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What is alcoholic hepatitis?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Alcoholic hepatitis is a severe inflammation of the liver caused by heavy, long-term alcohol use. Liver damage can happen suddenly and intensely with obvious symptoms such as jaundice, severe pain, and fever.

A 2019 study conducted at the University of Massachusetts found that 14–24% of patients with alcoholic hepatitis died within their first month of diagnosis, and more than half died within five years. 

Table of Contents

Stopping alcohol use can feel impossible when dealing with severe liver disease, even when your health depends on it. At Ardu, we offer comprehensive alcohol rehabilitation services with medical support and compassionate care to help you safely break free from alcohol.

How does alcoholic hepatitis develop?

When you binge drink, your liver repeatedly performs a toxic conversion process. It first breaks down alcohol into acetaldehyde, which is highly toxic and inflammatory. While your liver tries to convert this acetaldehyde into safer substances, the constant exposure to alcohol and acetaldehyde triggers this dangerous chain reaction:

  1. The toxic substances damage and kill liver cells.
  2. Your immune system responds with intense inflammation.
  3. Inflammation causes more liver cell death.
  4. Fat builds up in the remaining liver cells.
  5. The ongoing cycle of damage and inflammation becomes self-sustaining.

Liver damage can worsen even after you stop drinking because the alcohol-triggered inflammation often continues. What makes alcoholic hepatitis particularly dangerous is that it can develop suddenly after years of drinking, even in people who haven’t had previous liver problems. If you stop drinking completely in the early stages, your liver may still recover

To stop and reverse alcohol’s damaging effects on your body, you must quit drinking completely. We understand this isn’t easy; alcohol use disorder (AUD) changes your brain chemistry and behavior patterns, which makes it extremely difficult to stop without support.

Ardu is here to help. Our Utah rehabilitation programs address the physical and psychological aspects of alcohol addiction. We help you build a sustainable path to recovery and a healthier life through evidence-based therapies, counseling, group support, and holistic treatments.

Contact Ardu today.

What stage of alcoholic liver disease involves hepatitis?

Alcoholic hepatitis (steatohepatitis) is a severe inflammatory condition where the liver becomes swollen and damaged as a result of years of excessive alcohol consumption. Alcohol and its toxic byproducts trigger an intense inflammatory response that causes the liver cells to die. This can happen suddenly, even in people who have been drinking heavily for years without previous liver problems. 

This condition is the second stage in the progression of alcohol-associated liver disease. Here’s how it typically progresses:

  1. Stage 1: alcoholic fatty liver disease (steatosis). Your liver cells begin storing excess fat, leading to inflammation. At this point, stopping alcohol use can completely reverse the damage, and your liver can heal itself.
  2. Stage 2: alcoholic hepatitis. Your liver becomes severely inflamed. This stage is critical; you can either recover if you stop drinking entirely, or face life-threatening complications if you continue. 
  3. Stage 3: fibrosis. Scar tissue begins forming in your liver as it tries to repair the ongoing damage. Early fibrosis can still be partially reversed if you stop drinking completely at this stage.
  4. Stage 3: alcoholic cirrhosis. Your liver develops permanent scarring that replaces healthy tissue. This damage can’t be reversed, though stopping alcohol use can prevent further deterioration.

The stages sometimes overlap, and the disease doesn’t always linearly progress. Some people develop alcoholic hepatitis even if they already have early cirrhosis.

What are the symptoms of alcoholic hepatitis?

The warning signs of alcoholic hepatitis can develop suddenly and may quickly intensify. Here are the most common symptoms of alcoholic hepatitis:

  • Jaundice (yellowing of skin and eyes)
  • Severe abdominal pain, especially in the upper right side
  • Unexplained fever
  • Extreme fatigue and weakness
  • Nausea and vomiting
  • Loss of appetite
  • Mental confusion or changes in behavior
  • Swelling in your abdomen (ascites)
  • Tender or enlarged liver
  • Weight loss
  • Easy bruising or bleeding
  • Spider-like blood vessels on your skin
  • Dark-colored urine
  • Light-colored stools

If you experience several of these symptoms, especially if you have a history of heavy alcohol use, seek emergency medical care immediately.

What is the difference between alcoholic hepatitis and cirrhosis?

Many people confuse alcoholic hepatitis and cirrhosis because both conditions can occur at the same time, and they share some similar symptoms. Here are the major differences:

  • Alcoholic hepatitis is an acute liver inflammation. It develops suddenly and can be life-threatening, but if you stop drinking completely, your liver might still recover from some of the damage.
  • Cirrhosis is permanent scarring of your liver. Over time, scar tissue replaces healthy liver tissue, preventing your liver from working properly. Cirrhosis damage can’t be reversed, but stopping alcohol use can prevent further scarring.

Japanese research indicates that alcoholic hepatitis shows active inflammation with white blood cells attacking liver tissue under a microscope. Cirrhosis shows permanent scarring where tough fibrous bands have replaced healthy liver tissue.

A 2018 study reveals that, when it comes to death rates, cirrhosis patients typically die from long-term liver failure and complications related to portal hypertension. Alcoholic hepatitis patients are more likely to die from sudden inflammatory responses and severe infections.

Don’t wait for liver damage to become permanent. If you have a history of heavy drinking, getting help now is paramount for your liver health. Ardu provides professional medical detox and tailored addiction treatment to help you navigate alcohol withdrawal.

How long does alcoholic hepatitis take to become cirrhosis?

The speed at which alcohol-associated hepatitis progresses to cirrhosis differs from person to person. Severe cases can develop cirrhosis within months, while others may take years to progress. Some people with alcoholic hepatitis may never develop cirrhosis if they stop drinking completely. 

According to a 2014 study published in the World Journal of Gastroenterology, for severe alcoholic hepatitis patients who make it through the critical first 6 months, about 70% will develop cirrhosis.

Researchers from the University of Massachusetts found that a significant number of patients with severe alcoholic hepatitis fail to recover despite stopping alcohol use. If they haven’t recovered by 3 months, spontaneous recovery carries the minimal risk and patients may progress to cirrhosis. Their research also indicates that alcohol-associated hepatitis generally develops after excessive drinking for at least 20 years, typically appearing in people’s 40s or 50s.

But that doesn’t mean that all people who drink excessively will develop alcohol-related liver disease.

Do all heavy drinkers get alcoholic hepatitis?

Not all heavy drinkers will develop alcoholic hepatitis or chronic liver disease. Research shows that only 35% of excessive drinkers develop hepatitis while only 10% ultimately develop cirrhosis.

Other factors that increase the risk of developing alcoholic hepatitis include:

  • Genetics.
  • Poor nutritional status.
  • Overall health conditions.
  • Obesity.
  • Presence of hepatitis C.
  • Gender.

Women seem to be more susceptible to developing alcoholic-related hepatitis than men because they show signs of liver disease with less alcohol consumption over shorter periods. Bizzaro, et. al. provide evidence that men’s risk increases at 60–80 grams of alcohol per day, but women face an increased risk of alcoholic hepatitis at just 20–40 g daily.

Our rehab experts understand the unique health challenges women face with alcohol dependency. Our specialized women’s rehabilitation program provides comprehensive medical support to protect your liver health. We include female-focused therapy groups and personalized counseling in a safe, supportive environment. 

Let us help you take the first step toward recovery with treatment designed specifically for women’s needs. Reach out to Ardu online or via phone (801-872-8480).

What is life expectancy with alcoholic hepatitis?

The life expectancy for alcohol-associated hepatitis varies significantly depending on its severity and the individual’s overall health, treatment, and lifestyle changes. A 2024 comprehensive review suggests that severe cases have short-term mortality rates of 25–40% within 28 days of diagnosis. In milder cases, mortality is 3–7% within the first 6 months, increasing to 13–20% by the end of the first year. 

Long-term life expectancy depends on abstinence from alcohol, liver function, and access to medical care. At Ardu, we deliver compassionate care and expert medical support to pave the way for your sobriety.

Get help with your drinking with Ardu

Dealing with alcoholic hepatitis is overwhelming, especially when health concerns and the challenges of quitting alcohol collide. But you don’t have to face this journey alone. Don’t wait until it’s too late—get the help you need to stop drinking, support liver healing, and rebuild your health.

At Ardu, we’ve created a wide variety of holistic and comprehensive treatment options to address alcohol-related liver conditions and help you achieve lasting sobriety. First, we start with an alcohol detox program to get you cleaned and ready to thrive in your rehab.

Our detox services include:

  • 24/7 medical supervision to make alcohol withdrawal safe and minimize complications.
  • Personalized detox protocols tailored to your needs.
  • Comprehensive monitoring of vital signs and overall health to address any complications promptly.
  • Medication management and expert care to alleviate withdrawal symptoms.
  • Professional support during the crucial early days of sobriety to help you build a strong foundation for recovery.

Our rehabilitation services for alcohol dependency involve:

  • A tranquil residential setting in Provo, Utah, where you can focus entirely on your recovery without outside distractions.
  • Evidence-based therapy programs, including cognitive behavioral therapy (CBT) and motivational enhancement, to address the emotional and psychological challenges of addiction.
  • Integrated mental health care as part of our dual diagnosis treatment to address co-occurring conditions such as anxiety, depression, or trauma that often accompany alcohol dependency.
  • Educational sessions on understanding addiction, its effects on your body and mind, and the tools for lasting recovery.
  • Holistic approaches such as mindfulness practices, yoga, and meditation therapy to reduce stress and promote emotional balance.
  • Group therapy and peer support to build connections with others on the same journey to recovery.
  • Family counseling to repair strained relationships, rebuild trust, and create a strong network of support.
  • Relapse prevention strategies tailored to your personal needs to help you maintain sobriety and thrive in the long term.

Healing from alcoholic hepatitis isn’t just about stopping alcohol use; it’s about reclaiming your health and quality of life. We’re here to support you every step of the way with compassionate, personalized care that helps you heal and thrive.

Contact Ardu online or call us today to learn how our comprehensive treatment plan empowers you to reclaim your life from alcohol.

“…I stayed an additional 30 days where I grew close to all the staff and felt very comfortable there. They introduced me to a huge variety of treatments that would help me stay sober. They taught me how to love myself again. Aftercare options were discussed and I chose an IOP that best fit me. I am very blessed to say that I have remained sober, going on 16 months. Thank you Ardu for helping me start my new life journey.”

Holly Scott

5/5
Brandon Okey

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Alcoholic hepatitis FAQ

Can you live a full life with alcoholic hepatitis?

Living a full life with alcoholic hepatitis is possible, but outcomes vary based on disease severity and management. Early diagnosis may require a liver biopsy to assess damage and guide treatment. The key to recovery is complete alcohol cessation combined with proper medical care and nutrition.

In severe cases where the liver has extensive damage, liver transplantation may be necessary. Patients must demonstrate long-term sobriety to be considered for a transplant. The activation of stellate cells during liver injury can lead to scarring and potentially cirrhosis if the condition progresses.

Regular monitoring is crucial as patients with alcoholic hepatitis have an increased risk of developing hepatocellular carcinoma, a type of liver cancer. With proper medical management, lifestyle changes, and consistent follow-up care, many patients can stabilize their condition and maintain a good quality of life. If you continue to drink alcohol, you may face an increased risk of requiring a liver transplant or developing life-threatening complications.

Is alcoholic hepatitis reversible?

Alcoholic hepatitis can be reversible, particularly in its early stages. When diagnosed early, abstaining from alcohol and adopting a healthy lifestyle can halt further liver damage and allow for liver function recovery. Medications such as corticosteroids may reduce inflammation and support liver healing in severe cases. The longer alcohol consumption continues, the higher the likelihood of progressing to cirrhosis, which is irreversible. 

Does alcoholic hepatitis ever go away?

Alcoholic hepatitis can improve or resolve if the individual stops drinking alcohol and receives the right treatment options. In mild cases, liver cells may regenerate over time with proper medical advice and care to pave the way for recovery. If alcoholic liver disease progresses to more severe conditions, such as chronic liver disease, acute hepatitis, or end-stage liver disease, the damage may become permanent. 

While liver injury may be reversed to some extent with alcohol rehabilitation and medication, advanced liver damage, including cirrhosis, may prevent full recovery. Avoiding alcohol and managing complications such as common vitamin deficiencies and ascites in cirrhosis improve liver function and prevent further deterioration.

Will 6 beers a day cause liver damage?

Consuming six beers a day increases the risk of liver damage, especially over time. Heavy alcohol consumption, such as this, can lead to alcohol-related liver disease, including acute hepatitis and cirrhosis. Chronic alcohol use overwhelms the liver’s ability to process toxins, leading to inflammation, liver injury, and scarring. 

The risk of developing severe liver conditions depends on factors such as overall health, genetics, and diet, but this level of alcohol intake significantly heightens the risk of liver dysfunction and long-term damage.

Will my liver heal if I quit drinking?

The liver’s healing capacity after quitting alcohol depends on several factors, including the presence of reactive oxygen species (ROS) that increase inflammation in the liver and overall liver function. A clinical diagnosis and assessment of portal blood flow determine the extent of damage. Your healthcare provider may use different alcoholic hepatitis scoring systems to evaluate your condition. Regular monitoring of blood pressure and liver function helps track recovery progress.

The management of patients typically focuses on improving blood flow through portal veins and preventing complications like bacterial peritonitis. A 2019 study showed that early intervention leads to better outcomes, while continued alcohol use results in poorer outcomes. The stage of fibrosis, as highlighted by pathologists Lackner and Tiniakos, determines how much healing is possible, with systematic staging systems helping to assess potential recovery.

Can you live 30 years with cirrhosis?

Long-term survival with cirrhosis varies significantly based on multiple factors. The management of patients requires careful monitoring through clinical trials and regular assessments. Those with complications like bacterial peritonitis or compromised portal blood flow typically experience poorer outcomes. The presence of reactive oxygen species and other inflammatory markers can indicate disease progression.

Your clinical diagnosis and alcoholic hepatitis score help determine the prognosis of cirrhosis and treatment approach. Maintaining stable blood pressure and preventing complications in the portal veins is crucial for long-term survival. Treatment may involve participating in clinical trials and following strict management protocols. Without proper intervention and lifestyle changes, patients may face serious complications that significantly impact life expectancy.

How do I know my liver is healing?

Here are several ways you can tell your liver is healing:

  • Improved liver function tests: A reduction in liver enzymes, such as ALT and AST, indicates less liver damage and better function.
  • Decreased symptoms: You may notice a reduction in symptoms such as jaundice (yellowing of the skin), fatigue, and abdominal pain as the liver heals.
  • Imaging tests: Ultrasounds or other imaging methods might show a decrease in liver inflammation or scar tissue over time.
  • Overall improvement in well-being: As your liver heals, you may feel less fatigued and experience a return to normal appetite and energy levels.

When doctors diagnose alcohol-induced hepatitis, they use specific tools like the Discriminant function score to determine how severe your condition is and your risk of death. Based on clinical trials and practice guidelines, doctors then create a therapeutic strategy that might include steroids and other treatments to improve the survival of patients.

Can you ever drink again after hepatitis?

Clinical practice guidelines strongly advise against drinking after experiencing acute alcohol-associated hepatitis, as it significantly increases your risk of developing decompensated cirrhosis and severe disease. A 2021 prospective study has shown that even if you’ve achieved long-term survival through treatment, resuming alcohol consumption can rapidly worsen your condition and lead to liver failure. 

To avoid complications and prevent further liver damage, maintaining months of alcohol abstinence, following your therapy in liver disease patient protocol, and prioritizing proper nutrition improve your chances for recovery.

How can doctors tell if I have alcohol-related liver damage?

Doctors diagnose alcohol-associated liver disease through several clinical practice guidelines. 

  • They’ll start with a physical examination and blood tests to assess alcohol-induced hepatitis and end-stage liver disease. 
  • A liver biopsy may be required, especially if there are signs of decompensated cirrhosis or portal hypertension. 
  • Prospective studies have helped develop different scoring systems, including the discriminant function and alcoholic hepatitis score, to determine disease severity. 
  • Your doctor will monitor for complications like hepatocellular carcinoma, particularly if you have chronic liver disease or severe liver disease. 
  • Regular follow-up care is essential for tracking your liver injury progression.

Can liver transplantation help with my hepatitis?

For patients with severe alcohol-associated hepatitis who haven’t responded to standard therapeutic strategies, liver transplantation can be life-saving. Clinical trials show improved survival of patients who undergo transplantation, but most programs require months of alcohol abstinence first. The management of patients includes careful risk-of-death assessment and evaluation for complications like bacterial peritonitis. 

Your long-term survival depends on maintaining complete abstinence from alcohol and following medical advice. The liver transplant evaluation looks at factors such as the prognosis of cirrhosis and patients with ascites to determine candidacy.

What is the best rehab treatment to heal the liver?

Alcohol rehabilitation combined with strict abstinence from alcohol forms the foundation of treatment for alcohol-associated liver disease. Clinical practice guidelines emphasize that management of alcohol and proper follow-up care are crucial. Poor nutrition must be addressed because many patients develop common vitamin deficiencies. Your therapeutic strategy should include monitoring for complications like ascites in cirrhosis and portal hypertension. 

What is the role of corticosteroids in healing liver hepatitis?

Corticosteroids are an important treatment for acute alcohol-associated hepatitis, particularly in severe disease cases. Clinical trials have demonstrated their effectiveness in reducing liver injury and improving the survival of patients with high discriminant function scores. 

Apart from the benefits of corticosteroids, the management of patients requires careful monitoring for complications such as bacterial peritonitis or decompensated cirrhosis. If the prescribed corticosteroid dose isn’t effective, your doctor might consider liver transplantation. Clinical practice guidelines recommend a comprehensive therapeutic strategy that includes abstinence from alcohol, proper medical advice, and regular assessment of end-stage liver disease progression.

Resources

Hosseini, N., Shor, J., & Szabo, G. (2019). Alcoholic Hepatitis: A Review. Alcohol and Alcoholism (Oxford, Oxfordshire), 54(4), 408. https://doi.org/10.1093/alcalc/agz036

Toshikuni, N., Tsutsumi, M., & Arisawa, T. (2014). Clinical differences between alcoholic liver disease and nonalcoholic fatty liver disease. World Journal of Gastroenterology: WJG, 20(26), 8393. https://doi.org/10.3748/wjg.v20.i26.8393

Ohashi, K., Pimienta, M., & Seki, E. (2018). Alcoholic liver disease: A current molecular and clinical perspective. Liver Research, 2(4), 161-172. https://doi.org/10.1016/j.livres.2018.11.002

Chayanupatkul, M., & Liangpunsakul, S. (2014). Alcoholic hepatitis: A comprehensive review of pathogenesis and treatment. World Journal of Gastroenterology: WJG, 20(20), 6279. https://doi.org/10.3748/wjg.v20.i20.6279

Hosseini, N., Shor, J., & Szabo, G. (2019). Alcoholic Hepatitis: A Review. Alcohol and Alcoholism (Oxford, Oxfordshire), 54(4), 408. https://doi.org/10.1093/alcalc/agz036

Bizzaro, D., Becchetti, C., Trapani, S., Lavezzo, B., Zanetto, A., Merli, M., Lapenna, L., Invernizzi, F., Taliani, G., & Burra, P. (2023). Influence of sex in alcohol‐related liver disease: Pre‐clinical and clinical settings. United European Gastroenterology Journal, 11(2), 218. https://doi.org/10.1002/ueg2.12370

Philips, C. A. (2024). A comprehensive review of diagnosis and management of alcohol-associated hepatitis. SAGE Open Medicine. https://doi.org/10.1177/20503121241297000

Bataller R., Arteel, G. E., Moreno C., & Shah VH. (2019). Alcohol-related liver disease: Time for action. Journal of Hepatology, 70(2), 221. https://doi.org/10.1016/j.jhep.2018.12.007

Thomes, P. G., Rasineni, K., Saraswathi, V., Kharbanda, K. K., Clemens, D. L., Sweeney, S. A., Kubik, J. L., & Casey, C. A. (2021). Natural Recovery by the Liver and Other Organs after Chronic Alcohol Use. Alcohol Research: Current Reviews, 41(1), 05. https://doi.org/10.35946/arcr.v41.1.05

Further reading

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The extent of alcohol-related DNA damage

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All about alcohol fetal syndrome

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