Alcoholic Hepatitis

An acute inflammation of the liver caused by excessive alcohol intake. It’s characterised by liver dysfunction and hepatocellular necrosis.

• Typically seen in individuals with a long history of high alcohol intake.
• Amount and duration of alcohol intake, genetics, and diet can influence susceptibility.

• Rapid onset jaundice.

• Anorexia, nausea, and vomiting.

• Abdominal pain (usually in the right upper quadrant).

• Fever.

• Hepatomegaly.

• Ascites and signs of liver failure in severe cases.

• Blood tests: Raised bilirubin, raised transaminases (with AST typically greater than ALT, often in a 2:1 ratio), elevated gamma-glutamyltransferase (GGT), and leucocytosis.
• Alcohol levels: Might be elevated.

• Liver biopsy: Gold standard for diagnosis but not always necessary; shows hepatocyte ballooning, neutrophil infiltration, and Mallory bodies.

• Imaging: Ultrasound or CT may show hepatomegaly and exclude other pathologies.

• Abstinence from alcohol: Primary intervention and is essential for improvement.

• Corticosteroids: Used for severe alcoholic hepatitis, reduces inflammation; typically prednisolone.

• Nutritional support: Many patients are malnourished.

• Supportive care: Addressing complications like ascites, encephalopathy, and bleeding varices.

• Maddrey’s discriminant function: A score to determine severity and prognosis.

• Continued alcohol consumption has a poor prognosis.

• Abstinence can lead to complete recovery or progression to cirrhosis in some cases.

• Liver failure

• Portal hypertension

• Hepatic encephalopathy

• Ascites

• Variceal bleeding