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 necessary to detoxify the human body of all the junk we put into it. If it gets impaired, we may suffer, through 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 and it has to work harder. If left untreated and alcohol consumption remains the same, it develops into alcoholic steatohepatitis. Complications can arise, such as Zieve syndrome, characterized by hyperlipidemia, hemolytic anemia, jaundice and abdominal pain. Other complications that can occur are sudden death due to a fatty embolism, hypoglycemia. Once the liver has fibrosis, it could generate upper gastrointestinal bleeding which can also lead to death. The endgame is cirrhosis of the liver, in which the liver has so much scar tissue, it can no longer function and the body dies from the toxicity.
Symptoms Of Alcoholic Steatohepatitis
Most patients don’t feel any symptoms until later in the progression of the disease, although they will report they have persistent fatigue, malaise or abdominal pain, also 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 MRI’s.
Management Of Alcoholic Steatohepatitis
The first thing a doctor will recommend is to stop all alcohol consumption. This by itself will give the liver a chance to reverse some or all of the damage, providing it hasn’t gotten too far. Also, a change of diet (usually higher amounts of protein) and adding vitamin B-12 or amino acids to the diet has 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, if left untreated will kill you. The symptoms are subtle at best, but if you or a loved one drinks anywhere near the amounts indicated above, it is best you or they 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. Being with your family longer is well worth the price having that check-up.