Alcoholic liver disease is the most common liver disease in the United States. It is encountered most commonly and results in between 20,000 and 40,000 deaths per year. It is the fourth leading cause of death among Americans.
Alcoholic liver disease is an extremely broad and multi-system disease. Alcoholic hepatitis is an inflammation of the liver secondary to excessive alcohol ingestion. A patient is often times identified when an enlarged liver or elevations in amino transferases are seen during routine exam.
Symptoms of alcoholic hepatitis include vague abdominal pain, nausea, vomiting, weight loss, fever, diarrhea, fatigue and malaise.
Amino transferases are usually identified in these patients. AST levels are usually between 300 and 500 International Units. ALT levels are less increased. As a result, the AST, ALT ratio is greater than 2 to 1. The alkaline phosphatase may be elevated or normal. Bilirubin may be increased or normal.
Most patients with alcoholic hepatitis stabilize after 4-5 days. In fact, most patients without alcoholic hepatitis experience some form of deterioration within the first 4-5 days of hospitalization. After 4-5 days, the sequences of alcoholic hepatitis begin to become less.
Severe alcoholic hepatitis can result in death. In fact, severe alcoholic hepatitis carries a mortality rate of approximately 50 percent within the first 30 days. Patients at risk for this have multiple organ failure, abnormal electrolytes, abnormal fluid dynamics and change in mental status (encephalopathy) and are jaundiced. These patients are severely ill.
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