In our article, we will talk about the symptoms of alcoholic hepatitis and the causes that cause it. Excessive consumption of alcohol adversely affects the whole body, but the liver suffers first of all. Degenerative changes occur in it, which in some cases can even cause cirrhosis, which ultimately can lead to death. What factors exactly cause alcoholic hepatitis, symptoms and treatment of the disease - all these issues will be considered in this review article.
Causes of alcoholic hepatitis
The main reason causing alcoholic hepatitis is already visible from the very name of the disease - it is alcohol, or rather, abuse of it. Basically, this disease is affected by alcoholics - people with persistent alcohol dependence. There is evidence that if a person for several years daily introduces 100 grams into his body. ethyl alcohol, then it is at risk. Such an amount of ethanol is contained:
- In one glass of vodka.
- In 1.25 liters. dry or semi-sweet wine with a strength of 9-13 degrees.
- In 2.5 liters. classic beer.
Moreover, the onset of the disease is caused not by ethanol itself, but by the toxin that is formed during the processing of ethanol in the body. This toxin is aldehyde or acetaldehyde. It is this substance that disrupts the synthesis of phospholipids in the liver. And phospholipids are organic compounds, thanks to which oxygen and important nutrients get into the liver cell structures.
As soon as the normal permeability of cell membranes is violated, this serves as a signal to start the onset of the inflammatory process. The body begins to produce cytokines - protein markers of inflammation. In normal tissue inflammation, the immune system, having received a command from cytokines, begins an attack on foreign cells (bacteria, viruses). In the case of alcoholic hepatitis, immunity takes the liver cells for “strangers” and the process of their destruction begins.
The liver is the main filter (along with the kidneys) to cleanse the blood from the body’s vital products, from toxins secreted by microbes and bacteria that multiply in the body during its infection and the inflammatory processes occurring in it. If such a filter fails and ceases to fulfill its functions, then self-poisoning of the body occurs.
Chronic alcoholic hepatitis: symptoms
A formidable disease such as alcoholic hepatitis, in most cases, develops slowly. For a long time (5-8 years or more), a person may not notice any manifestations of the disease. However, over time, as the pathology progresses, the symptoms of alcoholic hepatitis begin to increase. The following symptoms should be alert:
- Drowsiness, feeling of weakness, lethargy.
- Significant decrease in performance.
- Digestive upset, nausea, loss of appetite, vomiting.
- Lowering blood pressure.
- Yellowing of the mucous membrane of the mouth and skin.
- Pain on the right under the ribs.
- An increase in liver in size, which can be detected by palpation.
- The appearance on the face of a grid of capillary vessels.
- Redness of the feet and hands.
If a person observes similar symptoms at home, not necessarily all together, but at least part of them, then this is an occasion to consult a doctor to exclude or confirm the diagnosis - alcoholic hepatitis. Symptoms in women and men who are addicted to alcohol should by no means be ignored by them.
The temperature in the first stages of the disease may not rise or remain subfebrile. There are also signs of hepatitis that manifest in the stronger sex: fat deposition on the hips, hair loss on the body, the development of erectile dysfunction, in conjunction with the main signs listed above - these are symptoms of men’s alcoholic hepatitis.
Are there any differences in the disease of alcoholic hepatitis by gender
Women are not for nothing called a weaker sex, because they are weaker than men in many ways. So the disease, which is discussed in our article, develops and progresses more rapidly in them. The thing is that special enzymes that can neutralize alcohol in the female body contain much less than in the male. But the main specific symptoms of alcoholic hepatitis in women are the same as in men.
Three stages of the disease
Three main stages of alcoholic liver damage can be distinguished .
Firstly, fatty hepatosis or fatty degeneration of the organ. This symptom is observed in 90% of people who abuse alcohol for a long time. As a rule, at this stage, people do not consider themselves ill and do not suspect that they are threatened by alcoholic hepatitis. Symptoms, signs of an onset disease are still mild. These include:
- Decreased appetite.
- Fatigue and loss of strength.
- Increase in adipose tissue.
- The formation of bruises on the skin, even with slight pressure.
At this stage, fat is actively stored inside the liver cells, which is why they swell and, as it were, swell.
Secondly, the stage of hepatitis. Pathological changes in the liver are steadily progressing. The fibrosis process starts, in which normal tissue is replaced by connective scars. Symptoms of alcoholic hepatitis begin to manifest actively. On the right side, under the ribs, the patient may experience very painful sensations, the liver is enlarged, which is well felt on palpation. A person begins to lose weight, experiences constant weakness. In the stage of hepatitis, complications such as peritonitis or venous bleeding can be observed .
And the last stage is cirrhosis. Alcoholic hepatitis and cirrhosis, the symptoms of which can be detected in severe cases of the disease, often follow one after another, i.e., hepatitis goes into the stage of cirrhosis. In this case, the following is observed in patients:
- Severe exhaustion.
- Ascites (accumulation of fluid in the abdominal cavity, which makes the stomach look unnaturally bloated).
- On palpation of the liver, a person feels very severe pain.
- Pronounced jaundice not only of the skin, but also of the sclera of the eyes.
- Portal hypertension.
- Bad biochemical blood counts.
Mass death of the liver cells occurs in the organ, large areas of connective tissue are formed that change the structure of the liver and its functionality. Also, patients have an increase in body temperature and encephalopathy (poisoning of nerve fibers by the breakdown products of the liver structures).
Forms of chronic alcoholic hepatitis
The disease can occur in one of two forms:
- Reversible form. In the case of complete abstinence from taking alcohol and well-chosen treatment, it is possible to restore all liver functions and symptoms of alcoholic hepatitis then completely disappear.
- Progressive form. Alas, in this case, the symptoms gradually increase and the patient's condition is steadily worsening. This is due to the fact that liver cells degenerate into connective tissue, that is, in the vital organ dead spots form that do not perform any functions. The liver is greatly increasing in size, thereby trying to compensate for the loss of its functionality.
With a complete rejection of alcohol, persistent treatment and the implementation of all the recommendations of the attending physician, even in the presence of a progressive form of the disease, it is still possible to achieve stabilization. If it is not possible to achieve this, then, unfortunately, alcoholic hepatitis in a progressive form, eventually passes into cirrhosis or even liver cancer.
Acute alcoholic hepatitis: symptoms
A condition that is extremely life-threatening is acute hepatitis. In most cases, the disease manifests itself in this way after several years of abuse of drinks containing alcohol. But the organisms of different people have their own characteristics, so there are cases when acute hepatitis occurs the day after a long feast with a lot of alcohol (for example, on holidays).
Here is a list of the initial symptoms of acute alcoholic hepatitis:
- Sensation of bitter taste in the oral cavity.
- Nausea and subsequent vomiting.
- A sharp jump in temperature (above 38 degrees).
- Bloating.
- Pain on the right in the hypochondrium.
- Loose stool.
- Feeling of numbness of the legs and tongue.
- Growing weakness.
- Mental disorders, manifested in inappropriate behavior, unmotivated aggression, etc.
- A day or two after the above symptoms, the skin becomes yellowish.
It should be noted that acute alcoholic hepatitis can occur in different forms, which give different symptoms. Severe condition can last from three to five weeks.
Four forms of disease development
- Icteric form. According to statistics, it occurs most often. It manifests itself, in addition to icteric coloration of the skin, severe weakness, weight loss, decreased appetite (up to a complete rejection of food), nausea and vomiting, fever, enlarged spleen. Below you can see what the jaundice caused by alcoholic hepatitis looks like. Symptoms photo shows very clearly.
- The latent form of the disease. It is considered very dangerous, because it proceeds with almost no symptoms. The patient feels in the right hypochondrium minor pains (not always) and a decrease in appetite. The liver may be enlarged (not in all cases). Blood tests usually show anemia and an increase in white blood cell count.
- Cholestatic form. In most cases, it leads to death. It is recognized by the following manifestations: light stool, dark urine, itchy skin, the skin acquires a pronounced yellow hue, the bilirubin content in the blood and urine goes off scale.
- Fulminate form. It is characterized by the transient nature and rapid progression of the disease. The patient's condition deteriorates sharply, the skin turns yellow, the temperature rises, the patient completely refuses to eat, complains of severe weakness and pain under the ribs on the right side, and kidney failure can develop. Due to the rapid progression of the disease, after two weeks a person can die.
Diagnostics
As can be seen from the above, alcoholic hepatitis is a serious illness and often carries a direct threat to human life. A successful outcome of the disease depends on how quickly a diagnosis is made and treatment is started. Therefore, do not hesitate to consult a doctor if you find symptoms of alcoholic hepatitis.
Diagnosis may include the following tests and procedures:
- Blood test (general). It reveals the presence of anemia and the level of leukocytes in the blood.
- Ultrasound of the abdomen. An ultrasound examination allows you to see the pathological changes that have occurred in the liver, to identify inflammatory processes, to measure the diameter of the portal vein, to see if there is an accumulation of fluid in the abdominal cavity, etc.
- Blood test (biochemical). It allows you to determine how much liver function is preserved.
- Coagulogram.
- Lipidogram.
- Studies to determine the duration of the period of alcohol intake.
- Urinalysis (general).
- Coprogram.
- MRI
- Liver biopsy. During the procedure, a small piece of the organ is taken for examination.
- Elastography. During this examination, the state of the liver structures is assessed.
Drug treatment
Continuing the conversation about alcoholic hepatitis, the symptoms and treatment of this disease, I want to say that success largely depends on the behavior of the patient himself, who must necessarily refuse to take even the smallest doses of alcohol. With medical treatment, the patient must strictly follow the instructions for taking the medicine. With alcoholic hepatitis, doctors prescribe:
- Medicines that preserve and stimulate the activity of liver cells, they are called hepatoprotectors (Essential, Karsil, Heptral, etc.).
- Preparations are choleretic, as well as neutralizing toxic substances and having a restorative effect.
- Vitamin complexes (Duovit, Undevit, Dekamevit, Oligovit, etc.)
- Glucocorticoids.
- Drugs that prevent the formation of connective tissue in the liver.
- In severe forms of the disease, antibiotic courses are prescribed.
Surgery
In the case of alcoholic hepatitis, doctors resort to surgery only if the lesions in the liver are so huge that drug therapy is powerless.
In such difficult situations, transplantation of part of the liver of one of the patient's relatives can help. But even this is not always able to help, as sometimes the patient’s body begins to reject foreign tissue.
What should be the nutrition of the patient?
You already know a lot about chronic and acute alcoholic hepatitis. Symptoms and treatment were considered in the article. But there is another important component in the fight against hepatitis. Patients are prescribed a diet that spares the liver as much as possible and allows you to give a break to the whole body. Of course, first of all, you must completely get rid of alcohol and exclude fatty foods from the diet. Then you need to follow these rules:
- Eat at least 5-6 times a day, in small portions, trying to maintain equal intervals between meals.
- It is important to saturate the daily diet with easily digestible proteins.
- The patient's nutrition should include a sufficient amount of vitamins and minerals needed by the body.
Of course, even strict adherence to the diet is not able to cure the disease, the right diet only reduces the load on the body and helps to restore it.
Disease prevention
As can be seen from the article, alcoholic hepatitis can kill a person very quickly, and this disease can in a short time reduce even young and strong people to the grave if they abuse alcohol.
To avoid this disease with a 100% guarantee, it is better to reduce alcohol consumption to a minimum, and even better to abandon it altogether. Balanced rational nutrition, restriction or refusal of smoked meats, fried and canned foods, and fatty or too hot foods works well on liver health.
Alcoholic hepatitis, symptoms, causes and their consequences are inextricably linked. The liver is an amazing organ that can regenerate if pathological changes have not gone too far. Therefore, if a person, having felt for the first time after a feast with libations, unpleasant sensations in the liver area (heaviness, tingling in the right side) finally and irrevocably stops drinking and adheres to a reasonable diet, then the liver will recover and will not bother him anymore.
The difference between alcoholic hepatitis and viral hepatitis
Often in specialized forums people ask the question: "What are the symptoms of alcoholic hepatitis C in men and women?" Such a questioning indicates some confusion, since a disease such as hepatitis C, as well as hepatitis A, B, D, E, F, in contrast to alcoholic (toxic) hepatitis, is caused by various viruses that enter the body. Viral liver damage can occur even in young children who have never sniffed alcohol.
Confusion arises from the similarity of most of the initial symptoms of both viral and toxic hepatitis. This is jaundice, pain in the upper quadrant on the right, weakness, fever, digestive upset, etc.
There are situations when a person with hepatitis C also takes alcohol or even gets into a bout. In this case, the course of the disease is aggravated many times, since the protective functions of the liver are weakened by a viral disease, and the intake of ethanol practically completes the diseased organ. Such a frivolous attitude to health can lead to rapid death.
Final word
Well, our article came to an end, in which she spoke about chronic and acute alcoholic hepatitis, symptoms and treatment of this dangerous disease. Drunkenness and alcoholism bring people a lot of suffering, both moral and physical. This is probably known to every adult. Surprisingly, even being aware of the harmful effects of alcohol on the human body, many people still continue to drink. I would like to hope for the triumph of the mind. Let's take care of ourselves in order to stay active and healthy longer!