Alcoholic Liver Disease: Alcoholic Hepatitis

Digestive Health

Dr Saravana.K

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, it can also occur in people who drink moderately.

What is known is that the process of breaking down alcohol produces highly toxic chemicals. These chemicals trigger inflammation that destroys liver cells. Over time, web-like scars replace healthy liver tissue, interfering with the liver’s ability to function. This irreversible scarring, called cirrhosis, is the final stage.

As many as 35 per cent of heavy drinkers develop alcoholic hepatitis and more than a third of them die within six months after signs and symptoms begin to appear.

Signs and Symptoms:

  • Nausea and vomiting
  • Abdominal pain and tenderness
  • Malnourished. Drinking large amounts of alcohol suppresses the appetite
  • Confusion and behaviour changes. A liver damaged by alcoholic hepatitis has trouble removing toxins from your body. The build-up of toxins can damage your brain, leading to changes in your mental state, behaviour and personality.
  • Jaundice.  Skin and the whites of your eyes turning yellow in colour.
  • Fluid retention. It can cause large amounts of fluid to accumulate in your abdominal cavity (ascites). The fluid may become infected and require treatment with antibiotics.
  • Scarred liver (cirrhosis). Cirrhosis frequently leads to liver failure, which occurs when the damaged liver is no longer able to adequately function.
  • Kidney failure
  • Vomiting blood or passing foul black coloured stool.

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.

When circulation through the portal vein is blocked, blood may back up into other blood vessels in the stomach and oesophagus. 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. It is a life-threatening emergency that requires immediate medical care.

Risk increases with the following:

  • Other types of hepatitis. Long-term alcohol abuse worsens the liver damage caused by other types of hepatitis, especially hepatitis C and B.
  • Malnutrition. Many people who drink heavily are malnourished and the lack of nutrients contributes to liver cell damage.
  • Obesity.
  • Genetic factors. Having mutations in certain genes that affect alcohol metabolism may increase your risk of alcoholic liver disease. The exact genetic associations have not yet been identified.
  • Alcohol use. The amount of alcohol consumed is the most important risk factor for alcoholic liver disease.
  • Your sex. Women have a higher risk of developing alcoholic hepatitis.

When to see a doctor

  • If you have any signs or symptoms of alcoholic hepatitis.
  • If you ever feel as though you can’t control or need help in cutting back on your drinking.

Your doctor would likely order the following tests to look for liver disease:

  • Liver function tests
  • Complete blood cell count
  • An ultrasound, CT or MRI scan of the liver
  • Blood tests to exclude other causes of liver disease.


  • Stop drinking alcohol
  • Treatment for malnutrition
  • Liver transplant if required: You would have to meet the requirements including abstaining from alcohol for six months prior to transplant and agreeing not to resume drinking afterward.


You may reduce your risk of alcoholic hepatitis if you:

  • Drink alcohol in moderation, if at all.
  • Protect yourself from hepatitis C and B.
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