What is alcoholic hepatitis?

Alcoholic hepatitis is an inflammation of the liver caused by excessive alcohol consumption. According to the American Liver Foundation, alcoholic hepatitis occurs in up to 35 percent of heavy drinkers. 

The condition varies in severity. Milder cases may develop slowly, and are often reversible if they are caught in time. Severe cases may develop quickly, and lead to life-threatening complications.

Although this illness mainly affects heavy drinkers, there are cases of moderate drinkers developing alcoholic hepatitis as well. If you drink regularly, it’s important to be aware of this condition, and how it can be treated or prevented.

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When you drink alcohol, your liver is responsible for breaking it down and removing it from your system. If you drink more than your liver can effectively process, it can place that organ under a lot of stress. If you do this chronically, it can eventually damage your liver’s tissue.

Within the spectrum of alcohol-related liver disease, alcoholic hepatitis is more serious than fatty liver but not as severe as cirrhosis. However, it can still be life-threatening. Although alcoholic hepatitis generally develops slowly over time, in its acute form it can develop suddenly. This can rapidly lead to liver failure and even death.

Unlike viral forms of hepatitis (such as hepatitis B or hepatitis C), alcoholic hepatitis is not contagious. It is caused by alcohol use, not by a transmittable infection.

Alcoholic hepatitis is usually the result of excessive drinking over an extended period of time.

How much is too much? The minimum threshold for high risk is approximately 40 grams of alcohol per day for a woman, and 50-60 grams per day for men. This is about 3-4 standard drinks per day. According to The World Journal of Hepatology, people with alcoholic hepatitis have often drank at least 80 grams per day (more than 5 standard drinks) for over 5 years.

That said, things vary quite a bit from person to person. Periods of heavy alcohol use before the onset of alcoholic hepatitis can range from 3 months to 36 years. Even moderate drinkers occasionally develop alcoholic hepatitis, as do inconsistent binge drinkers.

Other factors include gender, ethnic background, overall physical health, and even when you drink. If you tend to consume alcohol with food, you may have lower risk of alcoholic hepatitis. Obesity, on the other hand, can increase your risk. Women and African Americans seem to have a higher risk as well.

As far as age is concerned, alcoholic hepatitis is most common in people 40-60 years old. However, it has occurred in patients from 20-80 years of age.

Jaundice is among the most common signs of liver disease, including alcoholic hepatitis. If you notice that your skin or the whites of your eyes are becoming yellow, have a doctor check the health of your liver.

Symptoms of alcoholic hepatitis may not appear right away, especially in milder cases. Keep an eye out for the development of any of these issues over time:

  • Nausea and vomiting
  • Abdominal tenderness
  • Low grade fever (may also be a sign of infection)
  • Weakness and fatigue
  • Loss of appetite
  • Weight loss
  • Dark urine
  • Dry mouth
  • Easy bruising or bleeding

If any combination of these occur, and you are drinking heavily and regularly, it is important to have yourself checked. Alcoholic hepatitis is a progressive disease, and can get worse the longer it goes untreated.

In addition to the possibility of liver failure, patients with alcoholic hepatitis may suffer from kidney disease, ascites (a buildup of fluid in the abdomen), high blood pressure, spider angiomas, hepatomegaly (enlarged liver), and even brain damage from toxins not removed by the liver.

In many cases the answer is yes, especially if you catch it in the early stages. In later stages of alcoholic hepatitis some or all of the damage to your liver may be permanent, and you may need a liver transplant. To prevent this worst-case scenario, your doctor may prescribe medications and dietary changes to help your liver repair itself.

In most cases, you will also need to quit drinking alcohol completely. Because drinking both causes and aggravates alcoholic hepatitis, removing it is crucial to reversing this disease. No matter what stage you’re at, quitting alcohol is shown to improve recovery rates.

If you’re struggling to stop drinking, there may be more options available than you might expect. Medications have made it easier to cut back, and there is broader access to support than ever before.

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The length of time it takes to recover depends on how severe the case of alcoholic hepatitis is, and how early treatment begins. Within two years many patients show significant improvement, and appear to have normal liver function. Recovery can be faster for those with milder cases.

However, these improvements are dependent on patients continuing to abstain from alcohol, and some complications can remain for the long-term. If you’ve recovered from alcoholic hepatitis, you should continue to have yourself checked regularly for liver cancer. And if you’ve developed any cirrhosis of the liver from hepatitis, that damage will be permanent.

Although all forms of hepatitis involve inflammation of the liver, hepatitis B and C are specifically caused by viruses, and not by drinking alcohol. The main risk factors for developing either hepatitis B or C involve exposure to blood, semen, or other infected body fluids. Alcoholic hepatitis has many of the same long-term consequences, but it is not the same illness, and it is not contagious.

That said, there is some evidence that heavy drinking makes you more susceptible to contracting hepatitis C if you are exposed to the virus.

Since both hepatitis B and C damage and weaken the liver, consistently drinking alcohol while infected with either virus can increase the risk of serious liver damage. Alcohol can also reduce the effectiveness of hepatitis C treatment, and worsen the side effects.

Alcohol is believed to weaken the body’s ability to fight off the hepatitis C virus. The relationship between alcohol and hepatitis B is less well understood, but appears to be similar. With hepatitis B, moderate drinking may be less risky. In both cases, however, heavy drinking should be avoided at all costs.

If you have hepatitis B or C, check with your doctor about what amount of alcohol, if any, is safe. But your best bet is to avoid drinking altogether.

Cirrhosis is a permanent scarring of the liver. It is not the same condition as hepatitis, but it often develops as a result of it.

While hepatitis is sometimes reversible, cirrhosis is not. And the more scar tissue you have in your liver, the harder it becomes for this vital organ to function. This can have many serious consequences for your overall health, and can eventually cause liver failure, which can be fatal. While milder cases of cirrhosis can be managed, the only treatment for advanced cirrhosis is a liver transplant.

Unfortunately, cirrhosis is on the rise, making it more important than ever to raise awareness of this condition. And since alcoholic hepatitis can lead to cirrhosis, this is another reason to be cautious about how much you drink, and how it is affecting your body. It can be difficult to quit drinking. But taking steps to get your alcohol consumption under control is one of the most important things you can do for the health of your liver, and your whole self.

Ria Health offers treatment for alcohol use disorder via telemedicine

We combine prescription medication, recovery coaching, and digital tracking tools to create custom plans for each member’s needs. The program is covered by many insurance plans, and can be done 100 percent from your smartphone or personal device.

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