The liver, which performs many important functions, is one of the largest organs in the body. It is positioned in the upper right part of our abdomen, below the diaphragm. Although there are ways to replace the liver artificially, using liver dialysis, this is only a short term solution, and the only solution for serious liver damage is transplantation.
What does the liver do?
The liver does a number of things:
- It produces many different proteins needed for our organism to function normally
- It produces coagulation factors
- It has an important role in the metabolism of lipids
- It produces bile which helps digest food.
- It also produces hormones and stores different vitamins, glucose, iron and copper.
- The liver has an important role in our immune system too.
Alcoholic beverages have been a part of tradition in many parts of the world. Even though alcohol is a toxin, and it does damage to our body, drinking alcohol in small amounts isn't harmful because the liver clears it out of our system. But, if alcohol intake is frequent, and the amounts of alcohol ingested are large, the liver takes damage and isn't capable of regenerating.
Symptoms of alcoholic liver disease
Chronic exposure to alcohol does damage to the liver. At first, it starts with minor, clinically insignificant damage, but then, if alcohol intake continues, the deterioration of liver progresses. Fatty liver (steatosis) is the next stadium. At this stadium, the liver cells, hepatocytes, store abnormal amounts of fat. If the damage to the liver continues, alcoholic hepatitis occurs. Up to this stadium, the damage is still reversible. But, if heavy drinking continues, inflammation can turn to fibrosis, then cirrhosis and, in the end, hepatocellular carcinoma.
Because of the inflammation, the liver becomes enlarged. this could be diagnosed using ultrasound, but the enlargement of the organ can also cause pain in the upper-right abdomen. Nausea and vomiting are also some of the symptoms which can be attributed to alcoholic hepatitis, along with diarrhea and loss of appetite.
If the illness progresses, more severe symptoms may occur. these symptoms include:
- Vomiting blood
- Lower limb swelling
- Blood in feces
- Weight loss
Since the liver produces many proteins needed for coagulation, symptoms of alcoholic hepatitis may also include getting bruised more easily, or bleeding from cuts for a longer time than usual. Decreased liver function affects other organs too. Other conditions caused by alcoholic hepatitis include:
- Gastrointestinal bleeding
- Diabetes mellitus
Diagnosis: How will your doctor determine if you have alcoholic hepatitis?
Any of these symptoms, combined with history of heavy drinking, may lead your doctor to suspect alcoholic hepatitis. Even though the statistics say that most patients with alcoholic hepatitis are 40 to 60 years old with decades of alcohol abuse, this isn't always the case. There have been reports of patients as young as 20 years old, and as old as 80 years old.
Some people are more susceptible to this disease than the others. There have been in which patients developed this disease after only a few months of heavy drinking. Binge drinking may cause the illness to progress more quickly. But, generally speaking, most patients have a history of consuming more than 80g of ethanol daily for over five years, which is about six standard US beers, or five standard European beers. The doctor may order blood tests to confirm liver damage, testing for bilirubin, AST, ALT, ALP, GGT levels, some of which should be elevated, depending on the level of liver deterioration.
Treatment: How should you manage alcoholic hepatitis?
First of all, you should stop drinking. If done in the early stages, quitting alcohol may reverse liver damage completely. If you're not able to quit drinking yourself, you should ask for professional help, since the symptoms of alcohol withdrawal may be severe, and sometimes even life-threatening. A lifestyle change could also help. Smoking and obesity contribute to liver damage, so people affected with alcoholic hepatitis should consider loosing weight and quitting smoking.
As for medications, your doctor may prescribe corticosteroids to reduce the inflammation. There are also drugs that could help with alcohol abstinence. Since most patients are malnourished, taking vitamin supplements is encouraged.