alcoholic hepatitis


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Related to alcoholic hepatitis: fatty liver, Alcoholic liver disease

Hepatitis, Alcoholic

 

Definition

Alcoholic hepatitis is an inflammation of the liver caused by alcohol.

Description

Irritation, be it from toxins or infections, causes a similar response in body organs. The response is known as inflammation and consists of:
  • an increase in the blood to the affected organ
  • redness and swelling of the organ
  • influx of immune agents like white blood cells and their arsenal of chemical weapons
  • pain
As the acute process subsides, there is either healing or lingering activity. Lingering activity—chronic disease—has a milder presentation with similar ingredients. Healing often takes the form of scarring, wherein normal functioning tissue is replaced by tough, fibrous, and non-productive scar. Both chronic disease and healing can happen simultaneously, so that scar tissue progressively replaces normal tissue. This leads to cirrhosis, a liver so scarred it is unable to do its job adequately.
Alcohol can cause either an acute or a chronic disease in the liver. The acute disease can be severe, even fatal, and can bring with it hemolysis-blood cell destruction. Alcohol can also cause a third type of liver disease, fatty liver, in which the continuous action of alcohol turns the liver to useless fat. This condition eventually progresses to cirrhosis if the poisoning continues.

Causes and symptoms

Inflammation of the liver can be caused by a great variety of agents—poisons, drugs, viruses, bacteria, protozoa, and even larger organisms like worms. Alcohol is a poison if taken in more than modest amounts. It favors destroying stomach lining, liver, heart muscle, and brain tissue. The liver is a primary target because alcohol travels to the liver after leaving the intestines. Those who drink enough to get alcohol poisoning have a tendency to be undernourished, since alcohol provides ample calories but little nutrition. It is suspected that both the alcohol and the poor nutrition produce alcoholic hepatitis.

Diagnosis

Hepatitis of all kinds causes notable discomfort, loss of appetite, nausea, pain in the liver, and usually jaundice (turning yellow). Blood test abnormalities are unmistakably those of hepatitis, but selecting from so many the precise cause may take additional diagnostic work.

Treatment

As with all poisonings, removal of the offending agent is primary. There is no specific treatment for alcohol poisoning. General supportive measures must see the patient through until the liver has healed by itself. In the case of fulminant (sudden and severe) disease, the liver may be completely destroyed and have to be replaced by a transplant.

Prognosis

The liver is robust. It can heal without scarring after one or a few episodes of hepatitis that resolve without lingering. It can, moreover, regrow from a fragment of its former self, provided there is not disease or poison still inhibiting it.

Prevention

Alcohol is lethal in many ways when ingested in excess. Research suggests that the maximum healthy dose of alcohol per day is roughly one pure ounce—the amount in two cocktails, two glasses of wine, or two beers.

Resources

Organizations

American Liver Foundation. 1425 Pompton Ave., Cedar Grove, NJ 07009. (800) 223-0179. http://www.liverfoundation.org.
Local chapters of Alcoholics Anonymous.

Key terms

Cirrhosis — Disruption of normal liver structure and function caused by any type of chronic disease such as hepatitis and alcohol abuse.
Fatty liver — An abnormal amount of fat tissue in the liver caused by alcohol abuse.
Hemolysis — Disintegration of read blood cells.
Protozoa — One celled microscopic organisms like amoeba.

alcoholic hepatitis

an acute toxic liver injury associated with excess ethanol consumption. It is characterized by necrosis, inflammation caused by the accumulation of polymorphonuclear leukocytes, and in many instances Mallory bodies.
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Alcoholic hepatitis

alcoholic hepatitis

Inflammation of the liver that occurs in a chronic alcoholic after an exceptionally heavy alcohol binge. Alcoholic hepatitis ranges from mild (confined to lab abnormalities) to severe liver dysfunction with jaundice, hepatic encephalopathy, ascites, bleeding esophageal varices, abnormal blood clotting and coma. Alcoholic hepatitis is reversible if the drinking stops, taking several months to resolve; it can lead to liver scarring and cirrhosis.

alcoholic hepatitis

Inflammation of the liver which occurs in a chronic drinker after an episode of exceptionally heavy alcohol consumption; AH ranges from mild–abnormal laboratory tests are the only indication of disease, to severe liver dysfunction with jaundice, hepatic encephalopathy, ascites, bleeding esophageal varices, abnormal blood clotting and coma Pathology Ballooning degeneration of hepatocytes, inflammation with PMNs and sometimes Mallory bodies–aggregates of intermediate filament proteins; AH is reversible if the patient stops drinking, but it usually takes several months to resolve; it can lead to liver scarring and cirrhosis, and often occurs in alcoholics with cirrhosis. See Wernicke syndrome.

al·co·hol·ic hep·a·ti·tis

(al'kŏ-hol'ik hep'ă-tī'tis)
Inflammation of the liver due to abuse of alcohol.
References in periodicals archive ?
The report reviews pipeline therapeutics for Alcoholic Hepatitis by companies and universities/research institutes based on information derived from company and industry-specific sources
Management practices of hepatitis C virus infected alcoholic hepatitis patients: A survey of physicians.
Professor Mark Thursz, from the Department of Medicine at Imperial College London, who led the study, said: "This study is four times larger than any previous trial in patients with severe alcoholic hepatitis, so it provides much stronger data on how effective the drugs are.
Washington, April 17 (ANI): Two French studies have shed new light on the treatment options for patients suffering from severe alcoholic hepatitis.
On one end of the spectrum is fatty liver (steatosis), which is reversible with abstinence, and the more severe alcoholic hepatitis and fibrosis, which may or may not improve with abstinence.
Risk of depression, heart attacks and strokes, alcoholic hepatitis, a range of different cancers, pancreatitis and diabetes are all greatly increased in those who drink to excess.
Serum type III procollagen peptide and laminin (Lam-P1) detect alcoholic hepatitis in chronic alcohol abusers.
Pathologic changes observed in patients with alcohol induced liver disease are categorised into alcoholic fatty liver (simple steatosis), alcoholic hepatitis and alcoholic cirrhosis.
Pentoxifylline improves short-term survival in patients admitted to the hospital with severe alcoholic hepatitis (strength of recommendation [SOR]: B, a single published randomized controlled trial [RCT]).
The probability of alcoholic hepatitis is directly related to the magnitude of the ratio.
Iron overload produces a micronodular cirrhosis characterised by an absence of fatty change, alcoholic hepatitis, alcoholic hyaline or alcoholic cirrhosis, in contrast to the picture seen in Western societies.