Treatment for alcoholic hepatitis involves drinking cessation and therapies to ease the signs and symptoms of liver damage.
If you've been diagnosed with alcoholic hepatitis, you must stop drinking alcohol and never drink alcohol again. It's the only way of possibly reversing liver damage or preventing the disease from becoming worse. Survival rates for people with alcoholic hepatitis who stop drinking are significantly better than survival rates for people who continue drinking.
If you are dependent on alcohol and want to stop drinking, your doctor can recommend a therapy that's tailored for your needs. Treatment might include:
- Alcoholics Anonymous or other support groups
- Outpatient or residential treatment program
Treatment for malnutrition
Your doctor might recommend a special diet to correct nutritional problems. You might be referred to a dietitian who can suggest ways to increase your consumption of the vitamins and nutrients you lack, including vitamin B1 (thiamine).
If you have trouble eating, your doctor might recommend tube feeding. A tube is passed down your throat or through your side and into your stomach. A special nutrient-rich liquid diet is then passed through the tube.
Medications to reduce liver inflammation
If you have severe alcoholic hepatitis, your doctor might recommend:
- Corticosteroids. These medications have shown some short-term benefit in increasing survival of certain people with severe alcoholic hepatitis. However, corticosteroids have serious side effects and generally aren't prescribed if you have failing kidneys, gastrointestinal bleeding or an infection.
- Pentoxifylline. Your doctor might recommend this anti-inflammatory medication if you have severe alcoholic hepatitis and can't take corticosteroids. The overall benefit of pentoxifylline for alcoholic hepatitis isn't clear. Studies indicate that pentoxifylline might not be effective for people with mild alcoholic hepatitis or for people who haven't responded to steroid treatment.
For many people with severe alcoholic hepatitis, a liver transplant is the only hope to avoid death. Survival rates for liver transplant for alcoholic hepatitis are similar to survival rates for transplants associated with other types of liver disease.
However, most transplant centers are reluctant to perform liver transplants on people with alcoholic liver disease because of the fear they will resume drinking after surgery. For transplant to be an option, you would need:
- To find a program that will consider you
- To meet the requirements of the program, including abstaining from alcohol for six months before transplant and agreeing not to resume drinking afterward
Aug. 04, 2017
- Friedman SL. Alcoholic hepatitis: Clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed Sept. 11, 2015.
- Ferri FF. Alcoholic hepatitis. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 12, 2015.
- Singal AK, et al. Alcoholic hepatitis: Current challenges and future directions. Clinical Gastroenterology and Hepatology. 2014;12:555.
- Kumar V, et al, eds. Liver and gallbladder. In: Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 11, 2015.
- Walker BR, et al, eds. Liver and biliary tract disease. In: Davidson's Principles and Practice of Medicine. 22th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Sept. 11, 2015.
- Friedman SL. Alcoholic hepatitis: Natural history and management. http://www.uptodate.com/home. Accessed Sept. 11, 2015.
- AskMayoExpert. Initial evaluation for alcoholic liver disease. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Goldman L, et al, eds. Alcoholic and nonalcoholic steatohepatitis. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 12, 2015.
- Mathurin P, et al. Trends in the management and burden of alcoholic liver disease. Journal of Hepatology. 2015;62:538.
- Anderson-Shaw L, et al. Ethical issues in liver transplantation. http://www.uptodate.com/home. Accessed Sept. 11, 2015.
- Cirrhosis. National Heart, Lung, and Blood Institute. http://www.niddk.nih.gov/health-information/health-topics/liver-disease/cirrhosis/Pages/facts.aspx#cause. Accessed Sept. 12, 2015.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 1, 2015.