Alcohol and Hepatitis
Alcohol and hepatitis are closely linked. Excessive drinking and illicit drug use are some of the most common methods by which individuals contract hepatitis.
The Relationship Between Alcohol and Hepatitis
Alcohol and hepatitis have a very close, and mutually destructive relationship. Long-term alcohol abuse is one of the leading causes of hepatitis, and any amount of drinking can grossly exaggerate the symptoms of hepatitis that was originally caused in a different way.
What Is Hepatitis?
Many diseases, injuries, and disorders cause inflammation of the liver, also known as hepatitis. Alcohol and hepatitis are closely linked due to the impact that alcohol has on the liver. Excessive drinking and illicit drug use are some of the most common methods by which individuals contract hepatitis. Whether acute (temporary) or chronic (long-term), there are no cures for hepatitis, though long-term treatment for symptoms does exist. The most noticeable symptoms of hepatitis include the yellowing of skin and eyes, abdominal tenderness, and vomiting.
There are five strains of viral hepatitis and several metabolic, autoimmune, and genetic forms. Only a few of these commonly affect individuals with substance addictions. Viral hepatitis is mostly spread by contaminated food and water, through unprotected sex, or through infected needle-sharing. The symptoms of acute viral hepatitis may be so slight as to go unnoticed, often delaying diagnosis and increasing the opportunity for further transmission. Metabolic hepatitis develops in the liver through excessive drinking or the ingestion of certain toxic, chemical agents. Hepatitis can be fatal if left untreated, or if the individual continues to damage his or her liver by drinking, meaning alcohol and hepatitis are a very dangerous combination.
The most common forms of hepatitis among people suffering from substance use disorders are:
Hepatitis B (HBV) was once known as “serum hepatitis” because it was believed to be transferred solely through infected blood. Today, we know that HBV is transmitted through unprotected sex, sharing needles, accidental needle sticks, contaminated tattoo and piercing equipment, and from infected mothers to newborns. An estimated 2.2 million Americans are infected with HBV. Up to 10% of those with HBV will remain infected for six months or longer, developing chronic HBV and increasing the risk for liver cancer or failure.
Hepatitis C (HCV) is spread primarily through intravenous drug use or sexual contact with infected bodily fluids. According to the Centers for Disease Control (CDC), there are more than 3.5 million people living with HCV in the US. As many as 85% of newly infected individuals will contract chronic, long-term HCV. The 3.2 million Americans living with HCV face an increased possibility of cirrhosis (liver scarring), liver failure, and cancer.
Hepatitis D (HDV) is also called the Delta Virus. HDV is unique in that an individual must already be infected with HBV to contract it. HDV and HBV can also be contracted at the same time. The combination results more quickly in severe cirrhosis and is difficult to treat.
Hepatitis may also be caused by a number of sources that are neither viral or bacterial, but is instead caused by a cascade of events. Metabolic hepatitis develops in the liver through protracted exposure to hepatitis-causing agents (such as harsh chemicals or binge drinking).
Alcoholic hepatitis (AH) is inflammation of the liver caused by excessive alcohol consumption. The liver is the body’s largest organ and, while capable of processing alcohol, can only do so in measured doses. Leftover alcohol stays in the body, causing the liver to build up an excess of fat in its cells. Approximately 90 to 100 percent of heavy drinkers have fatty livers, according to the American Liver Foundation. A fatty, inflamed liver may lead to AH and a 5 to 10 percent chance of developing a prolonged illness that results in death.
The longer an individual abuses alcohol, the higher their chance of developing alcoholic hepatitis. Thirty-five percent of long-time heavy drinkers will face the consequences of AH. Heavy drinking is defined as 5 or more drinks in a few hours, 5 or more times in a month. Most are diagnosed between the age of 40 and 60, after the damage is irreversible.
A typical patient of AH has consumed 6 to 7 drinks per day for more than 20 years (with some cases appearing in as little as 10 years). Yet, AH does not occur in all heavy drinkers, and some who drink only moderately will also develop it. Up to 40% of people with severe AH die within one month of diagnosis. It is important to seek medical attention if you believe you are exhibiting symptoms of AH (i.e. yellow skin or eyes, loss of appetite, fever, weakness).
Toxic and Drug-Induced Hepatitis
A variety of chemical compounds (including some prescription medications, industrial toxins/inhalants, illicit drugs, and dietary supplements) can cause hepatitis. The exposure to these substances necessary to produce hepatitis varies as much as the substances themselves. For instance, some inhalants can cause liver damage at first use, while some medication requires decades to cause hepatitis.
Symptoms of Hepatitis
Hepatitis causes liver scarring and a buildup of fatty tissue that prevents the organ from properly filtering the blood. Still, some individuals may not show any symptoms until their infection becomes chronic—though they are still infectious to others during this time. External symptoms of hepatitis include:
- Yellowing of the skin and whites of the eyes (i.e. jaundice)
- Weight loss (likely due to malnourishment)
- Sore abdomen
- Dark urine
- Reduced appetite
- Flu-like symptoms
- Fatigue or weakness
- Nausea or vomiting
Severe symptoms like the buildup of fluid in the abdomen, confusion, behavior changes, kidney, and liver failure may present themselves in people with severe hepatitis.
Hepatitis can be diagnosed through physical examination, blood tests, an ultrasound, CT scan, MRI, or a combination of tests. Alcoholic hepatitis doesn’t produce antigens in the body and must be observed in the liver rather than tested through blood. A liver biopsy may be necessary to make a diagnosis.
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Who Is at Risk for Hepatitis?
Individuals who share needles and practice unprotected sex increase their likelihood of contracting hepatitis. The main risk factor for alcoholic hepatitis is protracted alcohol abuse. Gender, weight, ethnicity, and certain genetic factors may affect the extent to which acute or chronic hepatitis develops in some people. Furthermore, some forms of hepatitis are transmitted genetically, through contaminated food, sharing silverware, or injury. So, it is difficult to completely reduce the risk of all forms of hepatitis. However, living a purposeful life enhanced by exercise and a healthy diet can reduce the risk for illness.
Effects of Untreated Hepatitis
The liver is responsible for filtering harmful substances from the blood. Both alcohol and hepatitis hinder the liver’s ability to clean our blood, but symptoms of hepatitis may be so slight as to go unnoticed for years.
About 40% of people with HCV develop at least one co-occurring health complication in addition to liver damage. Damage to blood vessels and joints can result in nerve damage, skin sores, stroke, and heart attacks. Rheumatoid arthritis, neurological problems, kidney damage, Type 2 Diabetes, and rare bone diseases all can stem from the damage caused by hepatitis.
Once diagnosed, it’s critical that individuals begin treatment of their hepatitis immediately to prevent any further damage. Those with alcoholic hepatitis must cease drinking permanently. There are no cures for hepatitis, but treatment by a number of medications can manage symptoms and curb the virus. Most cases of HBV and HCV will resolve without medical intervention and don’t require a visit to the hospital except for prescription medication. However, due to the concomitant alcoholism, alcoholic hepatitis requires medical attention.
It’s Ok to Ask for Help with Alcohol and Hepatitis
If your hepatitis was the result of behavior linked to an addiction or if you need to stop drinking in order to treat hepatitis but are having trouble doing so, a rehab center may provide the best care for you. Treatments may include:
- Clinical therapy and counseling
- Alcoholics Anonymous or other 12-step support groups
- Inpatient therapy
- Outpatient or residential treatment
Most rehab facilities are very familiar with the relationship between alcohol and hepatitis and will be both understanding and helpful. If you’re suffering from an addiction to alcohol and want to begin your recovery, contact a dedicated treatment provider now.
Clinical Reviewer — Last Reveiwed: May 20, 2019
American Liver Foundation. (2017). Liver Disease Statistics. Retrieved on July 5, 2018 at https://liverfoundation.org/liver-disease-statistics/#alcohol-related-liver-disease-and-cirrhosis
Centers for Disease Control and Prevention. (2017). Surveillance for Viral Hepatitis – United States, 2015. Retrieved on July 5, 2018 at https://www.cdc.gov/hepatitis/statistics/2015surveillance/Commentary.htm
Everyday Health. (2018). What Happens to Your Health When You Aren’t Treated for Hepatitis C. Retrieved on July 5, 2018 at https://www.everydayhealth.com/hs/hepatitis-c-living-well/dangers-untreated-hepatitis-c/
Healthline. (2017). Alcoholic Hepatitis. Retrieved on July 5, 2018 at https://www.healthline.com/health/alcoholic-hepatitis
Mayo Clinic. (2018). Alcoholic Hepatitis. Retrieved on July 5, 2018 at https://www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/symptoms-causes/syc-20351388
Medical News Today. (2016). What’s to know about alcoholic hepatitis? Retrieved on July 5, 2018 at https://www.medicalnewstoday.com/articles/313928.php
MedicineNet. (2017). Hepatitis (Viral Hepatitis, A, B, C, D, E, G). Retrieved on July 5, 2018 at https://www.medicinenet.com/viral_hepatitis/article.htm#viral_hepatitis_facts
NCBI. (2011). Definition, epidemiology and magnitude of alcoholic hepatitis. Retrieved on July 5, 2018 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124876/
WebMD. (2017). Alcoholic Hepatitis. Retrieved on July 5, 2018 at https://www.webmd.com/hepatitis/what-is-alcoholic-hepatitis#1
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