Curriculum · Gastroenterology
Alcoholic hepatitis
What it is
Alcohol in any amount is toxic to the liver and can cause acute and chronic injury and hepatitis. Acute alcoholic binges can cause fatty liver, and hepatic steatosis with inflammation is called alcoholic steatohepatitis. Mild forms of alcoholic steatohepatitis are common, are usually asymptomatic, and are associated with mild elevations in aminotransferase levels. The most severe form of alcoholic steatohepatitis is called AH, and what distinguishes it from alcohol-induced steatosis and steatohepatitis is the presence of symptoms; it is a potentially severe form of alcohol-induced liver disease.
Causes and risk
AH usually occurs in patients with daily, heavy alcohol use of more than 100 g/d for more than 20 years, although AH can develop in patients who drink moderately.
How it presents
Most people remain subclinical, but the presentation ranges from nausea and vomiting to fulminant hepatitis and liver failure. The examination may show the stigmata of chronic alcohol disease, such as gynecomastia and spider angiomata.