Alcoholic hepatitis Symptoms Causes Diagnosis And Treatment and ALTERNATIVE MEDICINE

DEFINITION

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, the relationship between drinking
and alcoholic hepatitis is complex. Not all heavy drinkers develop
alcoholic hepatitis, and the disease can occur in people who drink
only moderately.

SYMPTOMS

Yellowing of the skin and whites of the eyes (jaundice) and
increasing girth (due to fluid accumulation) are the most common
signs of alcoholic hepatitis that lead people to seek medical care.
People may also complain of:
Loss of appetite Nausea and vomiting Abdominal pain and
tenderness Weight loss

CAUSES

Alcoholic hepatitis occurs when the liver is damaged by the
alcohol you drink. Just how alcohol damages the liver -— and
why it does so only in a minority of heavy drinkers — isn't clear.
What is known is that the process of breaking down ethanol —
the alcohol in beer, wine and liquor — produces highly toxic
chemicals, such as acetaldehyde. These chemicals trigger
inflammation that destroys liver cells. Over time, web-like scars
and small knots of tissue replace healthy liver tissue, interfering
with the liver's ability to function. This irreversible scarring,
called cirrhosis, is the final stage of alcoholic liver disease.
Risk increases with time, amount consumed
Heavy alcohol use can lead to liver disease, and the risk
increases with the length of time and amount of alcohol you drink.
But because many people who drink heavily or binge drink never
develop alcoholic hepatitis or cirrhosis, it's likely that factors other
than alcohol play a role. These include:
Other types of hepatitis. Long-term alcohol abuse worsens the
liver damage caused by other types of hepatitis,
especially hepatitis C. If you have hepatitis C and also drink —
even moderately — you're more likely to develop cirrhosis than if
you don't drink.Malnutrition. Many people who drink heavily are
malnourished, either because they eat poorly or because alcohol
and its toxic byproducts prevent the body from properly absorbing
and breaking down nutrients, especially protein, certain vitamins
and fats. In both cases, 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 as well as of alcohol-associated cancers
and other complications of heavy drinking. The exact genetic
associations have not yet been identified.

TESTS AND DIAGNOSIS

Identifying alcoholic liver disease depends on two main things:
Evidence of excessive alcohol consumptionEvidence of liver
disease
Alcohol consumption
Your doctor will want to know about your history of alcohol
consumption. It is important to be honest in describing your
drinking habits. Your doctor may ask to interview family members
about your drinking. Many people will have signs of chronic
alcoholism, such as skin lesions known as spider nevi.
Liver disease
Your doctor will likely order the following tests to look for liver
disease:
Liver function tests (including international normalized ratio, total
bilirubin, and albumin)Complete blood cell countAn ultrasound,
CT or MRI scan of the liverBlood tests to exclude other causes
of liver disease

TREATMENTS AND DRUGS

Stop drinking alcohol
If you've been diagnosed with alcoholic hepatitis, you must stop
drinking alcohol. It's the only way of possibly reversing liver
damage or, in more advanced cases, preventing the disease
from becoming worse. Many people who stop drinking have
dramatic improvement in symptoms in just a few months.
If you continue to drink alcohol, you're likely to experience serious
complications.
If you are dependent on alcohol and want to stop drinking, your
doctor can recommend a therapy that's tailored for your needs.
This might include medications, counseling, Alcoholics
Anonymous, an outpatient treatment program or a residential
inpatient stay.
Treatment for malnutrition
Your doctor may recommend a special diet to reverse nutritional
deficiencies that often occur in people with alcoholic hepatitis.
You may be referred to a dietitian who can help you assess your
current diet and suggest changes to increase the vitamins and
nutrients you are lacking.
If you have trouble eating enough to get the vitamins and
nutrients your body needs, your doctor may recommend tube
feeding. This may involve passing a tube down your throat and
into your stomach. A special nutrient-rich liquid diet is then
passed through the tube.
Medications to reduce liver inflammation
Your doctor may recommend corticosteroids drugs if you have
severe alcoholic hepatitis. These drugs have shown some shortterm
benefit in increasing survival. Steroids have significant side
effects and are not recommended if you have failing
kidneys, gastrointestinal bleeding or an infection. About 40
percent of people do not respond to corticosteroids. Your doctor
may also recommend pentoxifylline, especially if corticosteroids
don't work for you. Some studies of pentoxifylline have shown
some benefit, others have not. You might also ask about clinical
trials of other therapies.
Liver transplant
For many people with severe alcoholic hepatitis, liver transplant
is the only hope to avoid death. Survival rates for liver transplant
for alcoholic hepatitis are similar to those for other forms of
hepatitis, greater than 70 percent five-year survival.
However, most medical centers are reluctant to perform liver
transplants on people with alcoholic liver disease because of the
fear they will resume drinking after surgery. For most people with
alcoholic hepatitis, the disease is considered a contraindication
for liver transplantation in most transplant centers in the U.S.
For transplant to be an option, you would need to find a program
that will consider you.

ALTERNATIVE MEDICINE

No alternative medicine treatments have been found to cure
alcoholic hepatitis. Some herbs and supplements are touted as
treatments for liver diseases. Herbs and supplements can't
replace your doctor's treatments or abstaining from alcohol. If
you'd like to try supplements, talk to your doctor about the risks
and benefits first.
Milk thistle
The leaves and seeds of the milk thistle plant are thought to
control inflammation in the liver. Milk thistle supplements are a
popular alternative treatment among people with liver disease.
But studies haven't found a benefit for people with alcoholic liver
disease who take milk thistle supplements.
Milk thistle is generally safe, but can cause diarrhea and nausea.
Talk to your doctor about milk thistle if you're considering taking
this supplement. Because milk thistle can interfere with
prescription medications, ask your doctor whether it's safe for you
SAMe
SAMe is a supplement that's thought to reduce liver inflammation
and help the liver repair itself. Your body naturally makes SAMe.
Some evidence suggests people with liver disease have a
deficiency of SAMe. In theory, taking a SAMe supplement might
restore levels of the substance in the liver. But there is insufficient
evidence to recommend use of SAMe for alcohol-related liver
disease.
SAMe is generally safe when taken as a supplement. Side effects
may include gas, nausea, vomiting and diarrhea. Because SAMe
can interfere with prescription medications, ask your doctor about  
whether SAMe is safe for you to take.