ALCOHOLIC HEPATITIS (disease caused by drinking alcohol)

Alcoholic hepatitis describes liver inflammation caused by drinking alcohol.

Though alcoholic hepatitis is most likely to occur in people who drink heavily over many years, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately.

If you're diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol can go on to develop more serious liver damage in the form of cirrhosis and liver failure

SYMPTOMS
Mild forms of alcoholic hepatitis

may not cause noticeable problems, but as the disease becomes more advanced and the liver more damaged, signs and symptoms are likely to develop. These may include:

·         Loss of appetite

·         Nausea and vomiting

·        Abdominal pain and tenderness

·         Yellowing of the skin and whites of the eyes (jaundice)

·         Fever

·         Abdominal swelling due to fluid accumulation (ascites)

·        Mental confusion

·         Fatigue

CAUSES


Alcoholic hepatitis occurs when the liver is damaged by alcohol you drink. Just how alcohol damages the liver — and why it does so only in a minority of heavy drinkers — isn't entirely clear. What is known is that the process of breaking down ethanol — the alcohol in beer, wine and liquor — produces highly toxic chemicals, such as acetaldehyde. These chemicals trigger inflammation that destroys liver cells. In time, web-like scars and small knots of tissue replace healthy liver tissue, interfering with the liver's ability to function. This irreversible scarring, called cirrhosis, is the final stage of alcoholic liver disease.

Risk increases with time, amount consumed
Heavy alcohol use can lead to liver disease, and the risk increases with the length of time and amount of alcohol you drink. But because many people who drink heavily or binge drink never develop alcoholic hepatitis or cirrhosis, it's likely that factors other than alcohol play a role. These may include:

·       Genetic factors. Having mutations in certain genes that affect alcohol metabolism may increase your risk of alcoholic liver disease as well as of alcohol-associated cancers and other complications of heavy drinking.

·         Other types of hepatitis. Long-term alcohol abuse worsens the liver damage caused by other types of hepatitis, especially hepatitis C. If you have hepatitis C and also drink — even moderately — you're more likely to develop cirrhosis than if you don't drink.

·       Malnutrition. Many people who drink heavily are malnourished, either because they eat poorly — often substituting alcohol for food — or because alcohol and its toxic byproducts prevent the body from properly absorbing and metabolizing nutrients, especially protein, certain vitamins and fats. In both cases, the lack of nutrients contributes to liver cell damage.

RISK FACTORS

·         Alcohol use. Consistent heavy drinking or binge drinking is the primary risk factor for alcoholic hepatitis, though it's hard to precisely define what constitutes heavy drinking because people vary greatly in their sensitivity to alcohol. Moderate drinking is generally defined as no more than two drinks a day for men and one for women. Binge drinking is usually defined as more than four alcoholic drinks in one sitting for women, and more than five drinks in one sitting for men. Also a matter of debate is whether certain types of alcohol cause more harm than others. Some experts believe that wine is less damaging than hard liquor or beer, but this has yet to be proven.

·       Your sex. Women have a higher risk of developing alcoholic hepatitis than men do. This disparity may result from differences in the way alcohol is absorbed and broken down.

·        Genetic factors. Researchers have discovered a number of genetic mutations that affect the way alcohol is metabolized in the body. Having one or more of these mutations may increase the risk of alcoholic hepatitis

COMPLICATIONS

·     Increased blood pressure in the portal vein. Blood from your intestine, spleen and pancreas enters your liver through a large blood vessel called the portal vein. If scar tissue slows normal circulation through the liver, this blood backs up, leading to increased pressure within the vein (portal hypertension).

·       Enlarged veins (varices). When circulation through the portal vein is blocked, blood may back up into other blood vessels in the stomach and esophagus. These blood vessels are thin walled, and because they're filled with more blood than they're meant to carry, they're likely to bleed. Massive bleeding in the upper stomach or esophagus from these blood vessels is a life-threatening emergency that requires immediate medical care.

·        Fluid retention. Alcoholic hepatitis can cause large amounts of fluid to accumulate in your abdominal cavity (ascites). Abdominal fluid may become infected and require treatment with antibiotics. Although not life-threatening in itself, ascites is usually a sign of advanced alcoholic hepatitis or cirrhosis.

·         Bruising and bleeding. Alcoholic hepatitis interferes with the production of proteins that help your blood to clot. As a result, you may bruise and bleed more easily than normal.

·         Jaundice. This occurs when your liver isn't able to remove bilirubin — the residue of old red blood cells — from your blood. Eventually, bilirubin builds up and is deposited in your skin and the whites of your eyes, causing a yellow color.

·         Hepatic encephalopathy. A liver damaged by alcoholic hepatitis has trouble removing toxins from your body — normally one of the liver's key tasks. The buildup of toxins can damage your brain, leading to changes in your mental state, behavior and personality (hepatic encephalopathy). Signs and symptoms of hepatic encephalopathy include forgetfulness, confusion and mood changes, and in the most severe cases, coma.

·         Scarred liver (cirrhosis). Over time, the liver inflammation that occurs in alcoholic hepatitis can cause irreversible scarring of the liver (cirrhosis). Cirrhosis frequently leads to liver failure, which occurs when the damaged liver is no longer able to adequately function

Picture of Liver cirrhosis and liver cancer.