Alcoholic hepatitis (Alcohol-associated hepatitis)

Alcoholic hepatitis—increasingly called alcohol-associated hepatitis—is a serious liver condition caused by drinking alcohol. It involves inflammation and damage to liver cells, which can lead to liver failure and death if alcohol use continues. What is alcohol-associated hepatitis? Alcohol-associated hepatitis occurs when long-term heavy drinking or binge drinking causes toxic injury and inflammation in the liver. It is part of alcohol-associated liver disease (ALD), a spectrum that ranges from fatty liver to fibrosis, cirrhosis, and liver failure. Not everyone who drinks heavily develops liver disease, but the risk is significant. Studies show that up to one-third of people with alcohol use disorder develop alcohol-related liver disease. Stopping alcohol completely is the single most important treatment step. Symptoms Symptoms range from mild to life-threatening. Common symptoms Yellowing of the skin and eyes (jaundice) Loss of appetite Nausea and vomiting Fatigue and weakness Low-grade fever Pain or tenderness in the upper right abdomen Advanced symptoms Fluid buildup in the abdomen (ascites) Confusion or behavior changes (hepatic encephalopathy) Bleeding from enlarged veins in the esophagus or stomach (varices) Kidney failure Liver failure Malnutrition is common because alcohol replaces food calories and interferes with nutrient absorption. Causes When the liver breaks down alcohol, it produces toxic by-products that: Damage liver cells Trigger inflammation Weaken the gut barrier, allowing bacterial toxins to reach the liver Over time, fat accumulation, inflammation, and cell death lead to fibrosis and eventually cirrhosis. Fibrosis may improve with abstinence, but cirrhosis is usually permanent. In people with both metabolic dysfunction (such as obesity or diabetes) and alcohol use, the condition may be called Metabolic dysfunction and alcohol-associated liver disease (MetALD). Risk factors Amount and duration of alcohol use Women: 3–4 drinks/day for 6 months or more Men: 4–5 drinks/day for 6 months or more Female sex Overweight or obesity Genetic factors Black or Hispanic ethnicity Binge drinking Acetaminophen (paracetamol) use with alcohol Prior bariatric surgery (faster alcohol absorption) Other liver diseases (e.g., hepatitis C) Poor nutrition When to see a doctor Seek medical care immediately if you: Have symptoms of alcoholic hepatitis Notice jaundice Have trouble controlling alcohol use Want help stopping drinking Alcohol-associated hepatitis is not contagious, unlike viral hepatitis. Early diagnosis and complete alcohol abstinence can be life-saving and may allow partial liver recovery.