Alcoholic hepatitis warning: watch how much alcohol you drink
2 minutes read
- There is no safe amount of alcohol; less is more, says hepatologist.
- 28 July has been designated World Hepatitis Day.
July 2024.- The liver is a vital organ that processes nutrients, filters the blood and fights infections; it has many functions and many ways of being damaged, explains hepatologist Shreya Sengupta.
The liver can become inflamed because of toxins, medicines, autoimmune hepatitis or viral infections. Drinking alcohol without moderation can also damage its tissue.
Acute alcohol-induced hepatitis may be just a temporary response to excessive drinking, but when it becomes chronic, it threatens to cause permanent liver damage, says Dr. Sengupta, medical director of the multidisciplinary alcohol programme in Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition.
There is no single formula that leads to alcohol-induced hepatitis. Some people are more sensitive and their livers react even to moderate drinking, while others can drink more without developing hepatitis. Genetic differences may partly explain this; people with a family history of alcohol use disorder or liver disease may be at greater risk.
The Cleveland Clinic specialist says that, looking at definitions of how much alcohol is enough to cause damage, experts put it at 40 grams of alcohol for women and 60 grams for men, as men can tolerate more.
“There’s probably no safe amount of alcohol that we’ve been able to define. Everyone has their own risk, and probably at the end of the day, less is more,” says Dr. Sengupta.
The signs and symptoms of alcohol-associated hepatitis can be very non-specific, which sometimes makes it a little difficult to diagnose. But the more specific symptoms are weight gain, particularly abdominal swelling, abdominal distension due to fluid in the abdomen called ascites, and then, counter-intuitively, weight loss, not of fat but of muscle mass.
Speaking on the Butts and Guts podcast, the specialist said patients may have jaundice or scleral icterus, a yellowing of the skin or eyes, as well as very particular skin rashes.
Diagnosis
The specialist will start by asking about your medical history, including your alcohol use, and will examine you for signs of damage to the organs involved. This may include a series of tests, such as blood tests, imaging tests and a liver biopsy.
Blood and urine tests to detect alcohol are increasingly common. Imaging tests are used to visualise the liver and look for signs of inflammation and damage, and a liver biopsy can be done by taking a sample of liver tissue through a hollow needle inserted into the liver.
Treatment
Treatment for alcoholic hepatitis includes stopping drinking alcohol. This is the first and most important step. Medicines are sometimes prescribed, but there are very clear guidelines on when steroids should be prescribed. Patients must meet the criteria for severe alcoholic hepatitis, have no infection or bleeding and have no kidney damage.
In addition, GCSF and other medicines approved by the FDA for other conditions are being studied. In the short term, there will be more medical options besides steroids.