Materiały źródłowe

• #1 Alcoholic hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/symptoms-causes/syc-20351388

  Alcoholic hepatitis is swelling, called inflammation, of the liver caused by drinking alcohol. Drinking alcohol destroys liver cells. […] Alcoholic hepatitis is caused by damage to the liver from drinking alcohol. Just how alcohol damages the liver and why it does so only in some heavy drinkers isn’t clear. […] These factors are known to play a role in alcoholic hepatitis: The body’s way of breaking down alcohol makes highly toxic chemicals. These chemicals trigger swelling, called inflammation, that destroys liver cells. Over time, scars replace healthy liver tissue. This keeps the liver from working well. This scarring, called cirrhosis, can’t be fixed. It’s the final stage of alcoholic liver disease. […] Other factors that can be involved with alcoholic hepatitis include: Other types of liver disease. Alcoholic hepatitis can make chronic liver diseases worse. For instance, if you have hepatitis C and drink, even a little, you’re more likely to get liver scarring than if you don’t drink. Lack of nutrition. Many people who drink heavily don’t get enough nutrients because they eat poorly. And alcohol keeps the body from using nutrients as it should. Lack of nutrients can damage liver cells.

• #2 Alcohol-Induced Hepatitis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17853-alcoholic-hepatitis

  Alcohol-induced hepatitis is inflammation of the liver caused by alcohol use. Too much alcohol overloads the liver with toxins that injure the tissues. Several things can cause hepatitis, including viruses and toxins. Heavy alcohol use is also one of them. Chronic, heavy alcohol use, or alcohol use disorder, can overload your liver with fat and toxins to process. When your liver can no longer keep up, these toxins and fat build up and begin to injure the liver. The injury produces an inflammatory response. This is your body’s way of attempting to heal and ward off further injury. However, everyone is different, and medically we can’t say what a safe amount of alcohol is. Some people develop alcohol-associated hepatitis and cirrhosis from seemingly insignificant quantities of alcohol. […] Alcohol-induced hepatitis begins quietly, often without symptoms. Many people fail to recognize the damage that chronic heavy drinking may be doing to their livers.

• #3 Alcohol-Associated Liver Disease | AASLD

  https://www.aasld.org/practice-guidelines/alcohol-associated-liver-disease

  Alcohol-associated liver disease (ALD) represents a spectrum of liver injury resulting from alcohol use, ranging from hepatic steatosis to more advanced forms including alcoholic hepatitis (AH), alcohol-associated cirrhosis (AC), and acute AH presenting as acute-on-chronic liver failure. […] ALD develops through several stages, beginning with hepatic steatosis, and, in some individuals, gradually progressing through AH (the histological correlate of which is alcoholic steatohepatitis), culminating in cirrhosis. […] Progression through these various stages is dependent on continued heavy alcohol use and other risk factors, including female sex, genetic susceptibility, diet, and comorbid liver disease. […] Due to longstanding usage, the term alcoholic hepatitis will likely persist.

• #4 Alcoholic hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Alcoholic_hepatitis

  The pathological mechanisms in alcoholic hepatitis are incompletely understood but a combination of direct hepatocyte damage by alcohol and its metabolites in addition to increased intestinal permeability are thought to play a role. […] Heavy alcohol consumption increases intestinal permeability by causing direct damage to enterocytes (intestinal absorptive cells) and causing disruptions of tight junctions that form a barrier between the enterocytes. […] Chronic alcohol consumption may alter the gut microbiome and promote the production of these pathogenic bacteria. […] Alcohol is also directly damaging to liver cells. Alcohol is metabolized to acetaldehyde in the liver via the enzymes CYP2E1 and aldehyde dehydrogenase. […] The chronic inflammation seen in alcoholic hepatitis leads to a distinctive fibrotic response, with fibrogenic cell type activation. This occurs via an increased extracellular matrix deposition around hepatocytes and sinusoidal cells which causes a peri-cellular fibrosis known as „chickenwire fibrosis”. […] Certain genetic variations in the PNPLA3-encoding gene, which codes for an enzyme involved in triglyceride metabolism in adipose tissue are thought to influence disease severity.

• #5 Alcoholic Hepatitis (Alcohol-Associated Hepatitis): Background, Etiology and Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/170539-overview

  Ethanol and its metabolite, acetaldehyde, have been shown to damage liver cell membranes. […] Acetaldehyde may be the principal mediator of alcoholic liver injury. […] Alcohol consumption may exacerbate liver injury caused by other pathogenic factors, including hepatitis viruses. […] Long-term alcohol abuse has been established as potentiating acetaminophen toxicity via the induction of CYP2E1 and depletion of glutathione.

• #5 Alcoholic Hepatitis (Alcohol-Associated Hepatitis): Background, Etiology and Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/170539-overview

  Alcoholic hepatitis is a syndrome of progressive inflammatory liver injury associated with long-term, heavy intake of ethanol. […] The pathogenesis is not completely understood. […] The relative risk of cirrhosis rises significantly for alcohol intake above 60 g/day for men and 20 g/day for women, over a decade. […] Although the association of alcohol and liver disease has been known since antiquity, the precise mechanism of alcoholic liver disease remains in dispute. […] Genetic, environmental, nutritional, metabolic, and immunologic factors, as well as cytokines and viral disease, have been invoked. […] Most patients with alcoholic hepatitis exhibit evidence of protein-energy malnutrition. […] In the past, nutritional deficiencies were assumed to play a major role in the development of liver injury.

• #6 Alcoholic Hepatitis | UMass Memorial Health

  https://www.ummhealth.org/health-library/alcoholic-hepatitis

  Alcoholic hepatitis is caused by drinking too much alcohol. The liver breaks down alcohol. Over time, if you drink more alcohol than the liver can process, it can become severely damaged. […] Alcoholic hepatitis usually develops over time with continued drinking. […] Severe alcoholic hepatitis can occur suddenly and quickly lead to liver failure and death.

• #7 Alcoholic Hepatitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/alcoholic-hepatitis

  Alcoholic hepatitis is an inflammatory condition of the liver caused by heavy alcohol consumption over an extended period of time. Ongoing alcohol use and binge drinking can both aggravate this condition. […] When alcohol gets processed in the liver, it produces highly toxic chemicals. These chemicals can injure the liver cells. This injury can lead to inflammation and, eventually, alcoholic hepatitis. […] Although heavy alcohol use can lead to alcoholic hepatitis, experts aren’t entirely sure why the condition develops in some people but not in others. […] Alcoholic hepatitis develops in a minority of people who heavily use alcohol no more than 35 percent, according to the American Liver Foundation. It can also develop in people who use alcohol only moderately. […] Because alcoholic hepatitis doesn’t occur in all people who heavily use alcohol, other factors may influence the development of this condition.

• #8 Alcohol-related hepatitis: A review article

  https://www.wjgnet.com/1007-9327/full/v29/i17/2551.htm

  Significant variability has been noted among patients in regard to the susceptibility of developing ARH as well as the severity of symptoms. […] The pathogenesis of ARH involves acute inflammation superimposed on chronic ALD. […] Initial hepatic injury results from the metabolism of ethanol into acetaldehyde by alcohol dehydrogenase and cytochrome P450 2E1 (CYP2E1). […] Acetaldehyde leads to the formation of adducts, in the form of bonds with proteins, lipids, and DNA. […] The oxidation of ethanol and acetaldehyde leads to an increase in the levels of nicotinamide adenine dinucleotide, which enhances lipogenesis in the liver. […] The stimulation of Kupffer cells also lead to an increase in polymorphonuclear leukocyte infiltrate in the liver, as a result of chemotactic factors such as interleukin-8.

• #9 Advances in alcoholic liver disease: An update on alcoholic hepatitis

  https://www.wjgnet.com/1007-9327/full/v21/i42/11893.htm

  The importance of an alcohol-induced increase in gut permeability as a mechanism underlying endotoxemia leading to activation of inflammatory cytokines is increasingly being recognized. […] Alcohol is normally metabolized to aldehyde by the enzyme alcohol dehydrogenase (ADH), which is located in hepatocytes and gastric mucosa. […] In chronic alcoholics, the overabundance of ethanol leads to high enzymatic activity of ADH and ALDH, along with induction of the microsomal enzyme oxidation system, in particular the cytochrome CYP2E1. […] The high enzymatic activity of cytochrome CYP2E1 causes increased production of reactive oxygen species, leading to chronic inflammatory changes as a result of oxidative stress. […] The histological features associated with alcohol-induced hepatocellular injury can be categorized into three distinct findings: alcoholic fatty liver (steatosis), alcoholic hepatitis and alcoholic cirrhosis.

• #10 Advances in alcoholic liver disease: An update on alcoholic hepatitis

  https://www.wjgnet.com/1007-9327/full/v21/i42/11893.htm

  The presence of focal intense lobular infiltration of neutrophils is what typically distinguishes alcoholic hepatitis from other forms of hepatitis, in which the inflammatory infiltrate is primarily composed of mononuclear cells. […] The alcohol-induced hepatic steatosis can largely be attributed to impairment of fatty acid oxidation through the expression of cytokines, reactive oxygen species, oxidative stress, and increased activity of lipogenic enzyme regulators including sterol regulatory element binding proteins (SREBPs) and SREBP-1. […] It has been suggested that pro-inflammatory cytokines including tumor necrosis factor alpha (TNF-), interleukin-1 (IL-1), IL-6, and IL-8 are activated and secreted by Kupffer cells and other inflammatory cells (neutrophils and macrophages) following chronic alcohol exposure.

• #11 06. Acute Alcoholic Hepatitis | Hospital Handbook

  https://hospitalhandbook.ucsf.edu/06-acute-alcoholic-hepatitis/06-acute-alcoholic-hepatitis

  Occurs in patients with a history of chronic, heavy alcohol use. However, alcohol use is often stopped prior to hospitalization as patients start to feel ill. […] Practice guidelines suggest that 10-35% of people with significant alcohol use may develop alcoholic hepatitis and 8-20% will develop cirrhosis. These two entities are not mutually exclusive. The incidence of acute alcoholic hepatitis is unclear. […] Acute alcoholic hepatitis is precipitated by alcohol-induced inflammatory pathways. Excess alcohol consumption results in increased intestinal permeability with increased bacterial translocation from the gut into the portal circulation. Alcohol also results in increased production of TNF-alpha and other proinflammatory cytokines. Neutrophil-mediated hepatocyte injury occurs. Glutathione is depleted by alcohol metabolism, increasing oxidative stress.

• #12 Alcoholic Hepatitis: Symptoms, causes, & prevention

  https://recovered.org/alcohol/alcohol-and-health/alcoholic-hepatitis

  When inflammation is severe and chronic, as in the case of continuing alcohol abuse, it damages the tissues of the liver, leading to cell death. These dead cells are replaced by scar tissue, known as fibrosis, leaving the liver incapable of metabolizing nutrients and filtering toxins. This is cirrhosispermanent and life-threatening damage to your liver.

• #13 Alcoholic Hepatitis: Causes, Symptoms And Treatment

  https://vertavahealth.com/alcohol/hepatitis/

  Alcoholic hepatitis is the clinical term for alcohol-induced liver inflammation or swelling that is accompanied by the destruction of liver cells. This condition is a type of alcohol-related liver disease, caused by the toxic chemicals released into the liver when it metabolizes alcohol. […] Although alcoholic hepatitis is caused, at least in part, by alcohol consumption, researchers are still not sure of its exact cause. Alcoholic hepatitis is most likely to occur in individuals who have participated in heavy drinking over many years. However, it does not occur in all heavy drinkers and may also develop in people who only drink in moderation. […] Researchers are still not sure why alcohol affects some people more than others, but they believe that alcohol-related liver disease may have more than one possible cause.

• #14 Alcohol Related Liver Disease | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/alcohol-related-liver-disease

  Alcohol related liver disease (ALD) is the result of drinking more alcohol than the liver can process, which damages the organ. […] Alcoholic Associated Hepatitis: This condition is marked by inflammation, swelling and the killing of liver cells. This scars the liver, which is known as fibrosis. […] Up to 35 percent of heavy drinkers develop alcohol associated hepatitis, which can be mild or severe. […] Alcohol related cirrhosis occurs when the entire liver is scarred, causing the liver to shrink and harden. […] Having viral hepatitis, especially hepatitis C virus: Adding alcohol to a liver already taxed by hepatitis increases the risk of developing liver disease, as well as liver cancer.

• #15 Acute Alcoholic Hepatitis, the Clinical Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6130321/

  Alcoholic liver disease (ALD) is a leading cause of advanced liver disease and is the number one cause of death in adults who drink excessively. […] An acute form of ALD, alcoholic hepatitis (AH) is regarded as a specific clinical entity characterized by rapid decompensation of hepatic function. […] AH has been linked to excessive alcohol drinking over a prolonged period of time (typically more than 2 decades). […] However, it is now recognized that many patients diagnosed with AH report alcohol use over shorter periods of time before diagnosis. […] In practice, most patients diagnosed with AH usually consume more than 100 grams of alcohol per day, with higher consumption being associated with more severe disease. […] Binge drinking is a potential risk factor for AH, and is particularly thought to contribute to the rising incidence of AH in younger individuals.

• #16 Alcoholic hepatitis: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/alcoholic-hepatitis-clinical-manifestations-and-diagnosis

  Excessive alcohol consumption is associated with a range of hepatic manifestations, including alcoholic fatty liver disease (with or without steatohepatitis), alcoholic hepatitis, and cirrhosis. […] The amount of alcohol intake that puts an individual at risk for alcoholic hepatitis is not known, but the majority of patients have a history of heavy alcohol use (more than 100 g per day) for two or more decades. […] Patients with alcoholic hepatitis typically have a history of daily heavy alcohol use (>100 g per day) for more than 20 years and in some cases, patients will have recently increased their alcohol intake in response to stressful life events. […] Alcoholic hepatitis can develop in patients with much shorter histories of heavy alcohol use. […] With the rising prevalence of obesity and metabolic syndrome, co-existent alcoholic and nonalcoholic steatohepatitis is increasingly common and together often increase the severity of alcoholic liver disease.

• #17 Advances in alcoholic liver disease: An update on alcoholic hepatitis

  https://www.wjgnet.com/1007-9327/full/v21/i42/11893.htm

  Alcoholic hepatitis (AH) is a life threatening complication of alcoholic liver disease and presents with a mortality rate of up to 25%. […] Amount of alcohol intake is the single most important predictor of severity of AH. While reports vary, current consensus is that patients with AH typically ingest over 100 to 120 g of ethanol on a daily basis for 10 to 20 years. […] Other risk factors for the development of AH include gender and genetic factors. For instance, women have a higher risk of developing alcoholic liver disease relative to men. […] Abstinence from alcohol use is the most fundamental step to successfully treat AH. […] Severe AH, as defined by Maddreys discriminant function 32 has been associated with poor prognosis with one-month mortality ranging between 25% to 35%. […] The most distinctive histologic feature of AH compared with other forms of hepatitis is predominantly neutrophilic inflammation.

• #18

  https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/

  Alcoholic hepatitis, which is unrelated to infectious hepatitis, is a potentially serious condition that can be caused by alcohol misuse over a longer period. […] Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time (binge drinking). […] The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently. […] Severe alcoholic hepatitis, however, is a serious and life-threatening illness.

• #19 Alcohol-Associated Liver Disease: Causes & Symptoms

  https://liverfoundation.org/liver-diseases/alcohol-associated-liver-disease/

  Alcohol-associated hepatitis is inflammation (swelling) of the liver. Liver cells can be destroyed because of this condition. It can reverse if a person stops drinking alcohol. […] People can still develop alcohol-associated liver disease even if they do not have alcohol use disorder (AUD), but it is important to note that people with AUD are at increased risk for liver disease. […] Liver damage can also happen because of binge drinking, when four to five alcoholic beverages are consumed within two hours. Binge drinking can also cause acute (sudden) alcoholic hepatitis, a rapid inflammation of the liver, which can be life-threatening.

• #20 Acute Alcoholic Hepatitis, the Clinical Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6130321/

  Aside from the quantity and pattern of alcohol consumption, a number of environmental and individual factors have been associated with the development of AH. […] Women are more prone to the toxic effects of alcohol and are at a higher risk of developing liver fibrosis and AH compared to men. […] Hispanics are more likely to develop AH at a younger age compared to Caucasians, and both Hispanics and African Americans are more likely to develop ALD. […] Obesity is an independent risk factor for cirrhosis in alcoholic patients and potentiates the severity of AH. […] Protein-calorie malnutrition is a major risk factor for developing AH and is an indicator of poor outcomes and decreased survival in patients with established AH. […] The combination of alcohol use and HCV infection has been associated with rapid progression to fibrosis and higher incidence of cirrhosis than either factor alone.

• #21 Alcoholic Hepatitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/alcoholic-hepatitis

  Risk factors include having genetic factors that affect how the body processes alcohol, living with liver infections or other liver disorders, such as hepatitis B, hepatitis C, and hemochromatosis, malnutrition, having a higher body weight, and timing of drinking in relation to eating. […] Women typically have a greater risk of developing alcoholic hepatitis. This may be due to the differences in how their bodies absorb and break down alcohol. […] Alcohol use both causes and worsens alcoholic hepatitis, so a diagnosis of alcoholic hepatitis means you may want to consider stopping drinking gradually. Quitting drinking can help reduce symptoms and prevent further damage to your liver. […] In the early stages of the condition, avoiding alcohol may even help reverse liver damage. Once more significant damage has occurred, the changes to your liver may become permanent.

• #22 Alcohol-related Liver Disease > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/alcohol-related-liver-disease

  What causes alcohol-related liver disease? In order to understand alcohols effect on the liver, its helpful to know the role of the liver in overall health. […] So, if someone drinks too much alcohol, the liver can become damaged by substances produced during the metabolism of that alcohol, the buildup of fats in the liver, and inflammation and fibrosis. This damage impairs the livers ability to function properly, which causes various symptoms and can even be fatal. […] In general, people who drink more alcohol are at elevated risk for alcohol-related liver disease. While the amount of alcohol and duration of alcohol use necessary to result in ALD can vary by person, studies have shown that there is a threshold of alcohol consumption at which the risk for the disease increases. […] Several other factors may contribute to an elevated risk for ALD, including: Female gender. Women are more susceptible to ALD than men.

• #23 Acute Alcoholic Hepatitis, the Clinical Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6130321/

  Variations in the genes for cytochrome P450 2E1 (CYP2E1) and alcohol dehydrogenase (ADH); the major enzymes involved in alcohol metabolism, affect alcohol-driven tissue damage in addition to having a proposed influence on patterns of alcohol consumption and dependency, which in turn can predispose individuals to AH.

• #24 Alcoholic liver disease: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/215638

  Having hepatitis C increases the risk, and a person who consumes alcohol regularly and has had any type of hepatitis faces a higher chance of developing liver disease. […] Genetic changes can affect the risk. If a person experiences changes in the genetic profiles of particular enzymes that are key to alcohol metabolisms, such as ADH, ALDH, and CYP4502E1, they will have a higher chance of developing alcoholic liver disease.

• #25 Alcohol-related hepatitis: A review article

  https://www.wjgnet.com/1007-9327/full/v29/i17/2551.htm

  The pattern of drinking as well as the type of alcohol consumed also contributes to the risk of developing ARH. […] There are significant differences based on gender. […] Patients who consume alcohol excessively are often malnourished and can suffer from vitamin deficiencies. […] It is well established that the combination of alcohol misuse and chronic hepatitis C (HCV) increases the incidence of cirrhosis and hepatocellular carcinoma (HCC) and is associated with reduced survival compared to patients with either HCV or alcohol use alone. […] While the literature clearly demonstrated worse outcomes in patients with concomitant alcohol misuse and chronic HCV, the data regarding the effect of alcohol use on patients with chronic hepatitis B (HBV) remains understudied. […] Obesity, diabetes mellitus and metabolic syndrome-underlying non-alcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome, can be additive to the damage sustained through alcohol misuse and lead to worse outcomes.

• #26 Alcoholic hepatitis: Symptoms, causes, risks, and treatment

  https://www.medicalnewstoday.com/articles/313928

  A person with alcoholic hepatitis may also experience malnourishment. Drinking significant amounts of alcohol can suppress the appetite. Alcohol may become the main source of calories for an individual. Malnutrition can also contribute to liver disease. […] According to the American Liver Foundation, up to 35% of people who consume alcohol heavily develop alcoholic hepatitis. Of these, 55% already have cirrhosis. […] Alcoholic hepatitis is a liver condition that mainly occurs due to heavy alcohol use on a regular basis. Alcohol can damage the liver, which may eventually lead to irreversible liver scarring, known as cirrhosis.

• #27 Alcohol and the Liver: Entire Lesson – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/alcohol/patient/single-page.asp

  Alcohol increases the damage done to the liver and speeds up the development of cirrhosis. For example, after about 25 years of hepatitis C infection, heavy drinkers show more than twice the scarring of light drinkers or non-drinkers. After 40 years of infection and heavy drinking, most heavy drinkers have developed cirrhosis. […] A heavy drinker with hepatitis C has 16 times the risk of cirrhosis compared with a non-drinker with hepatitis C. Alcohol and hepatitis C both damage the liver, so together, the risk of serious liver damage (cirrhosis) is much higher than with either alone.

• #28 Effect of alcohol on the progress of hepatitis B cirrhosis – Zhou – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/61289/html

  Hepatitis B virus (HBV) and alcohol are primary causes of cirrhosis. Alcohol can result in replication of HBV, an increase in oxidative stress, a compromised immune response to the virus and an increase in liver inflammation, all of which can result in progression of cirrhosis. […] Patients with chronic HBV infection and an excessive drinking habit activate HBV-DNA which increases liver inflammation, thus accelerating the progress of liver cirrhosis. Moderate drinking had no significant effect on the progress of liver cirrhosis. […] Discussion of whether alcohol synergizes with HBV to accelerate the progress of liver cirrhosis is limited. […] Excessive drinking may promote liver fibrosis and cirrhosis. […] This finding indicated that chronic hepatitis B patients with alcohol abuse will show accelerated progress of cirrhosis and even a decompensation period, which is consistent with some evidence suggesting that excessive alcohol intake by HBsAg-positive patients was associated with an increase in liver necroinflammatory changes. […] We also found that hepatitis B patients with excessive drinking were likely to be in the decompensation stage during which patients usually die.

• #29

  https://www.drugrehab.com/addiction/alcohol/effects-of-alcohol/hepatitis/

  Alcoholic hepatitis is inflammation of the liver caused by years of heavy drinking. […] Heavy drinking for prolonged periods of time is the main cause of alcoholic hepatitis, but some heavy drinkers never develop the condition. […] People who develop alcoholic hepatitis have usually been drinking heavily for years. […] In addition to heavy drinking, risk factors for alcoholic hepatitis include: Biological sex Women are more likely to develop alcoholic hepatitis than men. Weight People who are obese are more likely to have liver problems associated with alcohol. Genetics Some people are biologically more vulnerable than others. Ethnicity African-Americans and Hispanics may have a higher risk of developing the condition. Binge drinking Consuming a lot of alcohol in a short period of time increases the risk of liver inflammation. […] Alcohol addiction is a common contributor to alcoholic hepatitis.

• #30 Alcohol-Related Liver Disease – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/alcohol-related-liver-disease/alcohol-related-liver-disease

  Alcohol consumption is high in most Western countries. […] Disorders of the liver that occur in people with alcohol use disorder, often in sequence, but sometimes coexisting, include Alcoholic hepatitis (in 10 to 35%). […] The main risk factors for alcohol-related liver disease are Quantity and duration of alcohol use, Sex, Genetic and metabolic traits, Obesity. […] There appears to be a threshold effect above which the amount and duration of alcohol use increases the risk of the development of liver disease. […] Women are more susceptible to alcohol-related liver disease, even after adjustment for body size. […] Alcohol-related liver disease often runs in families, suggesting genetic factors (eg, deficiency of cytoplasmic enzymes that eliminate alcohol). […] Other risk factors include iron accumulation in the liver (not necessarily related to iron intake) and concomitant viral hepatitis.

• #31 Alcoholic hepatitis – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/alcoholic-hepatitis/

  Alcoholic hepatitis is swelling, called inflammation, of the liver caused by drinking alcohol. Drinking alcohol destroys liver cells. […] Alcoholic hepatitis is caused by damage to the liver from drinking alcohol. Just how alcohol damages the liver and why it does so only in some heavy drinkers isnt clear. […] The major risk factor for alcoholic hepatitis is the how much alcohol you drink. It isnt known how much alcohol it takes to cause alcoholic hepatitis. […] However, alcoholic hepatitis can happen to people who drink less and have other risk factors, including: […] Women seem to have a higher risk of getting alcoholic hepatitis. That might be because of how alcohol breaks down in womens bodies. […] Heavy drinkers who are overweight might be more likely to get alcoholic hepatitis. […] Studies suggest that genes might be involved in alcohol-induced liver disease. […] Black and Hispanic people might be at higher risk of alcoholic hepatitis. […] Having five or more drinks in about two hours for men and four or more for women might increase the risk of alcoholic hepatitis.

• #32 Pulsenotes | Alcoholic hepatitis notes

  https://app.pulsenotes.com/medicine/hepatology/notes/alcoholic-hepatitis

  Alcoholic hepatitis is a clinical syndrome due to progressive alcohol-mediated liver inflammation and injury. […] Alcoholic hepatitis is due to heavy alcohol consumption over many years (typically 100 g per day). […] Alcoholic hepatitis is usually induced by heavy alcohol consumption over years. However, it can develop with a shorter alcohol history and is increasingly seen in younger patients. […] The development of alcoholic hepatitis is multifactorial related to immunological dysfunction, disruption of the liver-gut axis with alteration in the microbiome, increased gut permeability with translocation of bacterial endotoxins and direct toxic effects of ethanol metabolism leading to oxidative damage and a pro-inflammatory response. […] Alcoholic hepatitis generally refers to the acute onset of symptomatic hepatitis due to heavy alcohol consumption.

• #33 Alcohol-Related Liver Disease – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/alcohol-related-liver-disease/alcohol-related-liver-disease

  Alcohol (ethanol) is readily absorbed from the stomach, but most is absorbed from the small intestine. […] Chronic excessive alcohol consumption induces the MEOS (mainly in endoplasmic reticulum), increasing its activity. […] Alcohol-related hepatic steatosis (fatty liver) is the initial and most common consequence of excessive alcohol consumption. […] Alcoholic hepatitis (steatohepatitis) is a combination of hepatic steatosis, diffuse liver inflammation, and liver necrosis (often focal) all in various degrees of severity. […] Alcoholic hepatitis may coexist. […] Alcohol-related cirrhosis is advanced liver disease characterized by extensive fibrosis that disrupts the normal liver architecture. […] Prognosis is determined by the degree of hepatic fibrosis and inflammation. […] Hepatic steatosis and alcoholic hepatitis without fibrosis are reversible if alcohol is avoided. […] Coexisting iron accumulation or chronic hepatitis C increases risk of hepatocellular carcinoma.

• #34 Alcoholic hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Alcoholic_hepatitis

  Alcoholic hepatitis is hepatitis (inflammation of the liver) due to excessive intake of alcohol. Patients typically have a history of at least 10 years of heavy alcohol intake, typically 8-10 drinks per day. […] Alcoholic hepatitis is distinct from cirrhosis caused by long-term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. […] Some alcoholics develop acute hepatitis as an inflammatory reaction to the cells affected by fatty change. This inflammatory reaction to the fatty change is called alcoholic steatohepatitis and the inflammation probably predisposes to liver fibrosis by activating hepatic stellate cells to produce collagen.

• #35 Advances in alcoholic liver disease: An update on alcoholic hepatitis

  https://www.wjgnet.com/1007-9327/full/v21/i42/11893.htm

  Several factors including cytokines and alcohol byproducts contribute to the development of AH-related steatosis, inflammation and fibrosis. […] Histologically, AH is characterized by a wide spectrum of changes including micro- and macrovesicular steatosis, acute inflammation with predominantly neutrophilic infiltration, hepatocellular necrosis, perivenular and perisinusoidal fibrosis, and characteristic eosinophilic fibrillar material (Mallorys hyaline bodies) noted in ballooned hepatocytes. […] Alcoholic cirrhosis develops as a result of longstanding alcohol use and is characterized by collagen deposition around the central hepatic vein and along the sinusoids. […] The most commonly noted laboratory abnormality associated with AH is an elevated bilirubin level. Other abnormalities in laboratory tests include moderately elevated transaminases with an AST to ALT ratio 2; elevated gamma-glutamyl transpeptidase (GGT); leukocytosis (with neutrophil predominance); macrocytosis; thrombocytopenia; and coagulopathy due to impaired production of coagulation factors and malnutrition.

• #36 Advances in alcoholic liver disease: An update on alcoholic hepatitis

  https://www.wjgnet.com/1007-9327/full/v21/i42/11893.htm

  The diagnosis of AH is made by comprehensive evaluation of clinical manifestations and laboratory data in a patient with history of alcohol consumption. […] The treatment of AH requires a multidisciplinary approach that focuses on alcohol cessation, psychosocial evaluation, pharmacologic therapy of AH and treatment of other complications of alcoholic liver disease including withdrawal and nutritional support. […] Alcohol abstinence is the most essential step towards optimizing the management of patients with AH. […] Chronic alcohol use induces a profound catabolic state by suppression of appetite, leading to poor oral intake of essential micro- and macronutrients. […] The use of specific supplements, in particular the branched-chain amino acids (BCCA), has produced some promising results.

• #37 Alcoholic-Associated Hepatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470217/

  The combination of systemic illness, malnutrition, concurrent renal injury, infections, lack of response to glucocorticoids or pentoxifylline result in poorer outcomes in severe alcoholic hepatitis. […] Further understanding of the pathophysiology of alcohol-induced liver injury, early recognition, including complications and potentially better pharmacological approach could in the future improve clinical outcomes in patients with severe AH. […] A better understanding of alcohol-related liver injury, inflammation, liver fibrosis, and liver regeneration and associated gut-barrier permeability and dysfunction, along with newer pharmacological breakthroughs to treat AH would likely improve our present management strategies.

• #38 Alcoholic Hepatitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p412.html

  Alcoholic hepatitis is a clinical syndrome characterized by acute-onset jaundice and liver enzyme abnormalities in the setting of long-term heavy alcohol use. […] Risk factors for the development of the disease include prolonged and heavy alcohol use, younger age, female sex, genetic susceptibility, higher body mass index, and comorbid liver disease. […] The presence of underlying cirrhosis and continued alcohol use negatively impact long-term prognosis. […] Alcohol-associated liver disease encompasses a range of pathologies from hepatic steatosis to cirrhosis. […] Alcoholic hepatitis is a clinical syndrome associated with acute-onset jaundice and liver failure. […] The incidence of alcoholic hepatitis is difficult to estimate because of inconsistency in diagnosis of the disease and overlap with concurrent, more easily diagnosed liver diseases, such as hepatitis C. […] Hospital admissions for alcoholic hepatitis are on the rise in the United States, accounting for 0.83% of all admissions in 2010. […] Overall and in-hospital mortality are high for severe alcoholic hepatitis, with a 28-day mortality rate of 16% to 30% and a one-year mortality rate of 56%.

• #39 Alcoholic Hepatitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/alcoholic-hepatitis

  Even if the damage is too severe to reverse, quitting drinking could prevent further harm to your liver. […] According to 2017 research, people with permanent liver damage due to heavy alcohol use who continued drinking had a 30 percent decrease in survival rate, compared to people who stopped drinking.

• #40 Alcoholic hepatitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/diagnosis-treatment/drc-20351394

  Treatment for alcoholic hepatitis involves quitting drinking as well as therapies to ease the symptoms of liver damage. […] If you’ve been diagnosed with alcoholic hepatitis, you need to stop drinking alcohol and never drink alcohol again. It’s the only way that might reverse liver damage or keep the disease from getting worse. People who don’t stop drinking are likely to have some life-threatening health problems. […] For many people with severe alcoholic hepatitis, the risk of dying is high without a liver transplant. […] In the past, those with alcoholic hepatitis have not been given new livers. This is because of the risk that they’ll continue drinking after transplant. But recent studies suggest that well-chosen people with severe alcoholic hepatitis have survival rates after a transplant similar to people with other types of liver disease who get liver transplants.

• #41 Can Alcoholic Hepatitis Be Cured? Treatment & Prognosis

  https://www.medicinenet.com/can_alcoholic_hepatitis_be_cured/article.htm

  Liver damage from mild alcoholic hepatitis can usually be cured by complete abstinence from alcohol and lifestyle changes. […] Liver damage from severe alcoholic hepatitis results in permanent scarring (cirrhosis) and liver cell death (necrosis), but further injury to the liver can be prevented with alcohol abstinence, and symptoms can be managed with good nutrition and medical treatments. […] Approximately 25% of heavy drinkers develop alcoholic hepatitis, but it is unclear what factors make some people more prone to alcoholic hepatitis than others. […] Alcoholic hepatitis is inflammation of the liver resulting from excessive consumption of alcohol. […] Heavy drinking for even a few days can cause the buildup of fat and lead to fatty liver, which is the earliest stage of alcoholic liver disease. Alcoholic hepatitis can also be caused by drinking large quantities of alcohol in a short time period (binge drinking on weekends, for example).

• #42 Can Alcoholic Hepatitis Be Cured? Treatment & Prognosis

  https://www.medicinenet.com/can_alcoholic_hepatitis_be_cured/article.htm

  Drinking in excess of 1-2 standard drinks a day regularly is considered heavy drinking and, over a period of time, can result in alcoholic hepatitis as the liver’s ability to process the alcohol is overwhelmed. […] Taking remedial steps for alcoholic hepatitis can help regain significant liver function, but liver damage from cirrhosis is permanent and often leads to liver failure. […] While some patients suffering from alcoholic hepatitis fully recover with abstinence, up to 70% develop liver cirrhosis despite abstinence, possibly because the liver is already significantly compromised at the time of diagnosis.

• #43 Alcohol-related Liver Disease > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/alcohol-related-liver-disease

  The best treatment for ALD, regardless of the stage of the disease, is abstinence from alcohol. […] However, if someone drinks heavily and/or regularly, it can be difficult to stop and it may be unsafe to do so without medical guidance. […] For patients with severe alcohol-related hepatitis or severe alcohol-related cirrhosis who arent helped by other therapies, liver transplantation may be an option.

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