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Alcoholic Hepatitis: Causes, Symptoms, Diagnosis and Treatment

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Ebiojo David
I am a Biochemist and Naturopath, I love writing and educating people on health and wellness matters.

Hepatitis which is a medical condition that is characterized by the inflammation of the liver can also be caused by alcohol and in this case it is called “Alcoholic hepatitis”.

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From our previous articles on hepatitis, we saw that many things cause hepatitis and some of them are drugs, toxins, viruses (which are the main cause), some medications and lastly alcohol. In this article, we will be looking at hepatitis caused by alcohol.

The main reason Alcohol is discouraged is because of the many health problems it causes in the body; it causes cancer, rapid aging, destroys the DNA, weakens the immune systems and many more and now we will be looking at how it destroys the liver.

The liver is the most important and largest organ of the body; it is one and once anything goes wrong with it, it can lead to serious health complications and even death because there is no second liver to replace and do the function of two like the kidneys.

The many important functions of the liver are production of bile which aids in digestion, filtering and excretion of toxins from the body, excretion of bilirubin, cholesterol, hormones and drugs, breakdown of fats, proteins and carbohydrates, activation of enzymes, production of hormones, storage of glycogen, minerals and fat soluble vitamin (A, D, E and K); synthesis of clotting factors and blood proteins like albumin.

When the liver is affected, all these functions and activities will also be affected and this can lead to serious and life threatening conditions and death can also occur if it is not treated well or left to progress beyond healing.

What is Alcoholic hepatitis?

This is the inflammation of the liver that is caused by drinking Alcohol; it mostly occurs in heavy drinkers or people that drink heavily over many years, this can also happen in people who drink  moderately too. In this case, treatment should start immediately and alcohol should not be consumed at all if not it will lead to serious liver damage and death.

The way alcohol damages the liver is not yet clear but it is known that the when alcohol is broken down in the body, it releases highly toxic chemicals as by products; these toxic chemicals are what triggers inflammation in the liver that destroys the cells of the liver.

When alcohol is continuously taken and the destruction of the liver progresses, the formation of scars sets in and replaces healthy liver tissues which will interfere with the function of the liver.

If left undiagnosed or untreated, it will lead to cirrhosis of the liver (scarring of the liver) which is the final stage of alcoholic hepatitis.

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There are also other factors that contribute to alcoholic hepatitis and make the symptoms worse; these factors are hepatitis C and malnutrition. Hepatitis C can lead to severe scarring of the liver (cirrhosis) if the patient drinks, even moderate drinking in hepatitis C patients can lead to cirrhosis of the liver.

The second factor malnutrition is caused by alcohol because heavy drinkers are malnourished. Alcohol and it’s by products which are harmful chemicals prevent the body from properly absorbing and utilizing nutrients and most heavy drinkers eat poorly; lack of vital nutrients give way to liver cell damage and liver failure. Other risk factors for alcoholic hepatitis are;

Obesity

Alcoholics who are overweight or any overweight person who drinks moderately has a higher risk of developing Alcoholic hepatitis and liver cirrhosis.

Sex

The risk of developing alcoholic hepatitis is higher in women than men; the possible reason is because alcohol is processed differently in the body of women.

Binge drinking

Consuming Alcohol in large quantities can increase the risk of one having alcoholic hepatitis; try to take it moderately if you cannot avoid it totally, do not exceed two drinks at a time because consuming five or more drinks at one time will increase the risk of alcoholic hepatitis.

What are the symptoms?

The most alarming thing about this medical condition is that it does not show any sign or symptoms until the liver has been severely damaged but the most common symptom of alcoholic hepatitis is yellowing of the eyes and skin.

Other symptoms are nausea and vomiting, loss of appetite, abdominal tenderness, dry mouth, pain or swelling in the abdomen, easy bleeding and bruising, changes in mental state, low grade fever, fatigue and weakness, unexplained weight loss and malnutrition.

If it is not promptly handled or well treated, it can lead accumulation of fluids in the abdomen , failure of the liver and kidneys, confusion, memory problems and behavioral problems due to accumulation of toxins in the body because the liver is no longer able to eliminate toxins from the body.

What health complications can it lead to?

If left to progress and heavy drinking is still continued; this can lead to a lot of complications and life threatening conditions, some of them are:

  • Liver hypertension: The formation of scar tissues in the liver can slow or stop the flow of blood through the liver; the will lead to an increase in pressure in the portal vein which is a major blood vessel.
  • Jaundice: When the liver is damaged; it can’t carry out its functions properly which includes the elimination of bilirubin from the blood. Bilirubin is the residue of old blood cells and when it is left to accumulate and build up in the body; it colours the skin and sclera of the eyes (white part of the eyes), this will give the skin and white of the eye a yellow colour.
  • Kidney failure: Severe scarring of the liver and liver damage can affect the flow of blood to the kidneys and this will in turn damage the kidney.
  • Ascites: This is a sign of advanced alcoholic hepatitis or severe scarring of the liver; it is characterized by the infection of the fluid that accumulates in the abdomen. This can be treated by antibiotic and it is not life threatening.
  • Varices also called enlarged veins: Obstruction of blood flow in the portal vein can lead to this condition; if the portal vein is obstructed, the blood will flow back and go to other blood vessels in the esophagus and stomach. These will lead to internal bleeding because these blood vessels have thin walls and this makes them to bleed when filled with blood. This can lead to heavy bleeding in the esophagus or upper stomach; this is a life threatening condition that needs urgent and immediate medical attention if not it can lead to death.
  • Liver cirrhosis: Cirrhosis of the liver is an irreversible scarring of the liver that usually leads to liver failure.
  • Coma and death: Severe and irreversible liver damage can lead to inability of the liver to carry out its life supporting functions and this can lead to death.

How to prevent Alcoholic hepatitis?

  • Avoid Alcohol: The main cause of Alcoholic hepatitis is heavy drinking and this medical condition has also been reported in cases of moderate drinking. So the best thing to do is to do or the best way to prevent this type of hepatitis is by avoiding all alcohol.
  • Don’t mix medications with Alcohol: Not all medications are safe to take when one is drinking; ask your doctor to be sure if it is safe to drink alcohol when taking your prescribed medications because this can lead to health complications. Do not drink alcohol when taking pain relievers like Tylenol, paracetamol and others, it will damage the liver.
  • Protect yourself from hepatitis C: Hepatitis C though caused by virus can lead to severe scarring of the liver if left untreated and it is worsened by alcohol; having Hepatitis C and drinking at the same time can increase the speed at which cirrhosis of the liver develops.

How is alcoholic hepatitis diagnosed?

Diagnosis of this type of hepatitis requires physical examination and the doctor will ask if you drink and your history of alcohol consumption.

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Then liver tests are carried out to see if the liver is damaged or the extent of the damage; the tests that will be carried out are blood test, liver function test, a liver biopsy and liver scan.

How is it treated?

The first treatment in Alcoholic hepatitis is to stop drinking; the patient is told to stop drinking immediately and never to drink alcohol again, this is the only way to reverse liver damage or to prevent it from getting worse. Alcoholic hepatitis patients who stop drinking have higher survival rates than those who don’t stop drinking.

Those who are addicted to alcohol or depend on it and want to stop drinking are put on medications or made to go through counseling. Others are put in alcoholic anonymous or residential treatment programs.

Alcoholic hepatitis patients are also treated for malnutrition; some of them are put on special diet to correct the problem. Those who have problem eating are tube feed; a tube is passed down the patient’s throat or through the side and into the stomach and a special nutrient rich liquid diet is then passed through the tube.

Medications are also given to reduce the inflammation in the liver; the most common drugs given are corticosteroids and pentoxifylline. Corticosteroids increase the rate of survival in certain people with this condition but they have serious side effects. They are not prescribed if the patient has failing kidneys, infection or gastrointestinal bleeding. Pentoxifylline are given to patient with severe alcoholic hepatitis patients that can’t take corticosteroids or that do not respond to corticosteroids.

In severe cases of this medical condition, where the liver has been damaged beyond repair; a liver transplant is the only hope to avoid death. However, most surgeons are reluctant to perform liver transplant on patients with alcoholic hepatitis because most of them resume drinking after surgery.

To undergo a liver transplant, patients have to find a programme that will consider them and meet their requirements; they will also be asked to abstain from alcohol for six months before transplant and they must agree that they will not resume drinking after surgery and for the rest of their lives.

Are the natural remedies for alcoholic hepatitis?

Yes, there are a lot of natural or home remedies that can help one overcome the symptoms and recover fast and we will be looking at some of them.

Good nutrition

From the above explanation, we saw that alcoholics are malnourished and this impairs the functions of the liver. To overcome this medical condition and help your body recover fast, the patient needs to avoid bad and unhealthy foods and start taking health and nutritious foods daily.

Inflammatory foods that worsen the case of alcoholic hepatitis are alcohol, high carb foods, sugary drinks and all forms of processed foods. Alcohol is one of the fastest things that destroy the liver; it is also worse when combined with prescription drugs, cigarette and poor diet. Avoid alcohol like a plague.

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High carbohydrate foods increase the level of insulin in the body and this can affect the liver; avoid white breads, grits, corn, rice and any type of refined carbohydrate. Sugary drinks like sport drinks, soda, energy drinks, sweetened fruit juices with artificial flavour and sweeteners should be avoided. This affects the liver and makes it fatty.

Processed foods which include foods made with bleached flour, hydrogenated oil, refined sugars and instant noodles should be avoided because they are toxic to the body, especially the liver. Avoid fatty foods like butter, cheese, cream, margarine and red meat.

Replace your diet with lots of foods that heals the liver and make sure that there are organic in nature. Raw vegetables have lots of healing nutrients and phytochemicals that can aid fast recovery; they should be eaten raw most of the times and this can be done by making salads or smoothies with them.

You can also juice the vegetables; vegetables that can heal the liver are kale, cabbage, beetroot, lettuce, dandelion, milk thistle, spinach, watercress, cauliflower, Brussels sprouts, carrots, cucumbers, parsley, mint, basil, cilantro, asparagus, beets, celery and broccoli. Other liver healing foods are ginger roots, turmeric, sweet potatoes, bananas and liver from organically raised or grass fed farm animals.

Liver cleanse

Liver cleanse is a way of detoxifying the liver of toxins and this will help and speed up the recovery of alcoholic hepatitis. To do a liver cleanse, one has to take liver healing foods consecutively for a number of days; it can be long or it can be short.

You can get in touch with a good herbalist or naturopath to guide you through this programme. Another way to do a liver cleanse is by taking lots of those vegetables mentioned above in their raw forms; this can be done by making vegetable smoothies or vegetable salads with them.

You also need to consume all colours of fruits and vegetables; pawpaw and watermelon should be your best friends, your drinking water should be infused with fig leaves and you should also take herbal teas.

Good herbal teas for the liver are anise, chamomile, fennel, ginger, grape seed extract, Reishi mushroom, ginseng and seaweed. Lightly cooked tomatoes and avocados are good for the liver;

Vitamin E

This vitamin is a powerful antioxidant that reduces inflammation; it helps the body to fight off serious medical conditions and in increases the strength of the immune system, you can take the supplement but it should be prescribed by the doctor and you can also eat vitamin E rich foods. Other supplements that will help are zinc and potassium.

Black seed oil

This oil is good for people with liver problems as it speeds up the healing process; it also inhibits the activities of free radicals, it reduces the complications of liver problems and stops it from progressing.

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Avoid medications

Especially painkillers, they should only be taken when prescribed by a doctor; their side effects are serious and they mostly affect the liver.

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