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Alcoholic Hepatitis: Its Signs & Symptoms

Alcoholic Hepatitis

Alcoholic Hepatitis: Its Signs & Symptoms

Hepatitis is an inflammation of the liver. That’s pretty much common knowledge. Less commonly known is you don’t necessarily need a virus to get an inflamed liver. That’s right. Chronic alcohol consumption can also do the trick. It can help open the door to Hepatitis C too. When it does, you’ve got Alcoholic Hepatitis.

Let’s be clear. Chronic alcohol consumption doesn’t cause hepatitis C (HCV). You need to be exposed to infected blood to actually contract the infection. Nevertheless alcoholic-level drinking almost certainly will raise the risk of acquiring HCV. That’s what the good folks at Medical News Today say anyway. So do the equally good people at the National Institute on Alcohol Abuse and Alcoholism. And they both have the knowhow to back it all up.

Calling Dr. Lieber

That’s largely thanks to the late great Dr. Charles S. Lieber. The Belgium-born American was the bright mind behind the original research warning of alcoholic hepatitis. And he also held the pen that then wrote it all up for the world.

The good Dr. Lieber was both chief of the Section of Liver Disease & Nutrition in the Bronx VA’s Alcohol Research Center and a professor of medicine and pathology at New York’s Mt. Sinai School of Medicine. In other words, he knew a thing or three about a thing or three. One of those things was the effects of alcohol consumption on the human body. It was Dr. Lieber who “established that excess alcohol consumption can cause cirrhosis of the liver even in subjects who have an adequate diet.” Sounds like a no brainer right? Wrong. At the time Dr. L’s conclusion actually contradicted scientific opinion.

That didn’t prevent the driven clinical nutritionist from carrying on with the show though. Quite the contrary. Not only did Dr. Lieber continue digging into chronic alcohol consumption, but back in 1977 he pushed the National Council on Alcoholism and Drug Dependence (NCADD) to create the journal Alcoholism: Clinical and Experimental Research. That journal, which “provides direct access to the most significant and current research findings on the nature and management of alcoholism and alcohol-related disorders,” is still published today.

Dr. Lieber had an even longer relationship with the National Institutes of Health. In fact, the NIH gave him his very first grant (in 1963). They also published the paper on alcoholic hepatitis that stokes this post. (Through the NIAAA, natch, but you get the gist.)

The good doctor found that HCV had become a leading cause of fibrosis and cirrhosis of the liver in the United States. No small thing considering HCV-related cirrhosis (with its associated complications, such as liver cancer) is a major cause of death in this country. Dr. L also found that alcohol can exacerbate HCV infection, promoting fibrosis, and accelerating the disease’s progression to cirrhosis. Even worse, alcohol may also exacerbate the side-effects associated with HCV treatment and impair the body’s immune defense against the virus. That means alcohol helps you get HCV, then helps prevent you from treating HCV too.


The kicker is that only a minority of the HCV-infected people who didn’t drink ever progressed to severe liver disease. Naturally those folks didn’t require antiviral treatment either. It all made perfect sense to Dr. Lieber. After all, “alcohol potentiates the fibrosis- and cancer-inducing actions of HCV.”


Alcoholic Hepatitis

Back to Medical News Today’s most helpful breakdown:

Alcoholic hepatitis is a severe consequence of alcohol abuse, says the MNT Team. Abuse that generally lasts at least 20 years. MNT also says that chronic drinkers can contract the disease even if they never contracted HCV.

But can hepatitis C and alcoholic hepatitis coexist?

Not only can the two coexist, a 2018 article in Alcohol and Alcoholism claims it’s quite common for the conditions to coexist. When that happens, the damage rate rises accordingly. Even small amounts of alcohol can exacerbate HCV. Larger amounts can cause the virus to become resistant to medication.

As for just who’s most at risk, well, MNT says alcoholic hepatitis is especially common in those who drink large amounts of alcohol, drink outside of mealtimes and have malnutrition. In other words, your garden variety alcoholic.

Symptoms & Diagnosis

Alcoholic hepatitis is sneaky. Real sneaky. The World Health Organization (WHO) claims around 80% of people with HCV don’t even show symptoms after contracting the initial infection. So they may not even realize they’ve got HCV until it becomes chronic and causes liver damage.

There are symptoms to be on the lookout for though, including fever, fatigue, low appetite, abdominal and joint pain, nausea and vomiting, dark-colored urine and grey feces, and jaundice.

Remember though: HCV IS CONTAGIOUS. If a person is unsure if they have contracted the infection, they should take safety precautions to prevent others from coming into contact with their blood. In fact, everyone should take safety precautions, regardless. That’s especially important for those involved in high risk behavior.

As for diagnosis, well, there really isn’t any surefire way to diagnose alcoholic hepatitis. HCV can be tested for, of course, via blood tests. But since there’s no test for alcoholic hepatitis, doctors must base their diagnosis on a person’s alcohol consumption history and whether or not there are symptoms of liver disease. Doctors can also conduct CT or MRI scans, which help rule out other causes of liver disease and help identify cirrhosis, as well as enzyme liver function tests. They can also conduct a biopsy to assess the severity of fat and fibrosis in the liver.

Living with Alcoholic Hepatitis

How does one treat alcoholic hepatitis? In short, you don’t. Chronic HCV can be treated using direct-acting antiviral drugs. Alcoholic hepatitis has no such thing. But if you’ve got HCV and are undergoing treatment, you can stop drinking. In fact, it’s highly recommended that you immediately cease all alcohol consumption. Everything. Again, even small amounts of alcohol can both exacerbate the condition and interfere with the treatment.

The only even kinda cure for alcoholic hepatitis is to stop drinking now. And though abstinence isn’t a guarantee the damage can be undone, you can definitely mitigate the damage. You can help your all around health too.

One of the most sensible things to do is to overhaul your nutrition program. The Med News Today team recommends seeing a dietician so you can put together a sound plan that addresses your particular needs. Healing Properties recommends seriously upping your nutritional game too. Only a reputable professional can fully outfit you for a fulfilling life change. And revamping your nutritional program will certainly change your life.

The MNT folks do make a few high protein suggestions of their own though too. That includes meat, fish, and seafood, nuts and beans, milk, cheese, eggs, and yogurt, plus whole grains, such as oatmeal, brown rice, and whole grain bread. A diet like that sounds healthy and delicious (and sensible) no matter what ails you.

Mostly though, “anyone who suspects they may have a liver condition should speak with a doctor as soon as possible.” That’s straight from Medical News Today. “The sooner a healthcare professional diagnoses liver conditions,” they continue, “the earlier treatment can begin. This may reduce the risk of permanent liver damage and complications.”

We concur wholeheartedly.

Get it? Seeking treatment is imperative if even you suspect your liver has been compromised, by alcohol or otherwise. Your life just may depend upon it.

Speaking of lives… Do you have a problem with drugs? Alcohol? Is addiction interfering with your work? Your family? Your life? Could you use some help? There are a lot of reputable outfits out there you know. Good, solid people who are ready, willing and eager to assist. You can reach then through the National Institute on Drug Abuse (NIDA). You can reach them through the Substance Abuse and Mental Health Services Administration (SAMHSA). And you can reach them through us. Heck, we may even be the kind of outfit you’re seeking. If, that is, you happen to be seeking a sober home with nearly two decades of experience. Either way, pick up the phone and call someone. Please. You’ll be happy that you did. Damn happy.

(Image Courtesy Wikimedia Commons)

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