In our article we will talk about the symptoms of alcoholic hepatitis and the causes of it. Excessive drinking of alcohol adversely affects the entire body, but first of all, the liver suffers from this. Degenerative changes occur in it, which in some cases can even cause cirrhosis, which ultimately can lead a person to an early death. What factors cause alcoholic hepatitis, symptoms and treatment of the disease - all these issues will be discussed in this review article.
Causes of alcoholic hepatitis
The main cause of alcoholic hepatitis is already visible from the very name of the disease - it is alcohol, or rather, its abuse. Basically, this disease affects alcoholics - people with a stable alcohol addiction. There is evidence that if a person for severalyears daily introduces into his body 100 gr. ethyl alcohol, then it is at risk. This amount of ethanol contains:
- In one glass of vodka.
- B 1, 25 l. dry or semi-sweet wine with a strength of 9-13 degrees.
- B 2.5 l. classic beer.
Moreover, the occurrence of the disease is not caused by ethyl alcohol itself, but by a 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 enter the liver cell structures.
As soon as the normal permeability of cell membranes is disturbed, this serves as a signal to start the inflammatory process. The body begins to produce cytokines - protein markers of inflammation. With 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, the immune system takes liver cells for "strangers" and the process of their destruction begins.
The liver is the main filter (along with the kidneys) to purify the blood from the waste products of the body, from toxins secreted by microbes and bacteria that multiply in the body when it is infected and inflammatory processes occurring in it. If such a filter fails and ceases to perform its functions, then self-poisoning of the body occurs.
Chronic alcoholic hepatitis: symptoms
Such a formidable disease 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 signs should cause alertness:
- Drowsy, feeling weak, lethargic.
- Perceptible decrease in performance.
- Indigestion, nausea, loss of appetite, vomiting.
- Lower blood pressure.
- Yellowing of the oral mucosa and skin.
- Pain on the right under the ribs.
- Increase in size of the liver, which can be detected by probing.
- The appearance of a network of capillary vessels on the face.
- Redness of the feet and hands.
If a person observes similar symptoms, not necessarily all together, but at least some of them, then this is a reason 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.
Temperature in the first stages of the disease may not rise or stay at the subfebrile level. There are also signs of hepatitis that appear in the stronger sex: fat deposition on the thighs, hair loss on the body, the development of erectile dysfunction, inin conjunction with the main symptoms listed above, these are the symptoms of alcoholic hepatitis in men.
Are there any gender differences in alcoholic hepatitis
Women are called the weaker sex for a reason, 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 the special enzymes that can neutralize alcohol are much less in the female body 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
There are three main stages of alcoholic liver damage.
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 the onset of the disease are still weakly expressed. 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, there is an active deposition of fat inside the liver cells, which makes them swell and swell.
Secondly, the stage of hepatitis. Pathological changes in the liver are steadily progressing. The process of fibrosis starts, in which normal tissue is replacedconnecting 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 enlarges, which is well felt on palpation. A person begins to lose weight, experiences constant weakness. In the hepatitis stage, complications such as peritonitis or venous bleeding may occur.
And the last stage is cirrhosis. Alcoholic hepatitis and cirrhosis of the liver, the symptoms of which can be detected in the severe course of the disease, often follow one after the other, i.e. hepatitis passes into the stage of cirrhosis. In this case, patients experience:
- Severe exhaustion.
- Ascites (accumulation of fluid in the abdomen, making the abdomen look unnaturally bloated).
- When 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.
- Poor blood chemistry.
In the organ, massive death of liver cells occurs, 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 decay 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 alcohol and well-chosentreatment, it is possible to restore all liver functions and the symptoms of alcoholic hepatitis then disappear completely.
- Progressive form. Alas, in this case, the symptoms gradually increase and the patient's condition steadily worsens. This is due to the fact that liver cells are reborn into connective tissue, i.e., dead areas are formed in a vital organ that do not perform any functions. The liver greatly increases 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 of the condition. If this cannot be achieved, then, unfortunately, alcoholic hepatitis in a progressive form, eventually turns into cirrhosis or even liver cancer.
Acute alcoholic hepatitis: symptoms
A condition that is extremely life-threatening - acute alcoholic 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 next 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:
- A bitter taste in the mouth.
- Nausea andsubsequent vomiting.
- Sharp jump in temperature (above 38 degrees).
- Bloating.
- Pain in the right hypochondrium.
- Loose stools.
- Feelings of numbness in 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. A serious condition can last from three to five weeks.
Four forms of disease progression
- 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 complete refusal of food), nausea and vomiting, fever, enlarged spleen. Below you can see what jaundice looks like, which is caused by alcoholic hepatitis. The photo shows the symptoms very clearly.
- Latent form of the disease. It is considered very dangerous, because it proceeds with virtually no symptoms. The patient feels slight pain (not always) and a decrease in appetite in the right hypochondrium. The liver may be enlarged (not in all cases). Blood tests usually reveal anemia and elevated white blood cells.
- Cholestatic form. In most cases, it leads to death. Recognized by the following manifestations: light feces, dark urine, skin itching, the skin becomes pronouncedyellow tint, the content of bilirubin in the blood and urine rolls over.
- Fulminate form. It is characterized by 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, kidney failure may develop. Due to the rapid progression of the disease, a person may die in two weeks.
Diagnosis
As can be seen from the above, alcoholic hepatitis is a serious disease and often carries a direct threat to human life. The successful outcome of the disease depends on how quickly the diagnosis is made and treatment is started. Therefore, you should not hesitate to contact a doctor if you have symptoms of alcoholic hepatitis.
Diagnosis may include the following tests and procedures:
- Blood test (general). It detects the presence of anemia and the level of leukocytes in the blood.
- Ultrasound of the abdominal cavity. An ultrasound examination allows you to see the pathological changes that have occurred in the liver, identify inflammatory processes, measure the diameter of the portal vein, see if there is fluid accumulation 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 length of the drinking period.
- Urine analysis (general).
- Coprogram.
- MRI.
- Liver biopsy. During the procedure, a small piece of the organ is taken for examination.
- Elastography. During this examination, the condition of the liver structures is assessed.
Medicated treatment
Continuing the conversation about alcoholic hepatitis, the symptoms and treatment of this disease, I would like 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 drug treatment, the patient is required to strictly follow the instructions for taking medications. For alcoholic hepatitis, doctors prescribe:
- Drugs that preserve and stimulate the activity of liver cells, they are called hepatoprotectors ("Essentiale", "Karsil", "Heptral", etc.)
- Choleretic drugs, 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, courses of antibiotics are prescribed.
Surgical treatment
In the case of alcoholic hepatitis, doctors resort to surgery only if the lesions in the liver are so massive that drug therapy is powerless.
In such difficult situations, a liver transplant of one of therelatives of the patient. But even this is not always able to help, because sometimes the patient's body begins to reject foreign tissue.
What should be the patient's diet?
You already know a lot about chronic and acute alcoholic hepatitis. Symptoms and treatment have been discussed in the article. But there is another important component in the fight against hepatitis. Patients must be prescribed a diet that is as gentle as possible to the liver and allows you to give a break to the whole body. Of course, first of all, it is necessary to completely avoid alcohol and exclude fatty foods from the diet. Then you need to follow the following 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 diet of the patient should include a sufficient amount of vitamins and minerals needed by the body.
Of course, even a strict diet cannot cure the disease, the right diet only reduces the load on the body and helps it recover.
Disease prevention
As can be seen from the article, alcoholic hepatitis can kill a person very quickly, and this disease can quickly bring 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, or even better to give it up altogether. Well balanced rational effect on liver he althnutrition, restriction or refusal of smoked meats, fried and canned foods, fatty or too hot food.
Alcoholic hepatitis, symptoms, causes and consequences are inextricably linked. The liver is an amazing organ capable of regeneration if pathological changes have not gone too far. Therefore, if a person, having first felt discomfort in the liver area (heaviness, tingling in the right side) after a feast with libations, finally and irrevocably stops drinking and adheres to a reasonable diet, the liver will recover and will no longer bother him.
The difference between alcoholic hepatitis and viral hepatitis
Often on specialized forums people ask the question: "What are the symptoms of alcoholic hepatitis C in men and women?" This formulation of the question 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, are caused by various viruses that have entered 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. These are jaundice, pain in the hypochondrium on the right, weakness, fever, indigestion, etc.
There are situations when a person with hepatitis C also takes alcohol or even falls into a binge. In this casethe course of the disease is exacerbated many times, since the protective functions of the liver are weakened by a viral disease and the intake of ethanol into the body practically finishes off the diseased organ. Such a frivolous attitude to he alth can lead to a quick death.
Closing word
Well, our article has come to an end, in which we talked about chronic and acute alcoholic hepatitis, the symptoms and treatment of this dangerous disease. Drunkenness and alcoholism bring people a lot of suffering, both moral and physical. Probably every adult knows this. It is surprising that 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 reason. Let's take care of ourselves to stay active and he althy longer!
