Alcoholic Steatohepatitis is a chronic, progressive liver disease characterized by thickening and scarring (fibrosis) of the liver as well as possible death (necrosis) of the liver tissue, brought on by excessive, prolonged alcohol use. Alcohol consumption of more than 60-80 ml per day for men or 40-50 ml per day for women is considered toxic. Duration is also a key factor. The risk of alcoholic steatohepatitis is higher if these elevated levels of alcohol are consumed on a regular basis over the course of five years or more. Women are more susceptible to the disease because alcohol metabolism is lower in women than in men. Genetics may play a particular part in susceptibility as well. Among other factors are nutrition and the existence of chronic hepatitis B or chronic hepatitis C.
Progression Of The Disease
The liver is the organ that detoxifies the human body of all the junk we put into it. If the liver is impaired, we may suffer from obesity, lethargy, or jaundice. Usually, alcoholic steatohepatitis starts as fatty deposits in the liver, also known as fatty liver disease or steatosis. This causes the enlargement of the liver as it has to work harder. If left untreated and alcohol consumption remains the same, alcoholic steatohepatitis ensues. Complications such as Zieve syndrome can arise, characterized by hyperlipidemia, hemolytic anemia, jaundice, and abdominal pain. Other complications that can occur include sudden death due to a fatty embolism and hypoglycemia. Once the liver has fibrosis, it can generate upper gastrointestinal bleeding which can also lead to death. The endgame is cirrhosis of the liver where the liver has so much scar tissue that it can no longer function, and the body dies from the toxicity.
Symptoms Of Alcoholic Steatohepatitis
Most patients don’t experience any symptoms until the later stages of the disease, although they will report persistent fatigue, malaise or abdominal pain, anemia, anorexia, nausea, jaundice or weight loss. Once the symptoms have been discussed and it is determined that it may be steatohepatitis, a biopsy of the liver will be done, as this is the only way to make a definitive diagnosis and exclude any other causes. An ultrasound can determine the extent of the damage as well as CT scans and MRIs.
Management Of Alcoholic Steatohepatitis
The first thing a doctor will recommend is the cessation of all alcohol consumption. This by itself will give the liver a chance to reverse some or all of the damage, providing the damage hasn’t progressed too far. Also, a change of diet (usually higher amounts of protein) and adding vitamin B-12 or amino acids to the diet have been recommended. In some cases, corticosteroids have been administered to help with the inflammation of the fibrosis (thickening and scarring of the liver).
Alcoholic Steatohepatitis is a chronic and progressive liver disease that, left untreated, will kill. The symptoms are subtle at best, but if anyone drinks the amounts indicated above, it is best to see a doctor and get a check-up. We all need our livers; they are probably the most important organ in our body next to the heart (some doctors would say it is more important than the heart). Extending one’s life and time with the family is well worth the price of that check-up.