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Alcoholic Hepatitis: Symptoms, Causes, and Treatment


Author: Thomas Roth

Last Updated: 1/09/2023

Alcoholic Hepatitis, also known as Hepatitis C, is inflammation of the liver caused by drinking alcohol. There are several symptoms which indicate that the liver is inflamed to the point of Hepatitis C, but most times, the cause is down to extreme alcohol drinking likely due to alcohol dependence.

As with most diseases, there is no perfect science regarding why inflammation of the liver occurs in some heavy drinkers and not others, but doctors and scientists do concur that the major cause is the overconsumption of alcohol over an extended period: generally months and years. When alcohol begins to damage the liver, that is when alcoholic hepatitis can become a legitimate threat to the body.

What is Alcoholic Hepatitis?

Alcoholic hepatitis is severe inflammation of the liver caused by excessive drinking. When a person consumes alcohol, it is processed in the liver. In turn, the liver releases chemicals into the bloodstream as the alcohol is processed. It is this process that causes feelings of euphoria and drunkenness which can come from drinking alcohol.

While in small doses, generally one drink an hour, an adult with no health complications has a liver that is capable of processing alcohol, over drinking can overload the liver. Continued abuse of alcohol, and thus the liver, is what causes the inflammation and scarring which leads to alcoholic hepatitis.

The liver is vital for processing nutrients, purifying the blood, and aiding the digestive system in a person’s daily routine of consuming food and drink. When the liver becomes compromised, it can put a heavy toll on the rest of the body’s organs, as the body attempts to carry the load of the damaged liver. In this way, Alcoholic Hepatitis does not just attack the liver, but a damaged liver can cause complications to other organs, and may even result in death if the appropriate treatment is not carried out.

What are Possible Risk Factors for Alcoholic Hepatitis?

There are many possible risk factors for Alcoholic Hepatitis, the most impactful of which is the overconsumption of alcohol. As excessive alcohol drinking is what compromises the liver and leads to alcoholic hepatitis, it is essential to curb or quit drinking at the first sight of alcoholic hepatitis symptoms.

1. Amount of Alcohol

Unfortunately, there is no definitive quantity of alcohol recorded by scientists and doctors that will cause alcoholic hepatitis. As every person’s body is different, so is their propensity to develop alcoholic hepatitis. That being said, most of the recorded cases of the disease involve a person who consumes a daily amount of alcohol equaling up to or more than 3.5 ounces of alcohol over at least 20 years. This might seem like a massive amount of alcohol to expose the body to, but in the case of someone struggling with alcohol dependency, this amount, on average, can be common. While there is no exact reason why some people who binge drink never develop alcoholic hepatitis while others do, binge drinking is ultimately the major cause of the disease. Controlling one’s drinking habits, and ensuring careful, responsible, limited drinking is the best defense against Alcoholic Hepatitis.

2. Sex

However, alcoholic hepatitis does occur in individuals who do not necessarily consume such an amount, as there are certain demographics which have been known to be more vulnerable to the effects of alcoholic hepatitis. Women are considered to be more at risk than men because scientists have discovered women’s bodies on average process alcohol differently than men

3. Obesity

People diagnosed with obesity are also more susceptible to Alcoholic Hepatitis, if they are heavy drinkers, as the body’s organs are already under more strain in obese individuals.

4. Race & Genetic Factors

Records also indicate that genetic factors might be part of why some people are more at risk than others, as Blacks and Hispanics seem to be at higher risk. This could be down to the fact that Black and Hispanics have less genetic exposure to alcohol than White people, as alcohol was not part of their diets for as long, although there is a great deal of conversation ongoing as to why exactly race may be a factor.

What Causes Alcoholic Hepatitis?

Drinking too much alcohol over a long period is the most definitive cause of Alcoholic Hepatitis. Given the number of risk factors outlined above, there are many complicating factors which might place one individual at risk over the other, but all of these are additional factors in comparison to the main reason alcoholic hepatitis occurs: excessive, dangerous, alcohol consumption. If an adult can limit their alcohol consumption to the recommended amount, then the chances of developing alcoholic hepatitis are incredibly low. If alcohol becomes an addiction, and a person becomes dependent, then their drinking habit can cause alcoholic hepatitis.

Do All Alcohols Cause Alcoholic Hepatitis?

All alcohols can cause Alcoholic Hepatitis. There are three general categories of alcohol: beer, wine, and spirits. While each of the three does possess alcohol, they have varying percentages of alcohol per ounce, and so can require different amounts to achieve the mental and physical effects that can come from drinking. Regardless, overconsuming any or all of these alcohols, over a long enough period, can cause Alcoholic Hepatitis.

Do All Alcoholics Get Alcoholic Hepatitis?

It is most common for Alcoholics to get Alcoholic Hepatitis, but the reality is that not all alcoholics are diagnosed with Alcoholic Hepatitis. It is widely accepted by medical professionals that there are 5 stages of alcoholism, and these 5 stages do correspond with recorded cases of Alcoholic Hepatitis.

  • Stage 1: Early signs of alcoholism are in individuals who drink to feel calm, handle stress, and eliminate anxiety. Pre-Alcoholic
  • Stage 2: Lying about drinking, blacking out regularly, obsessive thinking about drinking. Early Alcoholic
  • Stage 3: Physical signs of alcoholism such as weight gain and changes to the face, irritability, and forgetfulness. Middle Alcoholic
  • Stage 4: Drinking becomes the number one purpose of life, and the rest of the responsibilities and experiences that come with life fall by the wayside. Late Alcoholic
  • Stage 5: Quitting drinking for good through rehabilitation leads to a life where alcohol is never again part of the equation. Recovery.

It is most common for those with Stage 3 and Stage 4 alcoholism to develop Alcoholic Hepatitis, as the vast majority of recorded cases are in people who have continued to abuse alcohol over several years. Unfortunately, it can also affect people who have made it to Stage 5, as their recovery might not have occurred fast enough to mitigate the adverse effects of their drinking, resulting in Alcoholic Hepatitis.

Is Alcoholic Hepatitis Contagious?

No, Alcoholic Hepatitis is not contagious. It occurs when the liver becomes compromised by excessive, abusive drinking over many years. It can not be transmitted in any way.

What Are the Clinical Symptoms of Alcoholic Hepatitis?

There are several clinical symptoms of alcoholic hepatitis which doctors use to diagnose individuals. Doctors conduct physical tests and ask about current and previous alcohol use to conclude whether or not certain symptoms might be caused by Alcoholic Hepatitis, but the clinical symptoms include:

  • Jaundice: the most common indication that hepatitis of the liver is taking place, jaundice is the yellowing of the skin and whites of the eyes.
  • Nausea and vomiting
  • Abdominal tenderness
  • Fever, most of the time low grade
  • Fatigue and weakness
  • Malnutrition: heavy drinkers sometimes get most of their calories from drinking, which can lead to nutritional deficiencies
  • Kidney and liver failure
  • Ascites: swelling in the abdomen caused by fluid accumulation.

How Is Alcoholic Hepatitis Diagnosed?

When Alcoholic Hepatitis is diagnosed, the integral question a doctor will ask is always in regards to the drinking habits of the individual in question. One needs to be honest about their drinking habits to assist the medical professional in developing the proper diagnosis.

Once it is determined that alcohol may be causing alcoholic hepatitis, there are several processes and methods a medical professional may commence.

1. Complete Blood Count (CBC)

A test that analyzes the overall health of an individual by evaluating several features and components of the blood. A CBC test requires a blood extraction, which can be slightly painful during the injection of the needle, but is otherwise a standard blood-drawing procedure. A CBC can uncover imbalances in the liver, which point to Alcoholic Hepatitis.

2. CT Scan

A CT Scan uses computer imaging to create cross-section images of bones, veins, and tissues, to get a complete image of the inside of the body. While not painful, a CT Scan does expose the body to high amounts of radiation, although with limited exposure these levels are not deadly. A CT scan on the liver, kidneys, and other affected organs will uncover scarring and inflammation that may be caused by Alcoholic Hepatitis.

3. MRI

Short for Magnetic Resonance Imaging, an MRI is a computer-generated technique using radio waves and a magnetic field to make detailed images of the internal organs. Similar to a CT Scan, an MRI can detect injury to the organs that are known to be connected to Alcoholic Hepatitis.

4. Ultrasound test

An ultrasound uses sound waves to map the inside of certain parts of the body and does not use any radiation. This can be an alternate means by which to assess whether or not there is dangerous inflammation occurring in the liver of someone who may be sick with alcoholic hepatitis.

5. Liver biopsy

A biopsy is a far more invasive procedure than the radiation and ultrasound mapping techniques described above. In a surgical procedure, a patient will be sedated, after which surgeons will cut into the body and extract a small piece of the organ in question so physical tests can take place. As this is a more extreme technique, a liver biopsy may only come into question with more severe, and life-threatening, examples of Alcoholic Hepatitis, especially late-stage alcoholic hepatitis.

6. Blood Clotting Tests

Also known as coagulation tests, Blood Clotting Tests are carried out with patients to assess the body’s ability to blood clot. The blood is better at clotting if there are a healthy amount of proteins in the blood. With people suffering from severe alcoholic hepatitis, the blood does not properly, so a test can determine whether or not alcoholic hepatitis is the diagnosis based upon the ability of the blood to clot.

What Is the Diagnosis Code of Alcoholic Hepatitis?

The diagnosis criteria for alcoholic hepatitis is tied directly to an assessment of the liver functions of an individual possessing the symptoms outlined above that are associated with alcoholic hepatitis. If these symptoms are prevalent, then blood tests, scans, and most successfully, a liver biopsy, can determine whether or not the liver of the individual in question is scarred and inflamed enough to warrant an alcoholic hepatitis diagnosis. Alcoholic Hepatitis is also known as Fatty Liver Disease, which is a disease that can be diagnosed after examination of the liver. If alcohol use disorder is diagnosed in an individual with a compromised liver, then a diagnosis of Alcoholic Hepatitis is a fair assessment.

What Are the Risks and Consequences of Alcoholic Hepatitis?

If left untreated, alcoholic hepatitis can result in total cirrhosis of the liver, which in turn results in complete liver failure, which can be catastrophic to the homeostasis of the body and the inner workings of all the other organs. At that point, liver disease and death are very real threats to the body. Although Alcoholic Hepatitis is the precursor to outright cirrhosis, it is still incredibly dangerous and unhealthy, and only from abstaining from drinking can the liver tissue heal and the body return to normalcy. Permanent liver damage may occur, and a coma is even possible, as the nervous system may shut down after several organs become compromised.

Is Alcoholic Hepatitis Fatal?

Alcoholic Hepatitis can lead to total liver failure and death if left untreated. If an individual continues to drink even though they are suffering from alcoholic hepatitis, such overloading of the liver can cause heavy bleeding of the esophagus and stomach. This internal bleeding can be fatal.

How Long Can You Live With Alcoholic Hepatitis?

Although everyone’s body is known to hold out differently with Alcoholic Hepatitis, the sad reality is that once the liver is compromised by the disease, it can have repercussions throughout the body. While survival rates do range between 50 and 65% reported at both 2 and 10 years, survival is significantly minimized if a severe injury to the liver occurs, or if the individual in question does not stop drinking. Early detection is key if someone is going to live with Alcoholic Hepatitis. As there is no cure, without early-onset prevention, treatment can only combat or slow the effect of Alcoholic Hepatitis.

How Possible is it to Treat Alcoholic Hepatitis?

Treatment of Alcoholic Hepatitis is possible, but as the damage to the liver is oftentimes irreversible, once Hepatitis C is diagnosed, it is impossible to cure and will affect the patient for the duration of their life. However, ceasing drinking alcohol, and never drinking again, can aid the liver’s performance and help it to operate to the best of its ability. Stopping drinking is absolutely a key component when it comes to the possibility of treating Alcoholic Hepatitis.

How Is Alcoholic Hepatitis Treated?

There are several forms of treatment for Alcoholic Hepatitis. After quitting drinking alcohol for life, improved vitamin and mineral consumption for improved nutrition is key. A doctor may prescribe two medications including Corticosteroids, which are highly volatile steroids with health complications that should only be used in extreme cases, and Pentoxifylline, a substitute for the steroid. If the alcoholic hepatitis is extremely severe, then a liver transplant is required, which can be a difficult operation. Without a liver transplant, survival from extreme hepatitis C and cirrhosis is not possible.

If consumption of alcohol becomes chronic, over time, a series of serious problems can occur, including heart disease, high blood pressure, risk of stroke, liver disease, and digestive problems. Cancer of the mouth, throat, liver, colon, rectum, breast, and voice box are all possible, as are memory problems, immune system deficiencies, and mental health problems.

What are the Differences between Alcoholic Hepatitis and Cirrhosis?

While Alcoholic Hepatitis is very serious and can only be prevented by ceasing to drink alcohol, the damage the disease causes to the liver can sometimes be reversible. Alcoholic Hepatitis can onset quickly, whereas Cirrhosis is a liver disorder that comes on more gradually. Cirrhosis is also irreversible damage, the result of chronic Alcoholic Hepatitis.