Alcoholic hepatitis is a reversible inflammatory condition for many people who stop drinking, but it can lead to permanent liver damage or death in severe cases.

Excessive alcohol use contributes to mental and physical health effects. Some are short-term, while others can be chronic. One possible effect is alcoholic hepatitis. Alcoholic hepatitis is an inflammatory condition lasting weeks or months3 for most people. The condition may lead to2 alcoholic cirrhosis, which is permanent. Alcoholic hepatitis can differ in how long it lasts and its severity. For most patients, it’s mild. However, severe alcoholic hepatitis puts some people at risk of early death1.

What Is Alcoholic Hepatitis?

Alcoholic hepatitis is an inflammatory liver injury2 that progresses if someone doesn’t stop drinking or receive treatment. The liver condition is associated with long-term, heavy alcohol use and is part of alcoholic liver disease (ALD). Alcoholic hepatitis occurs because the liver can no longer balance inflammation properly15. Alcoholic hepatitis is not related to infectious hepatitis. 

If someone continues to drink after they have alcoholic hepatitis, it will usually progress to cirrhosis. Typically, before someone has alcoholic hepatitis, they’ll have fatty liver disease or steatosis16 stemming from ongoing heavy alcohol use. Alcoholic hepatitis is considered a severe syndrome related to ALD. The symptoms have a rapid onset.

Symptoms of Alcoholic Hepatitis

A person with alcoholic hepatitis may present with symptoms including4:

  • Fever (usually low-grade)
  • Upper right abdominal pain or discomfort
  • Abdominal tenderness
  • Jaundice (yellowing of the skin and the whites of the eyes)
  •  Nausea
  • Vomiting
  • Fatigue
  • Weakness

In severe instances4 of alcoholic hepatitis, symptoms can also include:

  • Ascites (accumulation of fluid in the abdomen)
  • Confusion or changes in behavior because of toxin buildup
  • Kidney and liver failure

Risk Factors for Alcoholic Hepatitis

Risk factors2 that can make it more likely for someone to develop alcoholic hepatitis include:

  • Heavy, long-term alcohol use
  • Being a woman
  • Obesity
  • Genetic factors
  • Race and ethnicity4 — black and Hispanic people may be at higher risk
  • Patterns of binge drinking

Diagnosing Alcoholic Hepatitis

Since alcoholic hepatitis can look different in every patient, the diagnosis is usually clinical5. For a diagnosis of alcoholic hepatitis, a person must have acute-onset jaundice and lab abnormalities relating to liver function. They will also have a history4 of alcohol use. Usually, for a diagnosis, someone would have consumed an average of three standard drinks a day as a woman or four a day as a man for years. A liver biopsy would likely only be used if the diagnosis wasn’t clear from clinical signs and symptoms.

Blood and lab tests6 can be used to make a diagnosis of alcoholic hepatitis or determine whether someone has an acute or chronic liver disorder and include:

  • Serum bilirubin: This measures the bilirubin level in someone’s blood. The liver produces bilirubin and excretes it in bile. High levels may show the liver is having problems processing bile.
  • Serum albumin: It’s a protein used to measure blood levels of albumin, which is produced in the liver.
  • Serum alkaline phosphatase: This measures the alkaline phosphatase level in the blood. This enzyme is found in high concentrations in the liver and can help assess liver function.
  • Serum aminotransferases: This lab test measures an enzyme released when liver cells are damaged.
  • Alanine transaminase (ALT): This test measures an enzyme released into the blood after acute damage to liver cells. This test can help assess liver function and evaluate how well treatments for acute liver disease work.
  • Aspartate transaminase (AST): This test measures the level of an enzyme released into the bloodstream during liver or heart problems.

Potential Complications of Alcoholic Hepatitis

Complications of alcohol hepatitis can include2:

  • Hepatic encephalopathy7: A nervous system disorder stemming from severe liver disease. When toxins build up in the body, they can travel to the brain, affecting its function and causing cognitive impairment.  
  • Variceal bleeding8: When the liver is damaged, it can raise blood pressure in the portal vein. The liver can’t filter blood effectively because inflammation is increasing blood pressure. This can strain blood vessels; they can swell and bleed, leading to internal bleeding. 
  • Malnutrition:9 When liver function is affected, it impacts how food is absorbed, which can lead to malnutrition.
  • Ascites10: A buildup of fluid in the abdomen can happen when the liver isn’t working properly. Ascites can cause problems with breathing and discomfort.
  • Cirrhosis11: A progressive disease, scar tissue begins to replace healthy liver cells, affecting the liver’s function over time.
  • Liver cancer12: Alcohol is associated with a higher risk of many types of cancer, including liver cancer.
  • Organ failure13: When the liver is damaged, it can also affect blood flow reaching the kidneys.

Is Alcoholic Hepatitis Reversible?

Alcoholic hepatitis is usually only reversible if you stop drinking permanently. Severe alcoholic hepatitis can be life-threatening. However, if someone stops drinking immediately and receives supplemental vitamins and minerals to replace lost nutrition9, their outlook can be good. If someone is diagnosed with a liver condition when some scar tissue has already formed, but they completely stop alcohol use from that point on, inflammation in the liver will dissipate, and the liver will regain15 as much function as possible. However, liver damage becomes irreversible at a certain point and can lead to liver failure, cancer or death.

Alcoholic Hepatitis Treatment

The primary treatment for alcoholic hepatitis is to stop drinking completely. Some people may need an alcohol addiction treatment program to do so. If a person has mild alcoholic hepatitis, no specific treatment3 or hospitalization may be needed. However, someone with severe alcoholic hepatitis is at high risk of death and may need treatments that can reduce liver injury and help the liver regenerate. Medications to stop inflammation might also help, such as corticosteroids3. Nutritional support is important in treating alcoholic hepatitis. If someone isn’t responsive to steroids5 or other treatments, they may be considered for a liver transplant3, but many programs don’t offer transplants to patients with alcoholic hepatitis.

Seek Help for Alcohol Abuse and Addiction

Once you notice symptoms3 of liver problems, there may already be a fair amount of damage to your liver. It’s always best if you can proactively stop drinking before extensive damage. We understand it’s not easy to stop drinking and can teach you how to live an alcohol-free life. Our evidence-based alcohol addiction treatment can help you overcome alcohol in a comfortable environment. Contact our team at The Recovery Village Cherry Hill at Cooper today to learn more and get started.

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Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
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Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more
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Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.