Alcoholic Hepatitis

Alcoholic hepatitis is an inflammation of liver tissue which is induced by alcohol drinking. It is a form of alcoholic liver damage. This article is devoted mainly to problematic of acute alcoholic hepatitis but also chronic alcoholic hepatitis exists. Chronic alcoholic hepatitis is connected with long-term alcoholism and has a great risk of progression into liver cirrhosis.


As the name implies, alcohol is the causative factor. Acute alcoholic hepatitis can appear virtually by everyone after a single excessive use of alcohol. People drinking regularly have of course higher risk of acute hepatitis occurrence and by alcoholics with permanently impaired liver function acute hepatitis can very easily lead to liver failure.


Symptoms may be variable. Sometimes the affected person only complains only about abdominal pain in right upper quadrant of the abdomen where we find enlarged liver sensitive to palpation. In more severe cases, however, there may be symptoms of hepatic impairment, sometimes even liver failure. They manifest as jaundice, fluid in the abdomen (ascites), hepatic encephalopathy etc. The state may end up by impaired consciousness, disruption of internal environment and followed by death.


We suspect diagnosis by patient with above stated symptoms who experienced recent excessive intake of alcohol. In blood tests we may find increase in liver enzymes and by jaundice increased serum level of bilirubin (a substance normally secreted by liver). Other serology findings depend on the severity of liver disease. It is suitable to perform an ultrasound which informs us about status of liver tissue (it can diagnose cirrhosis) and shows us presence of intraabdominal fluid. Very clear and definitive mean of diagnosis is a liver biopsy which obtains a sample of liver tissue for histological examination. A biopsy is performed mainly in cases when we are not sure whether the patient's abnormal liver tests are related to alcohol and we want to rule out other possible causes.


Alcohol prohibition is a necessary precaution. Hepatotoxic (toxic for liver) drugs should not be administered to people with alcoholic acute hepatitis and especially to those with impaired liver functions. More severe cases should be hospitalized, liver-protective drugs could be administered (their effectiveness is unfortunately doubtful). When liver functions are impaired it is important to treat complications of liver failure and stabilize the inner environment of the organism.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources