Hepatitis is an inflammatory disease of the liver of diffuse or focal nature caused by various causes. Alcoholic hepatitis is toxic.
Alcoholic hepatitis in the vast majority of cases (with the exception of acute poisoning with alcohol with toxic impurities) develops gradually, slowly and imperceptibly in the systematic use of alcoholic beverages of varying strength. Concerning the safety of an adult, the dose is assumed to be 40 ml of alcohol per day for men and 20 ml for women. But the ability to neutralize alcohol in everyone is individual and depends on a number of factors.
The main factors influencing the appearance of alcoholic hepatitis:
- sex - the acceptable dose of alcohol in women is almost 2 times lower than that of men,
- age - children, teens and elderly people are much more sensitive to alcohol,
- Body weight - People with low body weight and those who are obese are more likely to be exposed to alcohol,
- The presence of diseases Liver and other digestive organs reduces the body's ability to neutralize alcohol,
- General condition of the organism - in the presence of a number of chronic diseases of various organs and systems, chronic fatigue, allergies and other conditions, the toxic effect of alcohol on the body increases significantly,
- The presence of other (non-alcoholic) toxic effects on the body (industrial, professional, household poisons, drugs, radiotherapy, etc.) contributes to the earlier development of alcoholism,
- Hereditary and population (ethnic) propensity - it is due to the genetically engineered ability of the liver to develop certain types of enzymes that neutralize alcohol (family alcoholism, individuals of the Mongoloid race are more prone to alcoholism than the European-race race).
Changes in the body with alcoholic hepatitis
When passing alcohol through the gastrointestinal tract, it is rapidly absorbed into the bloodstream, but before that, chronically affecting the mucous membrane, damaging its epithelium, and strong alcohol - causing chemical burn with subsequent scarring. With the flow of blood, alcohol enters the liver, where it is neutralized by a group of special enzymes (alcohol dehydrogenase). At the same time, at the intermediate stage, a very toxic substance, acetaldehyde, is formed which, in the course of further transformations, is completely neutralized and excreted in the urine.
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But under the influence of a number of negative factors there is an exhaustion of these enzymatic systems, some of them just do not have time to recover with frequent (or constant) use of alcohol. Therefore, acetaldehyde and alcohol are not completely neutralized, they have a toxic effect on liver cells (hepatocytes) - hepatitis develops, and then some of the cells die, they are replaced by the connective tissue, forming cirrhosis. In the future, hepatic insufficiency develops, in addition, there is a toxic effect of alcohol on other organs and tissues of the organism and, in the first place, the central nervous system, the endocrine system, immunity.
Manifestations of alcoholic hepatitis
The earliest and constant symptoms of alcoholic hepatitis are gradually increasing weakness, fatigue, lack of appetite and weight loss.
- Blister and vomiting bitterness
- Metal smack in the mouth
- As well as a sense of discomfort and severity in the right hypochondrium, accompanied by a dull pain that intensifies after eating, with physical activity and palpation of the abdomen.
- Diarrhea, especially after taking alcohol, greasy and spicy foods,
- Symptoms of dysbiosis develop,
- Chronic cholecystitis and pancreatitis,
The body temperature rises. There is a tendency to the formation of bruises, bleeding gums, which is associated with a violation in the blood coagulation system.
With further progression of hepatitis, it appears yellowness of sclera, mucous membranes and skin, accompanied by severe itching. This indicates the stagnation of bile in the liver: a violation of its outflow leads to the entry of bilirubin into the blood and its accumulation in the skin and mucous membranes. At the same time there is discoloration of feces and darkening of the color of urine.
Forecast for alcoholic hepatitis
Alcoholic hepatitis at the initial stage of development with adequate treatment and complete refusal to use alcohol, the exclusion of negative effects on the body can end with a complete recovery. But in case of inadvertent cases or in case of non-compliance with the recommendations of doctors, taking alcohol, hepatitis passes into cirrhosis with the development of liver failure and other complications (including liver cancer), which shorten the life expectancy of the patient and lead to a fatal outcome.
- General blood and urine test
- Biochemical analysis of blood with the definition of bilirubin and its fractions, ALT and AST, protein fractions.
- Research of the system of coagulation of blood (coagulogram),
- Ultrasound of the abdominal cavity
- Liver biopsy.
Basic principles of treatment for alcoholic hepatitis
- Adherence to the diet (table number 5 for Pevzner) and complete refusal to drink alcohol.
- Prolonged reception of hepatoprotectors, which promote the recovery of the liver
- To improve the metabolic processes in the liver, administer lipotropic substances, corticosteroids, as well as intravenous administration of glucose solution with insulin, conduct plasmapheresis.
- Cholesterol is prescribed to relieve symptoms of cholestasis (stagnation of bile) and to reduce itching.
- In the treatment of severe forms of chronic hepatitis with signs of liver failure, hemisorption, hyperbaric oxigenation is used.
- Vitamin therapy (vitamins of group B, C, PP, folic acid and others).
- Transplantation (transplantation) of a liver is used at a difficult course of alcoholic hepatitis with hepatic insufficiency.