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 ?
He said: "Liver disease is the only leading cause of preventable death that is increasing in the country, yet very little research is currently being undertaken on conditions such as alcoholic hepatitis.
Among 46 men who received standard medical therapy for severe alcoholic hepatitis, 23 received subcutaneous GCSF twice daily for five days.
For example, EZH2 levels were not changed in mice that exhibited a precursor stage to HCC (as characterized by the presence of balloon cells and MDBs) after drug treatment, in liver biopsies of patients with alcoholic hepatitis, or in MDB-forming HCCs (French et al.
Increased tumor necrosis factor production by monocytes in alcoholic hepatitis.
The first research showed the positive potential of performing liver transplantation for patients suffering from severe alcoholic hepatitis (SAH) earlier than the recommended 6-months rule (required minimum of recorded abstinence for an alcoholic patient to be eligible for a liver transplant).
Histologic injury from alcohol is usually staged into three groups: fatty liver (steatosis), alcoholic hepatitis, and chronic hepatitis with fibrosis or cirrhosis.
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.
The aminotransferases can often be increased by as much as 50 times the upper reference limit in acute viral, ischemic, and toxic hepatitis, whereas in alcoholic hepatitis the increases are generally <10-fold.
Since then, studies focused on chronic viral infections or alcoholic hepatitis showed inconsistent results (Deak et al.
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.
The probability of alcoholic hepatitis is directly related to the magnitude of the ratio.