Alcoholic Hepatitis and Alcohol-Related Liver Disease (ARLD) have been on the rise since the start of the pandemic. Though it can take years to manifest, hospitals have seen a 50% spike in the number of people needing liver transplants due to alcoholic hepatitis.
Alcoholic hepatitis is a stage of ARLD and is an inflammatory condition of the liver, often caused by extended periods of regular heavy alcohol use. The alcohol the liver produces creates highly toxic chemicals that can damage the liver cells severely enough that one may need a liver transplant in order to survive.
There are a number of signs, symptoms, and risk factors to look out for when it comes to ARLD and alcoholic hepatitis.
The Rise in Alcohol-Related Liver Disease and Alcoholic Hepatitis Cases
One study reported that alcohol sales rose by 34% during the first month of the pandemic and in a survey by the American Psychological Association, 1 in 4 Americans reported drinking more due to stress caused by the pandemic. Stressful situations and stressors like lock-down, isolation, or job loss can be so overwhelming that people feel they can only turn to alcohol and other harmful substances to cope.
This dramatic increase in alcohol sales and consumption has led to more people being diagnosed with alcohol-associated liver disease. Liver damage can appear relatively quickly in those who consume alcohol in high amounts, and without treatment can induce permanent damage to the liver. The mortality rate for severe alcoholic hepatitis can be as high as 40 percent and the risk of death for those who fail to treat the onset of symptoms can rise to 70 percent.
Pandemic-Fueled Alcohol Abuse
Alcoholic liver disease increased dramatically during the pandemic due to the increase in alcoholism, and hospitals have reported an increase in admissions for alcoholic liver disease. Doctors are also seeing a disturbing spike in lethal alcoholic liver disease, especially among young women. The recent trend has been supercharged by the pandemic’s isolation and pressures. Alcoholism is a dangerous condition that causes many problems for those who suffer from it. People with alcoholic liver disease are even more likely to get sick from COVID-19.
ARLD is increasing among younger people due to the coronavirus outbreak. Young people are struggling economically and are turning to alcohol to cope and as a result of using alcohol as a coping mechanism, alcohol abuse increases.
Lockdown periods have led many who struggle with alcohol and substance misuse to relapse during the pandemic. People simply fighting to cope with the current crisis may end up fighting other issues beyond their control.
What is Alcohol-Related Liver Disease (ARLD)?
Alcohol-Related Liver Disease (ARLD) refers to liver damage caused by excessive alcohol consumption. There are several stages of severity and a range of associated symptoms. These symptoms do not usually appear until the liver has been severely damaged.
The Liver and Alcohol
The liver is the main organ responsible for the detoxification and metabolism of drugs and other chemicals. It also helps in producing bile and plays a major role in maintaining overall health.
It regulates blood glucose levels by breaking down carbohydrates into simple sugars. Alcoholic beverages are toxic to the liver and it can take the liver more than two decades to recover from alcoholic consumption.
Alcohol misuse is the leading cause of ARLD.
Stages of ARLD
There are three main stages of Alcohol-Related Liver Disease – with an overlap of these stages sometimes.
- Alcoholic Fatty Liver Disease
Alcoholic fatty liver disease, also called steatosis, is the first stage of ARLD. Consuming too much alcohol can lead to a build-up of fats in the liver, resulting in fatty liver disease.
Though it is an essential warning sign of harmful drinking levels, fatty liver disease is reversible. Withdrawing from alcohol for two weeks should help significantly in returning your liver back to regular fat levels.
- Alcoholic Hepatitis
Alcoholic hepatitis is an inflammatory condition that affects the liver. It is a severe form of liver disease. It is a consequence of heavy alcohol consumption and occurs when one’s body stops producing enough enzymes to break down toxins. As a result, the liver begins to swell and this swelling causes pain and inflammation. Alcoholic hepatitis can also cause scarring of the liver.
People who drink alcohol excessively or regularly may develop this condition and many die from this condition each year. A study of patients from the MGB Research Patient Data Registry revealed that the rate of transplant evaluations for alcoholic hepatitis was more than double in the first year of the pandemic.
Though potentially fatal, the liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently.
- Alcohol-Related Cirrhosis
Cirrhosis is a stage of ARLD where the liver has become significantly scarred and damaged by heavy drinking. This scarring reduces the function of the organ. When the liver is inflamed or damaged, it may become infected with viruses or bacteria.
Cirrhosis is not generally reversible so it is essential that one stops drinking immediately in order to prevent further damage. Refraining from drinking completely can not only help prevent further damage but also extend your life. A person who has alcohol-related cirrhosis and continues to drink has less than a 50% chance of living more than 5 years.
A person who suffers from cirrhosis usually experiences:
- abdominal pain
- yellowing skin
- dark urine
- and bleeding from the nose and gums
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What are the Symptoms of ARLD and Alcoholic Hepatitis?
Symptoms of alcoholic hepatitis and ARLD include:
- belly (abdomen) pain
- vomiting blood or blood in your stools
- poor appetite
- yellowing of the skin and eye (jaundice)
- weight loss
- tiredness and weakness
Alcoholic hepatitis typically occurs over time with continued drinking but severe alcoholic hepatitis can occur suddenly. Severe alcoholic hepatitis can lead to liver failure and even death. The symptoms of alcoholic hepatitis may look like other medical problems or conditions.
Always consult your doctor for a diagnosis.
How Is Alcoholic Hepatitis Diagnosed?
Your healthcare provider will take a full medical history and perform a thorough physical examination.
Alcoholic liver disease is a common problem that leads to scarring of the liver. Liver biopsies help diagnose this condition. Alcoholic liver disease may be suspected if someone has a history of drinking too much alcohol over time. A blood test may be performed to rule out other causes of liver damage. Liver biopsies may be needed to confirm the diagnosis.
Alcohol-associated liver disease may be suspected based on a person’s history of alcohol abuse, laboratory or radiologic abnormalities, or medical conditions related to alcohol abuse. During a biopsy, a small piece of liver tissue is removed and studied in the lab.
Tests may include:
- Blood tests
- Liver biopsy
- CT Scan
Who Is At Risk of Alcoholic Hepatitis?
Binge drinking and heavy alcohol use cause liver damage. Heavy alcohol use is binge drinking at least 5 or more times in the past month. That means 5 or more standard drinks within a few hours for men and 4 for women. A standard drink is about one 12-ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot of 80-proof liquor. Most people who are diagnosed with alcoholic hepatitis are between ages 40 and 60.
What Are The Risk Factors for Alcoholic Liver Disease?
Excessive alcohol consumption is the leading cause of alcoholic hepatitis, and those who drink more than two drinks per day are at an increased risk of developing alcoholic liver disease. This risk increases over time and may affect some more than others. In addition to heavy drinking, there are additional risk factors to look out for that play a role in a person’s susceptibility. These additional factors include:
- Obesity: The combined factor of alcohol and obesity is worse than the effect of either one of them alone.
- Malnutrition: Many people who drink heavily are malnourished, either because they eat poorly due to loss of appetite or nausea, or it is because the alcohol and its toxins prevent the body from breaking down absorbing essential nutrients. In both cases, this lack of nutrients contributes to liver cell damage.
- Genetic Factors: Genetics can influence how your body processes alcohol and may predispose you to alcoholism and alcohol-related liver disease.
- Race and Ethnicity: A higher risk of injury appears to be associated with one’s race and ethnic heritage. For Example, rates of alcoholic cirrhosis are higher in African-American and Hispanic males compared to Caucasian males.
- Gender: Women are more likely to be affected by the adverse effects of alcohol.
- Chronic viral hepatitis, particularly hepatitis C.
Untreated Alcohol-Related Liver Disease Effects
Without treatment there can be numerous complications to ARLD including:
- Permanent scarring and loss of liver function entirely
- bleeding esophageal varices (enlarged veins in the esophagus)
- high blood pressure of the liver (portal hypertension)
- A loss of brain function caused by the buildup of toxins in the blood (Hepatic encephalopathy)
Despite all of the risks above, the best thing one can do to increase the expected lifespan of having ARLD as well as significantly improve your quality of life is to manage your drinking or stop drinking completely.
Get Help for Alcohol Abuse at Riverside Recovery of Tampa
If your alcohol-related liver disease is a result of alcohol abuse or addiction, you may want to consider contacting a rehab program for alcoholism. Recovery from alcohol abuse takes time and is a lifelong journey.
No matter where you are in the process, Riverside Recovery of Tampa is here to help you and your loved ones. Our admissions team can answer any questions about our treatment options and admissions process.
Contact us today to learn more about alcohol abuse and the options available for you or your loved one.