Alcoholic hepatitis

Alcoholic Hepatitis: Liver Inflammation Linked to Alcohol Abuse

Alcoholic hepatitis is an inflammatory condition of the liver caused by excessive alcohol consumption. It is characterized by liver cell death, immune cell infiltration, and the presence of Mallory bodies within liver cells. This article explores the pathophysiology, symptoms, diagnosis, treatment, and potential progression of alcoholic hepatitis.

Introduction

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A liver biopsy showing characteristic features of alcoholic hepatitis, including Mallory bodies.

Alcoholic hepatitis is a serious and potentially life-threatening condition. It occurs after years of heavy drinking and is part of a spectrum of alcohol-related liver diseases that can eventually lead to liver cirrhosis and liver failure.

Pathophysiology

The pathogenesis of alcoholic hepatitis involves:

• The metabolism of alcohol to toxic compounds that directly damage hepatocytes (liver cells)
• The induction of an inflammatory response in which neutrophils infiltrate the liver tissue
• The accumulation of Mallory bodies, which are abnormal protein aggregates within liver cells

Symptoms

Symptoms of alcoholic hepatitis may include:

• Jaundice (yellowing of the skin and eyes)
• Abdominal pain and swelling
• Nausea and vomiting
• Fever
• Fatigue

Diagnosis

Diagnosis is based on a combination of medical history, physical examination, blood tests, imaging studies, and sometimes liver biopsy. Key tests include liver function tests, complete blood count, and imaging modalities like ultrasound or CT scans.

Treatment

Treatment for alcoholic hepatitis includes:

• Cessation of alcohol intake
• Nutritional support
• Medications to reduce liver inflammation, such as corticosteroids
• Management of complications, such as infections and kidney dysfunction

Prognosis and Progression

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Liver cirrhosis, a potential outcome of untreated alcoholic hepatitis.

The prognosis of alcoholic hepatitis varies with its severity. Mild forms may be reversible with abstinence from alcohol, while severe cases can progress to liver cirrhosis and necessitate consideration for liver transplantation.

Prevention

Prevention of alcoholic hepatitis is centered on the moderation of alcohol intake, education on the risks of heavy drinking, and early intervention in cases of alcohol abuse.

Conclusion

Alcoholic hepatitis is a preventable condition that requires a high index of clinical suspicion for timely diagnosis and management. With appropriate treatment and lifestyle modifications, patients can often recover liver function and avoid progression to cirrhosis.

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