Alcoholic hepatitis is an inflammation, or irritation, of the liver caused by alcohol. It typically occurs in people who drink heavily for many years; however, not all heavy drinkers develop it and it can also occur in those who drink only moderately. Alcoholic hepatitis can progress to scarring and irreversible destruction of the liver with continued abuse of alcohol. When the liver is inflamed, there is an elevation of liver enzymes in the blood.
Liver Enzymes
Acetate transaminase (AST) and alanine aminotransferase (ALT) are two liver enzymes produced by liver cells and are indicators of liver function. In alcoholic hepatitis, both AST or ALT are elevated but more specifically, AST concentration in the blood is usually twice that of ALT. When liver cells are damaged or destroyed, they release their contents into the blood, resulting in an elevation in the concentration of liver enzymes.
Liver and Alcohol
The liver is primarily responsible for the processing of alcohol in the body. The liver cells contain the enzymes needed to metabolize alcohol. Liver as a whole has a limited capacity for processing alcohol. When alcohol intake exceeds the capacity of the liver to metabolize it, the liver cells become susceptible to damage from alcohol. The alcoholic destruction of liver cells is implicated by the elevation of liver enzymes in the blood.
Associated Complications
The abuse of alcohol is associated with not only liver inflammation but also with heart dysfunction. Alcohol in itself is toxic to heart muscle cells and weakens their ability to contract strongly. Chronic alcohol abuse can eventually lead to liver cirrhosis or profound scarring of the liver, accompanied by severe loss of liver function. Alcohol abuse is associated with bleeding problems due to platelet dysfunction. Anemia can also occur with alcohol abuse due to the inactivation of folate by alcohol. Other complications include jaundice, fluid retention and mental status changes due to the buildup of toxins in the brain. A person with liver cirrhosis bears an increased risk for hepatocellular carcinoma or liver cancer.
Management of Alcoholic Hepatitis
Alcoholic hepatitis can be reversible. A person with alcoholic hepatitis can experience total remission of the disease when he stops abusing alcohol. The progression of alcoholic hepatitis to advanced liver disease is preventable with the cessation of alcohol abuse. If a person already has advanced liver disease, however, he will need further medical attention. When liver damage is extensive, a liver transplant may be the only available treatment option.
References
- MayoClinic.com: Alcoholic Hepatitis
- Lef.org: Cirrhosis and Liver Disease
- "Harrison's Principles of Internal Medicine": Kasper M.D.,et al.; 2005
