Alcoholic Hepatitis – Diagnosis and Treatment
Diagnosis
Doctors look for signs like yellow skin or eyes (jaundice) and ask about the person’s history of drinking. They do a physical check-up and may speak with family members to get more information.
Tests often used include:
- Blood Work: Checks for liver function and inflammation.
- Imaging (Ultrasound, CT, MRI): Looks for liver damage, cirrhosis, or liver failure.
- Liver Biopsy: Doctors perform this when the diagnosis is unclear or other diseases are possible.
These steps help doctors spot alcoholic hepatitis and determine how much harm the liver has.
Treatment
Stopping Alcohol Use Completely
One of the most important steps in recovery is to stop drinking alcohol for good. Quitting alcohol can slow down or sometimes even reverse some liver damage.
People who do not quit face a much higher risk for serious health problems, including death.
Treatment for alcohol dependence may include:
- Medications to help control cravings.
- Counseling and behavioral therapy.
- Support groups such as Alcoholics Anonymous.
- Outpatient or inpatient programs for more help.
Doctors recommend seeking medical help to quit if you are dependent, because stopping suddenly can be dangerous. A healthcare provider can help make a safe plan for quitting.
Improving Nutrition and Treating Malnutrition
Many people with this condition do not get enough nutrients. Eating well is important for liver health and recovery. A registered dietitian can help create a diet plan high in calories, protein, vitamins, and minerals to address deficiencies.
If someone cannot eat enough food because of illness, doctors may use a feeding tube to deliver nutrient-rich drinks directly to the stomach. Important vitamins, such as thiamine, and other supplements may be included to fix shortages.
Key Recommendations:
| Nutrient | Why Important | How Given |
|---|---|---|
| Protein | Builds tissue | Diet or tube feeding |
| Thiamine & Vitamins | Prevents deficiencies | Oral supplements or tube |
| Calories | Supports healing | High-calorie meals |
| Sodium restriction | Reduces swelling | Diet adjustment |
Medicines to Control Liver Inflammation
Some patients need medicine to manage liver swelling and damage. Two options include:
Corticosteroids: These drugs can lessen liver inflammation and sometimes increase survival in severe cases. They are not safe for everyone, especially if a person has kidney failure, bleeding, or infection.
- Methylxanthine Derivative: If corticosteroids are not possible, doctors might try a medication from this class. It may help some, but researchers are still studying how well it works.
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Other Options: An antioxidant and glutathione precursor may also help when used with other treatments. The benefits are still being studied.
Your healthcare provider will decide if medication is right based on your overall health and test results.
Doctors may use tools like the Model for End-Stage Liver Disease (MELD) score or Lille score to evaluate who is likely to benefit most from medicine.
Organ Transplant for Severe Cases
If the liver is badly damaged and other treatments do not work, a liver transplant may be the only option. Surgeons replace the sick liver with a healthy one from a donor.
Transplant programs have rules that patients must follow. Most require a promise never to drink alcohol again. Doctors also carefully choose people for transplant to make sure they are likely to have good results.
List of Transplant Requirements:
- Long-term promise to avoid alcohol.
- Commitment to a recovery program.
- Meeting the medical teamโs standards.
Some people need to wait for a donor, and medical care and counseling provide support during this time.
Getting Ready for Your Visit
Steps You Can Take Before Your Visit
- Check for special instructions. Find out if you need to avoid food or drinks before any planned tests.
- Write down your symptoms. Note every symptom, including those that might not seem related, and record when they started.
- List all medications. Include all prescriptions, over-the-counter drugs, vitamins, and supplements, along with their doses.
- Prepare medical details. Gather information about other health conditions you have.
- Personal background. Write down any significant life changes, recent stress, or challenges.
- Document alcohol use. Keep track of how much alcohol you drink each day and be ready to share your drinking pattern.
- Prepare questions. Bring a list of questions for the healthcare provider.
- Bring support. Consider asking a family member or friend to come with you to help remember details.
A table can help organize this information:
| Item | Example |
|---|---|
| Symptoms | Ongoing fatigue, yellow skin |
| Medications & Supplements | Vitamin D 1000 IU daily, Ibuprofen |
| Other Conditions | Diabetes, high blood pressure |
| Recent Stress or Life Changes | Lost job, moved to a new area |
| Alcohol Use (over several days) | 3-4 drinks per night, mostly weekends |
Helpful Things to Ask Your Healthcare Provider
- What are the possible causes of my symptoms?
- Could I have another liver condition?
- Do I have liver scarring or damage?
- What tests do I need? Should I do anything to get ready for them?
- Is this a temporary issue or could it last a long time?
- What treatment options are available?
- How do I handle my other ongoing health problems?
Ask how the symptoms or condition may be linked to heavy alcohol use and about the benefits of joining an alcohol treatment program. Bring all your concerns about inflammation of the liver and alcohol consumption.
Questions Your Healthcare Provider May Ask
Healthcare providers often ask about current symptoms, whether they come and go, and what makes them better or worse. They may also ask:
- Have you had yellowing of your skin or eyes?
- Have you used any illegal drugs?
- Do you ever feel the need to cut down on drinking, or feel guilty about alcohol use?
- Has your drinking led to problems with family, friends, or the law?
- Do you become upset when someone mentions your drinking?
- Do you ever drink first thing in the morning?
