What is Alcoholic Hepatitis?
Alcoholic hepatitis is inflammation of the liver caused by drinking alcohol. When alcohol gets processed in the liver, it produces highly toxic chemicals. These chemicals can injure the liver cells. This injury then leads to inflammation and alcoholic hepatitis. Alcoholic hepatitis is most likely to occur in people who drink heavily over many years. However, it can also develop in people who moderately use alcohol. Excessive alcohol consumption could result in fatty liver disease or steatosis, alcoholic hepatitis (AH), and eventually cirrhosis.
Approximately two-thirds of adults in the United States drink alcohol, while 7.2% suffer from alcohol use disorder (AUD). Excessive alcohol intake is the third leading preventable cause of death in the United States. A 10-year survey from 2001 through 2011 from 211 hospitals revealed a 0.08% to 0.09% admissions related to alcoholic hepatitis. This is according to NCBI [1] Addressing the underlying addiction to alcohol is an essential step in managing alcoholic liver disease (ALD), such as alcoholic hepatitis. You may be able to reverse the damage to your liver by avoiding alcohol in the early stages of the disease. However, if you have alcoholic hepatitis and do not stop drinking, no medical or surgical treatment can prevent liver failure.
According to the National Center for Biotechnology Information (NCBI) [2], virtually every patient with alcoholic hepatitis has some degree of malnutrition. Malnutrition is common in liver disease, especially in the more severe forms of chronic liver disease. The severity of the liver disease is generally correlated with the severity of malnutrition. Alcoholic hepatitis usually progresses to cirrhosis if drinking continues. For those who discontinue alcohol, hepatitis returns to normal within a few months.
Causes of Alcoholic Hepatitis
The main cause of alcoholic hepatitis is heavy drinking over an extended period. The process of breaking down alcohol in the liver causes damage to the liver. Over time, scars begin to replace functional liver tissue in the body. This interferes with how the liver works.
People with other types of hepatitis have a higher risk. They should not drink alcohol. A person with alcoholic hepatitis may experience malnourishment. Drinking significant amounts of alcohol can suppress the appetite. Alcohol may become the main source of calories for an individual. Malnutrition can also contribute to liver disease.
Risk Factors for Alcoholic Hepatitis
Biological Sex
Women are more likely to develop alcoholic hepatitis than men.
Weight
People who are obese are more likely to have liver problems associated with alcohol.
Genetics
Some people are biologically more vulnerable than others.
Ethnicity
African-Americans and Hispanics may have a higher risk of developing the condition.
Binge Drinking
Consuming a lot of alcohol in a short period of time increases the risk of liver inflammation.
Symptoms of Alcoholic Hepatitis
One-third of chronic heavy alcohol users develop alcoholic hepatitis and most will have no symptoms. A person with alcoholic hepatitis may also be asymptomatic (showing no symptoms). The symptoms of alcoholic hepatitis may look like other health conditions or problems.
The Most Common Symptoms of Alcoholic Hepatitis
- Belly (abdomen) tenderness or pain over the liver
- Nausea
- Vomiting blood or material that looks like coffee grounds
- Poor appetite
- Yellowing of the skin and eyes (jaundice)
- Weight loss
- Tiredness and weakness
- Fever
Alcoholic hepatitis usually develops over time with continued drinking. But severe alcoholic hepatitis can develop suddenly. It can quickly lead to liver failure and death.
Alcohol Abuse Treatment for People with Alcoholic Hepitits
According to NCBI [3], individuals with alcoholic hepatitis (AH) may also experience alcohol withdrawal symptoms. Mild to moderate symptoms include irritability, anxiety, headache, sweating, tachycardia, and hand tremors with clammy skin. Severe symptoms include delirium tremens in which the patient is confused and may have visual hallucinations along with agitation, convulsions, and fever.
The goal of treatment is to restore some or all normal functioning to the liver by addressing the underlying issue of alcohol abuse. You will need to stop drinking alcohol. To do this, you may need to be in an alcohol treatment program. Sometimes you may also need to change your diet. Scarring of the liver is permanent. But the liver is often able to repair some of the damage caused by alcohol so you can live a normal life.
Alcohol abuse is one of the primary causes of liver damage. Alcohol-associated liver disease is the leading cause of chronic liver disease. Chronic alcohol use will result in a progression from steatosis to alcoholic hepatitis and then finally to alcoholic cirrhosis. The complications associated with the alcohol-related disease can be severe. Significant alcoholic cirrhosis can increase the risk for liver cancer, other cancers, kidney failure, and dementia.
Medically Assisted Detox
Usually, the first step in inpatient treatment is medically assisted detox. Doctors and addiction specialists monitor clients’ vital signs while alcohol exit the system. Depending on the type of substance a person is detoxing from, withdrawal symptoms may differ.
Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medicine and medical expertise to lessen cravings and withdrawals.
Medication-Assisted Treatments
Medication-Assisted Treatments (MAT) for alcohol use disorder and liver disease are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. Typically, individuals undergoing withdrawal management are administered benzodiazepines under the supervision of an addiction medicine physician, whereas steroids are often used to deal with inflammation of the liver that is associated with alcoholic-related liver disease.
Because individuals who have the alcohol-related liver disease often suffer from nutritional deficiencies, physicians may consult with nutritionists and recommend a specific diet. In addition, nutrition therapy, including the use of supplementation and special diets, is often used in the treatment of alcohol-related liver disease.
Integrated Mental Health Care
Alcohol affects mental health, so people may use it to self-medicate undiagnosed disorders. Rehab centers typically provide mental health screenings, diagnoses, and integrated treatment for co-occurring disorders. In addition, holistic and therapeutic approaches are often used to treat recovering addicts with these conditions.
Behavioral Therapies
Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) can improve addicts’ behavior. CBT targets negative and maladaptive thought patterns as it promotes positive emotions and beliefs, while DBT helps clients address conflicting impulses so they can make healthy choices. Both therapies treat substance abuse, anxiety disorders, and other mood issues. Therapy also empowers clients to identify, avoid and mitigate cues that trigger drug cravings.
Individual and Group Counseling
Addiction and mental health counseling occur in both individual and group settings. One-on-one treatment sessions may address unresolved trauma, unconscious conflicts, and specific struggles, while group sessions often involve training in life skills, stress management, conflict resolution, and social connections. Group counseling also gives clients the chance to share their thoughts and experiences to develop social support, which is essential for lasting recovery.
Individual and Group Counseling
Addiction and mental health counseling occur in both individual and group settings. One-on-one treatment sessions may address unresolved trauma, unconscious conflicts, and specific struggles, while group sessions often involve training in life skills, stress management, conflict resolution, and social connections. Group counseling also gives clients the chance to share their thoughts and experiences to develop social support, which is essential for lasting recovery.
Find the Right Mental Health Treatment Plan with Co-Occurring Secondary Addiction Diagnosis
During your rehabilitation, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.
Please, do not try to detox on your own. The detox process can be painful and difficult without medical assistance. It’s hard enough that you are struggling with liver disease. If you or someone you know regularly exceeds these recommended daily limits or is experiencing some early signs of liver disease like Alcoholic Hepatitis, it is important to intervene early.
Inpatient medical detox and residential primary addiction treatment may be available at our affiliated facility at Level Up West Palm Beach Rehab. For some primary behavioral health treatment clients, medical detox and or addiction rehab may be required first. If you have a co-occurring severe substance abuse diagnosis, please contact us prior to beginning inpatient mental health therapy. Treatment services may vary. Please call us to learn which treatment options are most suited for your individual needs.