Alcoholic hepatitis

Definition

Alcoholic hepatitis is an inflammation of the liver caused by alcohol.

Description

Irritation, be it from toxins or infections, causes a similar response in body organs. The response is known as inflammation and consists of:

• An increase in the blood to the affected organ
• Redness and swelling of the organ
• Influx of immune agents like white blood cells and their arsenal of chemical weapons
• Pain.

As the acute process subsides, there is either healing or lingering activity. Lingering activity--chronic disease--has a milder presentation with similar ingredients. Healing often takes the form of scarring, wherein normal functioning tissue is replaced by tough, fibrous, and non-productive scar. Both chronic disease and healing can happen simultaneously, so that scar tissue progressively replaces normal tissue. This leads to cirrhosis, a liver so scarred it is unable to do its job adequately.

Alcohol can cause either an acute or a chronic disease in the liver. The acute disease can be severe, even fatal, and can bring with it hemolysis--blood cell destruction. Alcohol can also cause a third type of liver disease--fatty liver, in which the continuous action of alcohol turns the liver to useless fat. This condition eventually progresses to cirrhosis if the poisoning continues.

Causes & symptoms

Inflammation of the liver can be caused by a great variety of agents--poisons, drugs, viruses, bacteria, protozoa, and even larger organisms like worms. Alcohol is a poison if taken in more than modest amounts. It favors destroying stomach lining, liver, heart muscle, and brain tissue. The liver is a primary target because alcohol travels to the liver after leaving the intestines. Those who drink enough to get alcohol poisoning have a tendency to be undernourished, since alcohol provides ample calories but little nutrition. It is suspected that both the alcohol and the poor nutrition produce alcoholic hepatitis.

Diagnosis

Hepatitis of all kinds causes notable discomfort, loss of appetite, nausea, pain in the liver, and usually jaundice (turning yellow). Blood test abnormalities are unmistakably those of hepatitis, but selecting from so many the precise cause may take additional diagnostic work.

Treatment

As with all poisonings, removal of the offending agent is primary. There is no specific treatment for alcohol poisoning. General supportive measures must see the patient through until the liver has healed by itself. In the case of fulminant (sudden and severe) disease, the liver may be completely destroyed and have to be replaced by a transplant.

Prognosis

The liver is robust. It can heal without scarring after one or a few episodes of hepatitis that resolve without lingering. It can, moreover, regrow from a fragment of its former self, provided there is not disease or poison still inhibiting it.

Prevention

Alcohol is lethal in many ways when ingested in excess. Research suggests that the maximum healthy dose of alcohol per day is roughly one pure ounce--the amount in two cocktails, two glasses of wine, or two beers.

Key Terms

Cirrhosis

Disruption of normal liver structure and function caused by any type of chronic disease such as hepatitis and alcohol abuse.

Fatty liver

An abnormal amount of fat tissue in the liver caused by alcohol abuse.

Hemolysis

Disintegration of read blood cells.

Protozoa

One celled microscopic organisms like amoeba.

Further Reading

For Your Information

Books

• Boyd, William. Textbook of Pathology. Philadelphia, PA: Lea & Febiger, 1970, p. 875.
• Friedman, Scott L. "Cirrhosis of the liver and its major sequelae." In Cecil Textbook of Medicine, edited by J. Claude Bennett and Fred Plum. Philadelphia: W. B. Saunders, 1996, pp. 789-791.
• Lidofsky, Steven D. and Bruce F. Scharschmidt. "Jaundice." In Sleisenger & Fordtran's Gastrointestinal and Liver Disease, edited by Mark Feldman, et al. Philadelphia: W. B. Saunders, 1998, p. 1767.
• McQuaid, Kenneth R. "Alimentary tract." In Current Medical Diagnosis and Treatment, edited by Lawrence M. Tierney Jr., et al. Stamford, CT: Appleton & Lange, 1996, pp. 566-568.
• Podolsky, Daniel K. and Kurt J. Isselbacher. "Cirrhosis and alcoholic liver disease." In Harrison's Principles of Internal Medicine, edited by Kurt Isselbacher, et al. New York: McGraw-Hill, 1998, pp. 1704-1710.

  Organizations

• American Liver Foundation. 1425 Pompton Avenue, Cedar Grove, New Jersey 07009. 800-223-0179.
• Local chapters of Alcoholics Anonymous.

Gale Encyclopedia of Medicine. Gale Research, 1999.