Alcoholic Hepatitis

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Alcoholic Hepatitis is a form of Alcoholic Liver Disease characterized by inflammation of liver cells or hepatocytes caused by habitual alcohol consumption, one of the many causes of Hepatitis. Alcoholic Hepatitis is treatable when diagnosed early. However, this condition is asymptomatic in its acute form. Acute Alcoholic Hepatitis is self-limiting but continued alcohol intake can eventually manifest into further complications like liver cirrhosis. Mortality rate is as high as 45% within 30 days in patients diagnosed with severe form of Alcoholic Hepatitis.

Alcoholic Hepatitis

 

Depending on the severity of Alcoholic Hepatitis patients are likely to show some or all of the following characteristics.

  • Hepatomegaly: Increased liver size resulting from steatosis, also known as Fatty Liver, characterized by accumulation of triglycerides (type of fat molecules) in hepatic cells leading to cell enlargement.
  • Jaundice: Accumulation of a yellow pigment ‘Bilirubin’ in the blood due to liver malfunction causing yellowing of the skin.
  • Hepatic Encephalopathy: Inability of liver to process and flush toxins from the blood affects brain functions
  • Elevated liver enzymes: Increase in the level Aspartate Aminotransferase and Alanine Amino transferase.
  • Delayed blood coagulation
  • Hepatic Fibrosis: Excessive collagen and other protein deposits in the liver, the body’s response to liver damage
  • Hepatic Cirrhosis: Irreversible damage to hepatic tissue and its replacement by scar tissue

The above changes also form the basis of laboratory diagnosis of alcoholic hepatitis. Clinical diagnosis is based on the patient’s drinking history and symptoms like fever, yellowing of eyes, face, skin and nails, loss of weight, dry mouth due to dehydration, change of appetite, nausea, and abdominal bloating among others. As the symptoms are not specific to Alcoholic Hepatitis, a detailed lab diagnosis is necessary to confirm the condition and help identify the severity of the same. Liver ultrasound and liver enzyme activity test complete blood profile, CT scan of the abdomen and most importantly, a liver biopsy, aids in establishing the disease.

Abstaining from alcohol is primary in preventing the aggravation of Alcoholic Hepatitis. In severe cases, liver transplantation is the only way of saving a patient’s life. The first line of treatment is to reduce inflammation through medication (Glucocorticosteroids)followed by rehydration and mineral and nutrient supplementation, such as Vitamin B1, B6, and Vitamin K. Prolonged treatment and patient counseling are important to prevent the relapse of alcoholic hepatitis.

Various factors play a role in making a person more or less susceptible to Alcoholic hepatitis. These include:

  1. People with Hepatitis C pose a higher risk of Alcoholic Hepatitis(AH)
  2. In a lot of cases, an individual’s genetic makeup plays a role in making him/her prone to AH
  3. Obese and malnourished individuals run a greater risk of AH
  4. The susceptibility to AH is more in women than men, which is attributed to the fact that alcohol processing in women is slower due to presence lower levels of Alcohol dehydrogenase enzyme in their stomach lining compared to men. Intake of 80 grams of alcohol per day in men causes AH whereas in women intake of 20-40 grams alcohol per day can lead to AH.

The bottom line however is that alcohol intake can have severe and sometimes irreversible implications on one’s health. In addition to curbing alcohol intake, supportive care and adequate nourishment can help a patient recover from Alcoholic Hepatitis.

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