Alcoholic Hepatitis

Overview

What is alcoholic hepatitis?

Alcoholic hepatitis is a disease that affects the liver. It may develop in people who drink large amounts of alcohol for several years.

The definition of heavy drinking varies by gender. In men, heavy drinking is defined by more than 14 drinks per week; in women, heavy drinking is more than 7 drinks per week. A single drink is equal to 14-15 grams of alcohol, or 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.

Drinking too much alcohol may lead to an inflamed (swollen), scarred liver. Healthy cells within the liver are destroyed by years of alcohol abuse. The liver cannot function properly and the person’s health declines.

Like all foods and liquids a person consumes, alcohol passes through the liver. The liver takes the vitamins and minerals from those items, converts them into fuel for the body, and stores them for when they are needed.

Alcohol does not have any nutrients and actually turns into a toxic (poisonous) material once the liver converts it. When the liver is healthy, the toxic substance can be out of the body. If the liver is damaged and cannot rid itself of the toxic substance, it begins to damage the liver.

If heavy drinking continues, alcoholic hepatitis may continue to damage the liver and could lead to cirrhosis, a life-threatening condition in which scar tissue replaces healthy tissue in the liver. Cirrhosis can lead to liver failure and death.

In addition, patients with alcoholic hepatitis usually suffer from malnutrition and are more at risk for infections in the body.

How common is alcoholic hepatitis?

Among people who are chronic, heavy drinkers, about 10-35 percent will develop alcoholic hepatitis.

Who is at risk for alcoholic hepatitis?

Both women and men can have alcoholic hepatitis. Most people who are diagnosed with alcoholic hepatitis are between 40 and 60 years old. Patients at highest risk for alcoholic hepatitis typically drink more than 100 grams of alcohol a day for many years. Those who have a family history of alcoholism may also be at risk for the disease.

Symptoms and Causes

What are the symptoms of alcoholic hepatitis?

If the condition is mild, the patient who suffers from alcoholic hepatitis may not have any noticeable symptoms. Other times, the patient may complain of:

If the condition is severe, the patient may also have:

  • Jaundiced, or yellow, skin
  • Bleeding, either from the esophagus (the tube leading from the throat to the stomach) or the stomach

Diagnosis and Tests

How is alcoholic hepatitis diagnosed?

To diagnose alcoholic hepatitis, the doctor will ask about the patient’s drinking habits. The doctor will also examine the patient and look for signs of the disease, such as weight loss, a bloated abdomen, or yellow skin tone. The doctor may order blood tests to check for other problems in the liver and to check the liver’s function.

The doctor may also order a biopsy of the liver (a small piece of tissue is removed to be analyzed in the lab) if the patient’s condition is severe or if the diagnosis is unclear.

Management and Treatment

How is alcoholic hepatitis treated?

When alcoholic hepatitis is diagnosed, it is important that the patient stop drinking alcohol immediately. Once this happens, the condition may begin to correct itself. The liver’s health may improve after 6 to 12 months without alcohol in the system. The best results are seen if the patient gives up alcohol completely.

Most patients who have been diagnosed with alcoholic hepatitis also suffer from malnutrition (the body is not getting the proper amount of protein, vitamins and minerals in the diet). The doctor and/or a dietitian will recommend a special diet and may also suggest that the patient take vitamin supplements while recovering from the disease.

In many cases, the patient does not have an appetite and finds it difficult to get the proper nutrition. The doctor may recommend nutrition through a feeding tube or medicine that will stimulate the patient’s appetite.

If the alcoholic hepatitis is severe and the patient is very sick in the hospital, medications may be prescribed to treat it. In some cases, a clinical trial medication or treatment may be considered.

What are the side effects of treatments for alcoholic hepatitis?

Because alcohol is a drug and is addictive, suddenly stopping drinking is difficult and may cause dangerous side effects. For instance, it can cause alcohol withdrawal symptoms, which include anxiety, confusion, hallucinations and seizures. Patients may be referred to a medically supervised program, or recommended for counseling or a support group to help them stop drinking and to help cope with side effects.

Prevention

How can alcoholic hepatitis be prevented?

Limiting the intake of alcoholic drinks will greatly reduce the risk of getting any type of alcohol-related liver disease.

Outlook / Prognosis

What is the prognosis (outlook) for patients who have alcoholic hepatitis?

If the patient who has alcoholic hepatitis gives up drinking alcohol completely, the liver may improve, and the long-term prognosis is good if there is no underlying scar in the liver. However, if the patient continues to drink excessively, the liver will continue to get worse and possibly develop cirrhosis, a serious condition that may ultimately lead to liver failure over time. Other health problems may also develop, including infections and malnutrition.

Last reviewed by a Cleveland Clinic medical professional on 06/21/2018.

References

  • American Liver Foundation. Alcohol-Related Liver Disease. Accessed 6/22/2018.
  • PubMed Health. How does the liver work? Accessed 6/22/2018.
  • Basra G, Basra S, Parupudi S. Symptoms and signs of acute alcoholic hepatitis. World J Hepatol. 2011 May 27; 3(5):118–120. doi: 10.4254/wjh.v3.i5.118
  • Lucey MR, Mathurin P, Morgan TR. Alcoholic Hepatitis. N Engl J Med 2009; 360:2758-2769 DOI: 10.1056/NEJMra0805786

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy