damage that is caused by excessive alcohol consumption can sometimes be reversed depending on the stage of progression. It will continue to worsen for as long as the individual is consuming alcohol. With proper medical intervention, it may be possible to reverse some or all of the damage caused by the inflammation.

It is essential to note that some of the secondary illnesses that often go hand in hand with alcoholic hepatitis may not always be reversible. This includes diabetes, tuberculosis, pancreatitis, cancer, pneumonia, or complications due to internal bleeding.

Professional treatment for addiction is necessary for most people to be able to stop drinking so their body can heal, and the injury to their liver can be potentially undone. Research has shown that the most important primary intervention for alcoholic hepatitis management is abstinence counselling. [3]

Preventing Alcoholic Hepatitis

The most apparent prevention for alcoholic hepatitis is to abstain from imbibing alcoholic beverages. If you decide to partake in them, then do so at a moderate rate. Moderation is counted as one drink per day for anyone over the age of sixty-five and two drinks per day for anyone under the age of sixty-five.

If you have viral HCV, then you will most likely develop scar tissue around your liver unless you cease drinking alcohol entirely. You are much more likely to develop cirrhosis the longer you drink.

Always ask your doctor before mixing any kind of alcohol with medications and read any warning labels provided by the pharmacist. Never consume alcohol if this will interact with the medication you are taking. This includes everyday acetaminophens like Tylenol.

What’s the Difference Between Alcoholic Hepatitis and Cirrhosis?

While hepatitis is an inflammation of the liver tissues and can sometimes be reversible, cirrhosis is permanent scarring and cannot be removed. Cirrhosis is often caused by hepatitis, and if it worsens without treatment can lead to a full shut-down of the liver.

Cirrhosis of the liver is considered the end stage of alcohol abuse. This condition can, unfortunately, lead to many complications including liver cancer and liver failure. This is when the liver is damaged beyond repair, the functioning of the liver is lost, and it shrinks and solidifies. There is no known cure for liver cirrhosis.

Treatment Options for Alcoholic Hepatitis

The root cause of this disease is consuming toxic spirits. Removing alcohol from your diet entirely will significantly improve treatment options.

Some options to consider are as follows:

1. Abstinence

Stopping an alcohol addiction may involve attending a rehab facility, medication, and therapy. This is the only way to be sure that the symptoms will not worsen. If your alcoholic hepatitis is mild, then doing this will most likely reverse most of the damage.

2. Diet change

Nutritional support is a standard part of recovery care. Several studies have shown an association between protein-calorie malnutrition and higher short and long-term mortality rates in patients with severe alcoholic hepatitis. Eighty percent of the patients deemed malnourished suffered from fatal complications. [4] It is vital to work with your doctor to find a balanced, nutritional diet.

3. Antibiotics

Alcoholics are generally more prone to infections compared to those who do not suffer from alcoholism. This is due to malnutrition, being immuno-suppressed, and a lack of macrophage function, according to researchers.[5] Due to this increased vulnerability to infection, antibiotics are often used to help patients with alcoholic hepatitis to remain healthy enough to recover.

4. Steroids

Corticosteroids are useful in reducing the inflammation of the liver. This inflammation is what leads to scarring and other complications. They are only used in some instances as not all patients can benefit from steroid use.

I Think I May Have Alcoholic Hepatitis – What Should I Do Next?

Consult a medical professional. Write down any questions or symptoms you have noticed before the doctor’s visit. Alcoholic hepatitis often comes with substantial confusion and lack of focus, so you will also want to bring something to take notes with to your appointment and write down the diagnosis, prescriptions, and any treatment steps you agree to follow.

Make sure you note any testing procedures you need to attend along with their date, times, locations, and how to contact your doctor if you have any additional questions. It is helpful if you have someone who can accompany you to the appointment.

When Should I Call a Doctor?

Call emergency medical services immediately if you notice any of the following:

  • Your vomit or stool contains blood (bloody stool will look black and tarry)
  • You have a fever and continual shaking
  • Sudden onset of confusion
  • Unusual yellowing around the eyes or skin indicting jaundice

Looking For More Information?

Call a member of our referrals and advice team on 0800 140 4690 to discuss all things addiction and recovery today.

References:

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156777/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124878/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411952/#__sec12title

[4] https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/06/Nutrition-in-Alcoholic-Hepatitis-March-18.pdf

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124880/