Alcoholic hepatitis

Inflammation of the liver associated with alcohol abuse.

It usually occurs in patients between 40-60 years of age. Although women are more susceptible, it is more frequent in men because they are twice as likely to abuse alcohol. Other risk factors have been described: obesity, malnutrition, hepatitis C virus and genetic factors.

It has a variable presentation, from asymptomatic forms to cases presenting with severe liver failure. Most commonly, there is a lack of appetite, nausea, vomiting, muscle weakness, yellowing of the skin and whites of the eyes, abdominal distension and pain, and "coca cola" colored urine. In addition, fever, behavioral disorders, drowsiness, swelling in the legs, tingling, weakness, weight loss, etc. may occur.

It should be suspected when the symptoms described above are present together with a compatible physical examination. The diagnosis is confirmed by detecting analytical alterations and liver ultrasound, although the definitive diagnosis is made by liver biopsy. 

Mild and asymptomatic forms usually evolve well if alcohol intake is suspended and nutritional deficits are corrected. Severe forms require hospitalization and have a very high mortality rate that can exceed 50% after three months. There is no effective treatment.

Liver transplantation is an option, but only after a period of time of alcohol abstinence.