Alcoholic hepatitis

Diagnosis

Your doctor will conduct a physical examination and ask about your current and past alcohol use. It's important to be honest about your drinking habits. Your doctor might ask your permission to interview family members about your drinking.

To test for liver disease, your doctor might recommend:

• Liver function tests
• Blood tests
• An ultrasound, CT or MRI scan of the liver
• A liver biopsy, if other tests and imaging don't provide a clear diagnosis or if you are at risk of other causes of hepatitis

Treatment

Treatment for alcoholic hepatitis involves quitting drinking and therapies to ease the signs and symptoms of liver damage.

Quitting drinking

If you've been diagnosed with alcoholic hepatitis, you must stop drinking alcohol and never drink alcohol again. It's the only way to possibly reverse liver damage or prevent the disease from worsening. People who don't stop drinking are likely to develop a variety of life-threatening health problems.

If you are dependent on alcohol and want to stop drinking, your doctor can recommend a therapy that's tailored for your needs. It can be dangerous to stop drinking suddenly so if you're dependent, be sure to discuss a plan with your doctor.

Treatment might include:

• Medications
• Counseling
• 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.

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 the 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 can't take corticosteroids. The benefit of pentoxifylline (Pentoxil) for alcoholic hepatitis isn't clear. Study results are inconsistent.

Liver transplant

For many people with severe alcoholic hepatitis, the risk of death is high without a liver transplant.

Historically, those with alcoholic hepatitis have not been liver transplant candidates because of the risk that they will return to harmful drinking after transplant. Recent studies, however, suggest that carefully selected patients with severe alcoholic hepatitis have post-transplant survival rates similar to those of liver transplant recipients with other types of liver disease.

For transplant to be an option, you would need:

• To find a program that works with liver transplant patients who have alcoholic hepatitis
• To meet the requirements of the program, which would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

You might be referred to a digestive disease specialist (gastroenterologist).

What you can do

When you make the appointment, ask about restrictions, such as restricting your diet for certain tests.

Make a list of:

• Your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment, and when they began.
• All medications, vitamins and supplements you take, including doses.
• Key medical information, including other conditions you have.
• Key personal information, including recent changes or stressors in your life. Track your alcohol consumption for a few days so that you can let your doctor know how much you regularly consume.
• Questions to ask your doctor.

Have a relative or friend accompany you, if possible, to help you remember the information you're given.

Questions to ask your doctor

• What's the most likely cause of my symptoms? Are there other possible causes?
• What tests do I need? How do I need to prepare for them?
• Is my condition temporary or chronic?
• What treatments are available? Which one do you recommend?
• I have other health problems. How can I best manage these conditions together?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

• How severe are your symptoms? Are they occasional or constant?
• Does anything improve or worsen your symptoms?
• Have you had hepatitis or yellowing of the skin?
• Do you use recreational drugs?
• Are your family members or friends concerned about your drinking? Have you had social consequences — such as an arrest — because of your drinking?
• Do you get angry or anxious when the subject of your drinking is discussed?
• Do you feel guilty about drinking?
• Do you drink in the morning?