Alcoholic Hepatitis

Alcoholic Hepatitis
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Alcoholic hepatitis is one among four types of liver disease namely, alcoholic fatty liver, alcoholic cirrhosis and hepatocellular carcinoma (Talley, Locke, & Saito, 2008). It is a liver condition caused by excessive consumption of alcohol over a prolonged period of time. However, the condition also occurs among people who consume moderately. The condition affects the liver because it the organ that is most involved for biotransformation of alcohol. It is unfortunate that scientists have been unable to categorically indicate just how much exposure is enough to trigger the onset of alcoholic hepatitis (Doweiko, 2009). It is important to note that chronic alcohol dependency increases the chances of liver disease. Studies have indicated that the amount and duration of consumption, directly affects the type and level of alcoholic hepatitis. It also indicates that since alcoholics consume alcohol more than average alcohol consumers, they are at greater risk for alcoholic hepatitis (Talley, Locke, & Saito, 2008).
The disease is a known major cause of death particularly in the first world. Statistics indicate that the death rate for people with the disease is up to 20% to 65% of people suffering from alcoholic hepatitis. This occurs despite the patients’ access to the highest quality medical care (Doweiko, 2009). Alcoholic hepatitis is a preventable liver disease and health care professional are always encouraged to consistently advise their patients against chronic and excessive alcohol consumption behaviour (Talley, Locke, & Saito, 2008).
As noted above, the liver disease is lethal because it builds up slowly without the patients’ notice. It then presents itself at advanced level and people need to be sensitized about it to ensure prevention. Liver disease may go undetected for a long duration as it often starts without overt symptoms (Palmer, 2004). Efforts to educate the masses about how the disease occurs and how to prevent it must be undertaken. This is with the assumption that people refrain from unhealthy drinking habits when they are aware of the causes and effects.
It is known that when people with alcoholic fatty liver continue consuming alcohol, they end up developing alcoholic hepatitis which is a more advanced liver disease. Alcoholic hepatitis usually manifests with a low grade fever, malaise, jaundice, enlarged and tender liver as well as dark urine. The disease may also present with stomach pain (Doweiko, 2009). The best indication of alcoholic hepatitis is an enlarged liver while angiomas, gynecomatsia, ascites and ethanol intoxication are indicative of chronic liver disease (Burket, 2008).
Statistics indicate that about 20% of alcoholic hepatitis patients develop liver cirrhosis. When this condition develops and the patient continues consuming alcohol, the cells in his or her liver die and scar tissue replaces them. The scar tissues do not function and as they increase, the liver’s ability to cleanse blood is compromised. This in turn causes the body to be saturated with toxins which have debilitating effects such as ammonia on the central nervous system (Doweiko, 2009).
According to the Institute of Human Virology, nausea, weight gain due to fluid retention, confusion, excessive thirst, fatigue, and dry mouth are some of the other symptoms of the liver disease. It is also noted that vomiting blood, black or tarry bowel movements, rapid heart rate while rising to standing position, breast development in males, moodiness, hallucinations, impaired short term and long term memory are symptoms associated with the disease (Institute of Human Virology).
Patients may also develop anorexia, swelling of the abdomen and legs, loss of libido and irregular menses in women. Other symptoms may include skin changes such as spider nevi, palmar erythema and angiectases. There may also be evidence of insufficient vitamins in the body. There may be occasional stretching in the thorax and abdomen and patients may also experience delirium and coma (Swanson, 2008). Many alcoholic hepatitis patients lose weight due to nausea and anorexic symptoms. The fever experienced is due to the damage of the liver.
Alcoholic hepatitis is known to interfere with normal metabolism and as a result, patients may experience jaundice. This occurs when the hepatocyte in the liver fails to sift bilirubin. Bleeding may also occur when hepatocytes fail to synthesize clotting factors. Patients presenting with mental confusion do so because of the ammonia toxin which the liver fails to metabolize and it reaches the central nervous system. Estrogen is usually metabolized by the liver and when the metabolism is ceased, patients may present with spider angiomas as well as gynecomastia (Burket, 2008).
According to Swanson, there is a variable prognosis of Alcoholic hepatitis. He notes that a large number of patients develop only an acute illness. He however indicates that out the acute cases, about 10% to 15% die (2008). In case patients continue with drinking, their life expectancy is lowered (Institute of Human Virology). It is also important to note that alcoholic hepatitis in patients who don’t develop cirrhosis may be reversed (Burket, 2008). Encephalopathy, spider angiomata, ascites, renal failure, prolonged PT and a bilirubin concentration that is higher than 20 mg/dl is indicative of a poor prognosis (Ghosh, 2010).
Healing for alcoholic hepatitis is slow and the general mortality is between 10% and 20%. Many patients take between 2 and 8 months before complete recovery after alcohol abstinence. It has been noted that the disease accelerates after the initial days despite the initial degree of the symptoms (Avunduk, 2008).
When making a diagnosis for alcoholic hepatitis, it is important to consider its possibility in patients with prolonged regular exposure to alcohol use. After this, confirmation and an evaluation of the level of the liver’s injury which is done through a biopsy....