Alcoholic Hepatitis: A Serious Health Condition from Drinking

Some people with alcoholic hepatitis develop visible symptoms, such as yellowing skin. But others have the condition without such prominent signs. 

No matter whether you can see it or not, alcoholic hepatitis is serious. People who keep drinking can lose their lives due to organ damage. 

What Is Alcoholic Hepatitis? 

Alcoholic hepatitis is a medical term that describes liver swelling. Chronic, intense alcohol ingestion is typically the trigger. 

Most people who develop alcoholic hepatitis have consumed the following amounts of alcohol for 10 to 12 years:[1]

• Men: 40 to 80 g daily 
• Women: 20 to 40 g daily 

Note that these are just averages, and your individual risk can vary.

Most people who develop alcoholic hepatitis are ages 40 to 60, but people as young as 20 and as old as 80 have experienced the issue.[2]

Risk Factors for Alcoholic Hepatitis 

Heavy drinking over a prolonged period is the biggest risk factor for alcoholic hepatitis. People who engage in this habit can harm their livers with time. But other issues can raise the chances of liver problems.

Risk factors associated with alcoholic hepatitis include the following:[3,10]

• High body mass index (BMI): Alcohol contains empty calories, and weight gain is common. People with a high BMI put added strain on the liver, increasing the risk of hepatitis.
• Sex: Women have a higher risk of hepatitis than men do.
• Genes: People with a specific variation in the PNPLA3 gene are at a higher risk of developing alcoholic hepatitis. This gene is part of the digestive system that helps to remove toxins. This problem can’t be cured. People who know their parents had liver problems should approach alcohol with care.
• Heavy abuse: People with a history of drinking can trigger hepatitis after binge drinking. A weekend of indulgence could be enough to spark a problem.

Some of these factors you can change. For example, losing weight could alter your risk of abuse. But you can’t change things like your genes.

Symptoms of Alcoholic Hepatitis 

Doctors can diagnose alcoholic hepatitis by skin color. People with sudden yellowed skin (called jaundice) and a history of heavy drinking likely have alcoholic hepatitis.[4]

The amount of liver inflammation dictates symptom severity.[5] The bigger your liver, the more uncomfortable you’ll be. 

Common symptoms include the following:[5]

• Anorexia: People with alcoholic hepatitis don’t want to eat.
• Abdominal pain: Discomfort in the stomach or sides is common. Nausea and vomiting can make this pain worse. 
• Weight loss: Poor appetite combined with vomiting can lead to significant weight loss. Malnutrition is common too. 
• Ascites: This term refers to fluid accumulating in the abdomen. It can look like sudden weight gain. 
• Confusion: A swollen liver can’t remove toxins. Sometimes, that leads to disorientation. 

Alcoholic Hepatitis Health Complications 

The liver is a key part of your body. Swelling and dysfunction can lead to significant health problems. 

Common complications include the following:[1]

• Gastric varices: A clot or scar tissue blocks blood flow to the liver. The body detours the blood into tiny vessels, which can burst and bleed. 
• Esophageal bleeding: Some people develop intense bleeding deep within the throat and esophagus. 
• Coagulopathy: As the liver begins to fail, the body loses the ability to clot blood. Any tiny cut can lead to intense bleeding. 
• Hepatic encephalopathy: When the liver isn’t working properly, toxins build up in the blood and brain. Confusion and forgetfulness are common, but physical symptoms can include slurred speech and shaking hands and feet. 
• Liver cancer: When damaged tissues aren’t repaired properly, cancerous changes can appear. Dysfunction can worsen. 

Alcoholic hepatitis is serious. People with severe alcoholic hepatitis (as determined by scores involving serum bilirubin and prothrombin) can lose their lives due to the disease. Appropriate treatment, which might include a liver transplant, could make a big difference.[3]

Treatment Options for Alcoholic Hepatitis 

Alcoholic hepatitis requires treatment in the hospital. People are at risk of dying from this condition, and they need around-the-clock care to get better. The following treatment options are typically provided to manage alcoholic hepatitis: 

Medications 

People with alcoholic hepatitis are treated in the hospital with steroids. These medications can reduce swelling, allowing blood to flow and the liver to function properly.[6] Steroids can be a safe and effective treatment for hepatitis, but the treatment should be delivered for a short time. If people don’t respond, the therapy should stop.[3]

People with clotting problems may need additional medications for this issue. In severe cases, they may need transfusions to replace blood lost by vomiting and bleeding. 

Nutritional Support 

Many people with alcoholic hepatitis have vomiting and anorexia. They may feel unable or unwilling to eat, and nutritional deficits appear. Without the right nutrition, the liver can’t heal. 

Doctors offer meals with 35 to 40 kilocalories and 1.2 g to 1.5 g of protein per kilogram of body weight.[4] These high-density foods can provide the body with the tools to adjust the liver and heal. 

Eating high-calorie meals comes with few side effects and risks. However, that nutrition should be delivered orally. People who have meals delivered via a nasal tube have a higher risk of infection and injury.[3]

Hydration 

Intense vomiting and malnutrition can lead to dehydration. People without enough fluid in their bodies can feel even more confused and nauseated. Additional liquids, added via an IV needle, may be helpful. 

Benzodiazepines 

People with alcoholic hepatitis can become very ill when they stop drinking alcohol abruptly. But symptoms like esophageal bleeding and intense vomiting make drinking alcohol difficult or even impossible. Doctors may treat alcohol withdrawal to ensure their patients don’t become sicker. 

Benzodiazepine medications can ease brain changes caused by alcohol withdrawal. Without them, people can develop intense confusion, hallucinations, and seizures.[7] With them, people can stop drinking safely. 

Doctors should taper benzodiazepine use in their patients rather than making them quit abruptly. These drugs can cause problems during withdrawal.

Long-Term Recovery: How Does It Work?

People with alcoholic hepatitis must stop drinking. But that isn’t always easy. 

Researchers say about 25% of people with alcoholic hepatitis return to drinking within about a year.[8] Continued drinking causes even more harm to the liver, and the more people keep consuming alcohol, the worse the problem will get. 

Treatment for Alcoholism

Addiction treatment programs can help. Doctors can use medications like acamprosate to relieve chemical imbalances caused by alcohol. Therapy can help people pick up necessary skills to avoid relapse. People can begin to build a support network that encourages them in their recovery efforts. 

Increasing exercise and eating healthy foods are part of hepatitis recovery too.[5] They can also be part of a long-term sobriety plan. Exercise offers a natural mood booster, as well as an opportunity for companionship. And meals can provide sensory delights that bring joy to everyday life. 

In time, you may begin to feel greater enjoyment from your healthier lifestyle than you ever did from drinking. While it doesn’t happen overnight, real change is possible.

Get Help

If you’re struggling with alcoholic hepatitis, it’s critical to quit drinking. But you shouldn’t do this on your own. You need medical supervision and support to ensure you stay safe throughout the withdrawal process.[9]

Get help from a treatment program to learn more about what recovery might look like and how sobriety might work for you. 

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More