Dr. M.J. Bazos, MD Patient Handout

HEPATITIS, ALCOHOLIC

About Your Diagnosis

Alcoholic hepatitis is caused by excessive and chronic alcohol use. It is the first phase of alcoholic liver disease. It progresses to fatty liver and cirrhosis if alcohol abuse continues. A history of alcohol abuse is the key to diagnosis. Yet drunkenness is not needed for the development of the disease. To confirm the diagnosis a liver biopsy can be done. The disease usually affects those older than 30 years. The incidence is 3 cases per 10,000 individuals. The recovery is slow. It may take weeks to months for the liver to heal. If cirrhosis has developed, the liver may not be able to recover.

Living With Your Diagnosis
The symptoms of alcoholic hepatitis may not appear until the disease is severe. The symptoms are similar to those of viral hepatitis. The first symptoms may be a variety of rashes, joint pains, and other “flulike” symptoms. Finally jaundice, a yellow color to the skin or whites of the eyes, may be noted. The jaundice results from the excess bilirubin in the blood. The excess bilirubin can also lead to other symptoms such as pale or clay-colored stools, dark urine, and generalized itching. The symptoms of severe disease include high fever and enlargement of the liver, ascites (abdominal swelling caused by fluid), mental confusion, and coma. Because of the drinking of alcohol, the individual may be malnourished.

Treatment
The treatment of alcoholic hepatitis is supportive. The key to healing is to stop drinking alcohol. Working with an alcohol rehabilitation program is important in assisting with this. Dietary support is the treatment for malnurishment. The recommended diet is high in carbohydrates and calories. The nutritional status may be so severe that intravenous feedings are necessary. Salt (sodium) restriction may also be necessary to prevent ascites. Also needed is vitamin supplementation, especially B1 and folic acid.

The DOs
• Stop drinking.
• Eat a well-balanced diet. Protein may need to be avoided in the diet because the liver may not be able to break it down.
• Modify activity according to the symptoms. A good fitness program may help with the fatigue.
• Seek treatment for your alcohol problem.

The DON’Ts
• Avoid alcohol.
• Avoid medications that can be harmful to the liver such as acetaminophen, sedatives, and tranquilizers.

When to Call Your Doctor
• If you need help stopping drinking.
• If symptoms suggestive of alcoholic hepatitis develop.
• If symptoms develop after prolonged or heavy drinking.

Websites:
www.niddk.nih.gov
nddic@aerie.com