Alcoholic hepatitis versus Cirrhosis of the liver
The pathology behind Cirrhosis of the Liver is the increasing formation of fibrous tissues which slowly prevents the liver performing it’s vital intrinsic function within our body. Often we hear about the term “hepatitis” due to overuse of alcohol and link it to cirrhosis. The main difference between these two liver diseases is that alcoholic hepatitis is reversible while cirrhosis can’t be reversed. However, alcoholic hepatitis can lead to cirrhosis of the liver. Let’s find out how this occurs and how both of them are diverse in nature.
What is alcoholic hepatitis?
Hepatitis is defined as inflammation of the liver. The etiology behind this type of liver injury is chronic heavy alcohol intake and abuse over years. Less commonly, heavy alcohol intake over a short period of time called binge drinking, may also induce hepatitis. However this relationship between alcohol and hepatitis is complex. Not all heavy drinkers develop hepatitis and not all hepatitis patients are heavy alcohol drinkers. Only 35% percent of heavy drinkers develop alcoholic hepatitis. Hence it may be linked to many other conditions such as:
• Genetic differences in the processing of alcohol by the body. This is the reason why alcohol damages women more than men.
• Coexisting liver disorders like hepatitis C
However a continued alcohol intake may result in cirrhosis of the liver. This progression occurs in 10-20% of the heavy drinkers.
Types of Alcohol-related liver disease
Liver disease due to alcohol intake can be divided into three types:
1. Fatty liver disease
This is the condition in which the liver cells called hepatocytes accumulate excess fat. It is usually an asymptomatic condition or may have mild symptoms like fatigue, weakness and weight loss. This disease is present in almost all heavy drinkers (90-100%) and is reversible after a short period of around two weeks when the individuals stop drinking.
2. Alcoholic hepatitis
This is the condition in which hepatocytes swell up due to inflammation and become damaged. It may produce these symptoms, nausea, vomiting, abdominal pain, loss of appetite, fever and jaundice. Mild cases of hepatitis may be reversible but you may need to stop drinking for months or even years. On the other hand, severe hepatitis may have serious complications like liver failure or death.
3. Alcoholic cirrhosis
This is the condition where the liver cells become irreversibly scarred. This damage leads to loss of function of the liver. It is the most serious type of liver disease due to alcohol. The symptoms may be similar to alcoholic hepatitis. The damage in this condition cannot be reversed and eventually leads to liver failure.Removing alcohol may halt the progression of liver damage, but the most severe cases may need strict treatment measures including a transplant.
Progression to Cirrhosis of the Liver
A majority of heavy alcohol drinkers may progress from fatty liver disease to alcoholic hepatitis and eventually to cirrhosis of the liver. Some may skip the fatty liver stage and directly develop hepatitis. Other may have an asymptomatic form of alcoholic hepatitis. One in four drinkers with fatty liver will progress to alcoholic hepatitis. One in five drinkers with fatty liver develop cirrhosis. The risk of developing cirrhosis of the liver is strongly linked to coexisting hepatitis C in the individual.
Complications of alcoholic liver disease
These complications may occur after years or decades of heavy drinking habits. Many of them can be very serious in nature. These include:
• Ascites ( fluid buildup in the abdomen)
• Variceal bleeding ( from veins in esophagus or stomach)
• Spleen enlargement
• High blood pressure within the organ
• Hepatic encephalopathy ( brain disorders or coma)
• Kidney failure
• Liver cancer
Alcohol abuse over many years may raise suspicions of an alcoholic liver disease in the individual. Tests for Liver function may be required to rule out other conditions and to determine the condition of the liver. A liver biopsy is the most definitive standard test. It may reveal the degree of liver inflammation or help determine the onset of cirrhosis.
Treatment of Alcoholic Hepatitis and Cirrhosis of the Liver
Here are a few lifestyle and medical measures you might take to treat alcoholic liver disease or prevent a progression to the irreversible state of cirrhosis:
- Take a healthy balanced diet
- Avoid drinking alcohol: You may join alcohol recovery programs which may help you with the process.
- Medications to manage the complications that arise.
- A liver transplant may be required if cirrhosis of the liver progresses to an advanced stage
- Traditional Chinese medicine
- Health supplements
- Look at the dietary intake