Alcoholic hepatitis is inflammation of the liver usually due to heavy drinking. However, it can occur in people who drink only moderately. And sometimes those who drink heavily over many years never develop alcohol hepatitis.

If not treated and if heavy drinking continues, alcoholic hepatitis can progress to cirrhosis-the disease of the liver that can cause a number of serious health problems and eventually lead to death.

Symptoms

  • Loss of Appetite
  • Liver enlargement
  • Abdominal pain
  • Yellowing of the skin and whites of the eyes (jaundice)
  • Nausea and vomiting
  • Fever
  • Mental confusion
  • Fatigue
  • Abdominal swelling from fluid accumulation

Causes
With alcoholic hepatitis, a person's liver is damaged, usually by excessive long-term drinking. However, even moderate drinkers can get alcoholic hepatitis so the exact effects of alcohol on the liver on not entirely clear.

Experts do know that as ethanol, which occurs in wine, beer and liquor, is broken down, toxic chemicals such as acetaldehyde are produced. These chemicals inflame the liver's cells leaving scars that replace healthy liver tissue. This scarring over time builds up and interferes with the liver's functioning.

Risk Factors
Genetic factors. The presence of gene mutations could affect your alcohol metabolism and increase your risk of alcoholic hepatitis.

Other types of hepatitis. If you are a long-term heavy drinker and you have other types of hepatitis like Hepatitis C, you are more likely to develop cirrhosis than if you did not drink.

Malnutrition. Heavy drinkers are often malnourished because of poor eating habits or the effects of alcohol on the liver's ability to process vitamins, minerals and nutrients. Both cases can cause liver cell damage.

Complications
A number of complications can arise from an alcoholic hepatitis liver.

Increased portal vein blood pressure. Blood flows from the intestine, spleen and pancreas to the liver via a large blood vessel called the portal vein. But a damaged and scarred liver can slow the circulation of blood causing a back up in the portal vein. This can lead to increased pressure and what's known as portal hypertension.  

Enlarged veins (varices). If blood circulation is obstructed in the portal vein, other smaller veins and blood vessels in the stomach and esophagus can become blocked. These thin-walled blood vessels can start to bleed. And severe bleeding becomes a life-threatening emergency room visit.

Fluid retention. A liver with alcoholic hepatitis can accumulate large amounts of fluid in the abdominal cavity (ascites). This fluid while not life-threatening can become infected and require treatment with antibiotics.

Bruising and bleeding occurs when alcoholic hepatitis interferes with the production of proteins that help your blood to clot.

Jaundice occurs when your liver is not able to remove bilirubin - the residue of old red blood cells - from your blood. The bilirubin builds up and is deposited in your skin causing a yellowish color.

Hepatic encephalopathy occurs when the damaged liver has trouble removing toxins from the body. These toxins can eventually damage your brain, leading to changes in your behavior and personality.

According to the Mayo Clinic, "Signs and symptoms of hepatic encephalopathy include forgetfulness, confusion and mood changes, and in the most severe cases, coma."

For someone who has been drinking a lot over a long period, the liver can become severely scarred leading to cirrhosis. This is usually irreversible and can lead to liver failure.

Testing for Alcoholic Hepatitis
The liver is the second largest organ in the body. It performs a number of vital activities for the body's functioning. As such, it can become infected by causes ranging from environmental toxins to viral infections. To reach a diagnosis, a doctor will likely follow these testing procedures.

  • Perform a physical exam and ask about your health history including alcohol use.
  • A blood test will determine levels of liver-related enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
  • An ultrasound of the liver can provide images to determine/rule out problems.
  • A liver biopsy - where a small tissue sample is removed from your liver - can determine problems.

Treatments
Medications such as corticosteroids and pentoxifylline can control liver inflammation.

In certain situations, you may need a liver transplant. This may be the only option for those with a severely impaired liver.

However, a liver transplant for those with alcoholic liver disease is controversial for several reasons: The number of patients far exceeds the number of available livers. And some in the medical community are reluctant to perform a transplant for someone who may go back to drinking after surgery. They also worry these patients will require more care than the average liver transplant patient.

Many hospitals require transplant candidates to be sober for at least six months prior to surgery and to enroll in a counseling program.

Sources:
http://emedicine.medscape.com/article/170539-overview
http://www.mayoclinic.com/health/alcoholic-hepatitis/DS00785