Materiały źródłowe

• #1 Alcoholic hepatitis | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/alcoholic-hepatitis?content_id=CON-20157202

  You might reduce your risk of alcoholic hepatitis if you: […] Drink alcohol in moderation, if at all. For healthy adults, moderate drinking means up to one drink a day for women and up to two drinks a day for men. The only certain way to prevent alcoholic hepatitis is to avoid all alcohol. […] Protect yourself from hepatitis C. Hepatitis C is a liver disease caused by a virus. Without treatment, it can lead to cirrhosis. If you have hepatitis C and drink alcohol, you’re far more likely to get cirrhosis than if you don’t drink. […] Check before mixing medicines and alcohol. Ask your healthcare professional if it’s safe to drink alcohol when taking your prescribed medicines. Read the warning labels on medicines you can get without a prescription. Don’t drink alcohol when taking medicines that warn against drinking alcohol while taking them. This includes pain relievers such as acetaminophen (Tylenol, others).

• #2 Management of alcoholic hepatitis: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3554797/

  The primary and most effective intervention for alcoholic hepatitis is complete abstinence from alcohol consumption. Abstinence is the single most important factor in the prevention of disease progression and can improve survival. […] The cornerstone of supportive care remains aggressive nutritional support, and although acute alcoholic hepatitis has been extensively studied, few specific medical therapies have been successful. […] While liver transplantation for acute alcoholic hepatitis have demonstrated promising results, this practice remains controversial and has not been advocated universally, with most transplant centers requiring a prolonged period of abstinence before considering transplantation. […] The primary intervention remains abstinence, as this is the most important risk factor for disease progression and is required if transplantation is eventually needed.

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

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

  The best way to prevent alcoholic hepatitis is to avoid alcohol or drink only in moderation. Moderate drinking is defined as less than two drinks per day for men and less than one drink per day for women. […] You can also reduce your risk by taking steps to protect yourself from hepatitis B and hepatitis C. The bloodborne viruses that cause these conditions can be transmitted in several ways, including shared needles or razors and through body fluids during sex. Currently, vaccines are available for hepatitis B, but not for hepatitis C.

• #4

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

  Successful treatment for alcohol-related liver disease (ARLD) often depends on whether someone is willing to stop drinking alcohol and make changes to their lifestyle. […] Treatment for ARLD involves stopping drinking alcohol. This is known as abstinence, which can be vital depending on what stage the condition is at. […] If you have a more serious form of ARLD (alcoholic hepatitis or cirrhosis) lifelong abstinence is recommended. […] This is because stopping drinking is the only way to prevent your liver damage getting worse and potentially stop you dying of liver disease. […] Nevertheless, if you have alcohol-related cirrhosis or alcoholic hepatitis and do not stop drinking, no medical or surgical treatment can prevent liver failure.

• #5 Alcohol-Induced Hepatitis vs. Cirrhosis: Causes, Treatment, More

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

  The best way to prevent alcohol-related liver damage is by avoiding alcohol or, if you do drink, minimizing your consumption. […] According to the Centers for Disease Control and Prevention (CDC), even moderate drinking may increase your risk of alcohol-related complications compared to not drinking. […] You can prevent alcohol-induced hepatitis from progressing to cirrhosis by quitting drinking alcohol. Continuing to drink can put you at risk of severe liver damage and liver failure.

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

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

  The best way to prevent alcoholic hepatitis is to drink in moderation, if at all. Moderate drinking is less than two drinks per day for men and less than one for women. […] If you have other risk factors, including hepatitis B or C, fatty liver disease, or obesity, or previously drank heavily, you should avoid all alcohol. […] You should also try to avoid contracting hepatitis B and C, viruses known to increase the risk of alcoholic hepatitis. These viruses are most commonly spread through blood-to-blood contact, such as through shared needles in injection drug use or shared razors. They can less commonly be spread sexually. Vaccines are available for hepatitis B. […] Be careful mixing medication and alcohol. Some drugs are toxic to the liver, especially when taken alongside alcohol or by heavy drinkers. These include drugs in every medicine cabinet such as acetaminophen (Tylenol).

• #7 Current Management and Future Treatment of Alcoholic Hepatitis – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/april-2020/current-management-and-future-treatment-of-alcoholic-hepatitis/

  The cornerstone of therapy for all stages of ALD is abstinence from drinking alcoholic beverages. […] Although short-term mortality has improved, overall mortality may still reach 30% to 50% within 90 days of the diagnosis of severe AH. […] All patients who have fatty liver disease should be screened for quantity and frequency of alcohol consumption as well as for alcohol use disorders (AUDs). The adverse effect of continued alcohol consumption on mortality of ALD patients emphasizes the importance of treatment of AUDs. […] The estimated prevalence of alcohol-associated cirrhosis was 0.43%, accounting for approximately 38% of all cases of cirrhosis in the study population with an absolute risk of 9.8% in patients consuming more than 60 g of ethanol daily. […] The daily alcohol consumption threshold for the risk of ALD is clearly lower in women compared to men (11-20 vs 21-40 g daily).

• #8 Current Management and Future Treatment of Alcoholic Hepatitis – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/april-2020/current-management-and-future-treatment-of-alcoholic-hepatitis/

  The amount and duration of alcohol consumption are both risk factors for the development of ALD. […] Risk factors for the development of fibrosis and cirrhosis include not only the daily amount of alcohol consumed, particularly outside of meals, and the duration of heavy consumption, but also obesity and cigarette smoking. […] Importantly, the daily alcohol consumption threshold for the risk of ALD is clearly lower in women compared to men (11-20 vs 21-40 g daily). […] The cornerstone of therapy for all stages of ALD is abstinence from drinking alcoholic beverages. […] Glucocorticoid treatment may not increase the risk of infection during treatment, but following therapy, the risk of serious infection, including fungal infections, is higher. […] The adverse effect of continued alcohol consumption on mortality of ALD patients emphasizes the importance of treatment of AUDs.

• #9 Alcohol-Induced Hepatitis: Symptoms & Treatment

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

  People with this condition should ask their healthcare providers for help to quit drinking in order to prevent further liver damage. […] The only effective treatment is to quit drinking. However, it’s best to quit under medical supervision. Quitting cold turkey can lead to withdrawal symptoms and dangerous side effects. […] You can still prevent further damage and preserve the rest of your liver by quitting. You have to quit completely, and forever, but you can recover. […] Early recognition is your best hope of catching and reversing the effects of alcohol-induced hepatitis. If you have a history of heavy alcohol use and/or symptoms of liver disease, call your healthcare provider. They’ll check out your liver, assess any possible damage and help you change your habits to change your health future.

• #10 Alcoholic Hepatitis (Alcohol-Associated Hepatitis) Treatment & Management: Approach Considerations, Cessation of Alcohol Intake, Diet and Nutritional Support

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

  The 2019 American Association for the Study of Liver Diseases (AASLD) practice guidance recommends that all patients seen in primary care and gastroenterology/hepatology clinics, as well as all emergency department patients and hospital inpatients be screened for alcohol use using validated questionnaires. […] Patients engaged in hazardous drinking should be offered counseling, pharmacotherapy, and referral to treatment.

• #11 Alcoholic Hepatitis: Diagnosis and Management | AAFP

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

  Abstinence from alcohol is the mainstay of treatment. Clinicians should counsel all patients on alcohol cessation, offer medications for alcohol use disorder when appropriate, and consider early consultation with a substance abuse counselor, social worker, and/or psychiatrist, depending on institutional resources. […] Promote long-term abstinence from alcohol for all patients with alcoholic hepatitis. […] Provide nutritional support for patients with alcoholic hepatitis, with a daily energy intake of 35 to 40 kcal per kg of body weight and a daily protein intake of 1.2 to 1.5 g per kg of body weight. […] Administer corticosteroids to patients with severe alcoholic hepatitis without active infection. […] Guidelines recommend intravenous N-acetyl-cysteine, 40 mg per day for five days, as an adjunct to corticosteroids in patients with severe alcoholic hepatitis. […] There is growing support for early liver transplantation in some patients with severe alcoholic hepatitis, rather than requiring six months of alcohol abstinence and engagement in alcohol cessation counseling.

• #12 Alcohol-related liver disease | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/alcohol-related-liver-disease/

  Once you’ve stopped drinking, you may need further treatment to help ensure you don’t start drinking again. […] The first treatment usually offered is psychological therapy. […] If psychological therapy alone isn’t effective, you may also need medication to help you abstain from alcohol, such as: acamprosate, naltrexone, disulfiram. […] Many people with alcohol dependence find it useful to attend self-help groups to help them stop drinking.

• #13 Medical management of severe acute alcoholic hepatitis – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/medical-management-of-severe-acute-alcoholic-hepatitis/

  1. Abstinence from drinking alcohol is the cornerstone of treatment for alcohol hepatitis (AH). […] 2. Patients with jaundice and suspected AH should have cultures of blood, urine and ascites, if present, to determine the presence of bacterial infections regardless of whether they have fever. […] 3. Patients with AH who have jaundice should be admitted to the hospital to encourage abstinence, restore adequate nutrition and exclude serious infections. […] 4. Imaging of the liver is warranted as part of the evaluation, but caution should be used in administering iodinated contrast dye, as it increases the risk of acute kidney injury (AKI). […] 5. Patients with AH require a diet with 1-1.5 g protein and 30-40 kcal/kg body weight for adequate recovery. If the patient is unable to eat because of anorexia or altered mental status, a feeding tube should be considered for enteral feeding. Parenteral nutrition alone is inadequate.

• #14 Managing Your Alcoholic Hepatitis – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/digestive-health/alcoholic-liver-disease

  DO stop drinking. […] DO seek treatment for your alcohol problem. […] DO eat a well-balanced, high-calorie diet. People who drink too much alcohol are often malnourished. […] DO take vitamins, especially vitamin B and folic acid. […] DONT drink alcohol. You could get cirrhosis of the liver. […] DONT salt your food. Eating salt can make swelling of the abdomen worse. […] DONT use drugs, including acetaminophen, sedatives, and tranquilizers, that can harm the liver.

• #15 Alcoholic Hepatitis: Causes, Symptoms, and Treatment

  https://resources.healthgrades.com/right-care/liver-conditions/alcoholic-hepatitis

  Avoiding alcohol is the surest way to prevent alcoholic hepatitis. […] It may also help to adopt practices that can lower your risk of hepatitis C. These practices include: avoiding direct contact with other people’s blood, practicing sex with a condom or another barrier method, avoiding sharing personal care items. […] The only way to prevent alcoholic hepatitis is to stop using alcohol. Ongoing alcohol use can lead to complications like kidney failure and hepatic encephalopathy. In some people, it can also cause ascites, esophageal bleeding, and cirrhosis.

• #16 Alcohol and Viral Hepatitis – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/hcv/clinical-management/alcohol.asp

  When counseling a patient with hepatitis C, always evaluate the patient’s history of and current use of alcohol. Generally speaking, alcohol is a toxin that causes inflammation of the liver. When both alcohol and viral hepatitis are present, they can have a synergistic effect in causing liver damage. Research has shown that fibrosis scores in hepatitis C patients have correlated with patients’ degree of alcohol use. There is strong evidence that heavy alcohol use (50 grams per day) is associated with higher likelihood of advanced fibrosis in hepatitis C patients. Reducing and minimizing alcohol intake is one thing that patients with hepatitis C can do in their lifestyle to help reduce the progression to serious liver disease. However, controversy exists on the question of what amount of alcohol is safe in patients with hepatitis C.

• #17 Alcohol and Viral Hepatitis – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/hcv/clinical-management/alcohol.asp

  For patients with cirrhosis, due to hepatitis C or any other cause, there is a clear recommendation for zero alcohol consumption. […] The most important message for patients is that alcohol can worsen their liver disease. Recommending minimal alcohol is usually reasonable. […] Providers should recommend minimal alcohol use in patients without cirrhosis and zero alcohol use in patients with cirrhosis. […] There is a high prevalence of drinking among patients with hepatitis C. Collaborate with local substance abuse clinics and mental health providers to address this critical component of viral hepatitis patient care.

• #18 Medical management of severe acute alcoholic hepatitis – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/medical-management-of-severe-acute-alcoholic-hepatitis/

  6. Severity and prognosis of AH should be evaluated using Maddrey Discriminant Function (MDF), Model for End-Stage Liver Disease (MELD), age, bilirubin, international normalized ratio, and creatinine (ABIC), or Glasgow scoring systems. Current treatments are based on this assessment. […] 7. Presence of systemic inflammatory response syndrome (SIRS) on admission is associated with an increased risk of multi-organ failure (MOF) syndrome. Development of MOF, usually due to infections developing after initial diagnosis of AH, is associated with a very high mortality rate. […] 8. Nephrotoxic drugs, including diuretics, should be avoided or used sparingly in patients with AH, since AKI is an early manifestation of MOF. […] 9. Patients with MDF > 32 or MELD score > 20 without a contraindication to glucocorticoid, such as hepatitis B viral infection, tuberculosis, or other serious infectious diseases, may be treated with methylprednisolone 32 mg daily, but the appropriate duration of treatment remains a subject of controversy. Methylprednisolone does not improve survival beyond 28 days, and the benefits for < 28 days are modest.

• #19 Natural treatments for alcoholic hepatitis | EBSCO Research Starters

  https://www.ebsco.com/research-starters/complementary-and-alternative-medicine/natural-treatments-alcoholic-hepatitis

  Numerous other herbs possess known or suspected liver-toxic properties, including coltsfoot, comfrey, germander, greater celandine, kombucha, pennyroyal, and various prepackaged Chinese herbal remedies. For this reason, people with alcoholic liver disease should use caution before taking any medicinal herbs.

• #20 Alcoholic Hepatitis: Causes, Symptoms, Treatment, & Prevention | Zinnia Health

  https://zinniahealth.com/substance-use/alcohol/alcoholic-hepatitis

  Routine medical check-ups are essential for early detection and monitoring of liver health. Regular blood tests and liver function assessments can identify potential issues before they progress to more severe conditions. Timely intervention can significantly improve outcomes. […] Vaccinations against hepatitis A and B are recommended for individuals with alcoholic liver disease. These vaccinations prevent additional stress on the liver caused by viral infections, reducing the risk of complications. […] Maintaining a healthy weight is vital for liver health. Excess weight, especially abdominal fat, contributes to liver inflammation. Adopting a lifestyle that includes regular physical activity and a balanced diet helps manage weight and supports liver function. […] Some medications can exacerbate liver damage. Individuals with alcoholic hepatitis need to consult healthcare providers before taking any medications, including over-the-counter drugs and supplements. Medical professionals can recommend safe alternatives that do not harm the liver. […] Individuals with alcoholic hepatitis often have co-existing health conditions. Managing conditions such as diabetes, high blood pressure, and cholesterol levels can help your liver. By staying on top of these health issues, the burden your liver takes will be reduced.

• #21 Medical management of severe acute alcoholic hepatitis – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/medical-management-of-severe-acute-alcoholic-hepatitis/

  10. Patients with a contraindication to glucocorticoids may be treated with pentoxifylline 400 mg three times daily with meals. Data regarding the efficacy are conflicting. […] 11. Patients with severe AH, particularly those with a MELD score > 26 with good insight into their alcohol use disorder and good social support should be referred for evaluation for liver transplantation, as the 90-day mortality rate is very high. […] 12. Patients with mild to moderate AH defined by a MELD score < 20 and MDF < 32 should be referred for abstinence counseling and prescribed a high protein diet supplemented with B vitamins and folic acid.

• #22 Alcoholic Cirrhosis: Symptoms, Causes, Treatment, & Prevention | Zinnia Health

  https://zinniahealth.com/substance-use/alcohol/alcoholic-cirrhosis

  Nutrient-rich, well-balanced diets support overall health, including liver function. Diets high in fruits, vegetables, and whole grains, while low in processed foods and saturated fats, contribute to liver health. […] Maintaining a healthy weight through regular exercise is vital for preventing liver disease. Obesity is a risk factor for cirrhosis, and engaging in physical activity helps manage weight, improve metabolism, and enhance overall well-being. […] Vaccination against hepatitis viruses, particularly hepatitis B and C, is an essential preventive measure. Chronic hepatitis infections significantly contribute to the development of cirrhosis. […] Practices such as unsafe drug use and unprotected sex can expose individuals to hepatitis infections, accelerating the progression of liver disease. Avoiding risky behaviors contributes to overall liver health and complements other preventive measures.

• #23 Alcoholic Hepatitis: Symptoms, Causes, Diagnosis, Treatment, Complications & Prevention

  https://ghealth121.com/treatments/alcoholic-hepatitis/

  Preventing alcoholic hepatitis involves reducing alcohol consumption and managing risk factors: […] Moderate Alcohol Intake: Adhering to guidelines for moderate alcohol consumption can help prevent liver damage. For women, this generally means up to one drink per day, and for men, up to two drinks per day. […] Regular Health Checkups: Monitoring liver health in individuals with chronic alcohol use can help detect early signs of liver damage. […] Support and Education: Providing education and support for individuals with alcohol use disorders to promote abstinence and healthy lifestyle choices.

• #24 Alcoholic Hepatitis: Causes, Symptoms, Treatment, & Prevention | Zinnia Health

  https://zinniahealth.com/substance-use/alcohol/alcoholic-hepatitis

  Preventing alcoholic hepatitis is crucial for maintaining liver health and overall well-being. Here are key strategies, particularly beneficial for those at risk or in the early stages of liver disease: […] The most effective prevention measure is to cease alcohol consumption entirely. For those at risk or diagnosed with alcoholic hepatitis, stopping alcohol intake is paramount. This step allows the liver to recover and reduces the risk of further damage. […] Individuals struggling with alcohol dependence should seek professional assistance. Alcohol cessation programs, counseling, and support groups can provide guidance and motivation for sustained abstinence. Healthcare professionals can tailor treatment plans to individual needs. […] Proper nutrition supports liver regeneration and helps combat the effects of malnutrition associated with alcohol abuse. A diet that is rich in vitamins, minerals, and antioxidants will be beneficial to overall liver function.

• #25 Alcoholic Hepatitis: Its Clinical Trials, Factors and Prevention

  https://www.longdom.org/open-access/alcoholic-hepatitis-its-clinical-trials-factors-and-prevention-measures-103210.html

  Alcoholic hepatitis is a serious liver condition caused by excessive and prolonged alcohol consumption. […] The primary treatment goal for alcoholic hepatitis is to abstain from alcohol and allow the liver to heal. […] Early intervention, including alcohol cessation and proper medical care, can significantly improve the chances of recovery and reduce the risk of life-threatening complications associated with this condition.

• #26 Can You Reverse Alcoholic Hepatitis? Improve Your Lifespan

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

  Mild alcoholic hepatitis can usually be reversed. However, if it becomes severe and reaches the stage of liver cirrhosis, it is usually irreversible. […] Stopping alcohol consumption can slow down the progression of the disease and prevent further liver damage. […] If you’ve been diagnosed with alcoholic hepatitis, the most important thing you can do is abstain from alcohol. […] Enrollment in an alcoholic rehabilitation program within 30 days after hospital discharge can help people with alcoholic hepatitis reduce their risk of dying from the condition.

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