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

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 survey revealed that 51.1% of the 45 clinics offered liver transplantation to patients who had not yet been sober for 6 months, and 47.8% of transplant centers reported performing at least one liver transplant for severe alcoholic hepatitis. Just over a third (34.8%) of these centers had conducted three to five liver transplants, while only 8.9% of clinics performed at least six transplants.
The corresponding histological features of ALD grading and staging schema [7], Ishak score [9], Knodell score/histology activity index [10], and alcoholic hepatitis histologic score (AHHS) [8] were numerically evaluated.
Glucocorticoids are ineffective in alcoholic hepatitis: A meta-analysis adjusting for confounding variables.
The hepatocyte apoptotic index is strongly correlated with the neutrophil infiltration index in liver biopsies of alcoholic hepatitis [64].
Hussain et al., "Hyperoxidized albumin modulates neutrophils to induce oxidative stress and inflammation in severe alcoholic hepatitis," Hepatology, vol.
* The report provides a snapshot of the global therapeutic landscape of Alcoholic Hepatitis
There were a total of 221 subjects which included 144 patients with hepatitis B virus (HBV), 71 patients with HCV, and 6 patients with alcoholic hepatitis. Among all of the subjects, there were 125 men (56.6%) and 96 women (44.3%), and the average age of the subjects was 54.7911.46.
Clinicopathological comparison with alcoholic hepatitis in ambulatory and hospitalized patients.
LEADING North East experts are calling for urgent research into the treatment of alcoholic hepatitis as a major study reveals the only drugs used to treat the illness are not effective.
We will now turn our focus to enrolment in VTI-210, our second Phase 3 trial in severe acute alcoholic hepatitis (AAH), and VTI-212, our phase 2 trial in other forms of acute liver failure.'