Alcoholic Hepatitis Questions & Answers

Updated: Sep 19, 2019
  • Author: Douglas M Heuman, MD, FACP, FACG, AGAF; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is alcoholic hepatitis?

What are the signs and symptoms of alcoholic hepatitis?

How is alcoholic hepatitis diagnosed?

What are the treatment options for alcoholic hepatitis?

What is the presentation of alcoholic hepatitis?

What is the prognosis of alcoholic hepatitis?

What are the etiologic factors of alcoholic hepatitis?

What is the pathophysiology of alcoholic hepatitis?

What is the role of genetic factors in the etiology of alcoholic hepatitis?

What is the role of malnutrition in the etiology of alcoholic hepatitis?

How does ethanol damage the liver in alcoholic hepatitis?

What is the role of the hypermetabolic state of the hepatocyte in the pathophysiology of alcoholic hepatitis?

What is the role of free radicals in the pathophysiology of alcoholic hepatitis?

What is the role of steatosis in the pathophysiology of alcoholic hepatitis?

What is the role of acetaldehyde adducts in the pathophysiology of alcoholic hepatitis?

What is the role of the immune system in the pathophysiology of alcoholic hepatitis?

What is the role of cytokines in the pathophysiology of alcoholic hepatitis?

What is the role of hepatitis C in the etiology of alcoholic hepatitis?

What is the role of acetaminophen in the etiology of alcoholic hepatitis?

What is the prevalence of alcoholic hepatitis?

Which patient groups are at highest risk for alcoholic hepatitis?

How does the incidence of alcoholic hepatitis vary by sex?

What is the prognosis of alcoholic hepatitis?

Which prognostic scoring systems are used for alcoholic hepatitis?

What is the efficacy of model for end-stage liver disease (MELD) scoring system for alcoholic hepatitis?

What is the efficacy of Glasgow alcoholic hepatitis score (GAHS) prognostic scoring system for alcoholic hepatitis?

What is the efficacy of asymmetric dimethylarginine (ADMA) prognostic scoring system for alcoholic hepatitis?

How is variceal hemorrhage managed in alcoholic hepatitis?

How is hepatic encephalopathy managed in alcoholic hepatitis?

How is coagulopathy and thrombocytopenia managed in alcoholic hepatitis?

How are ascites managed in patients with alcoholic hepatitis?

How is spontaneous bacterial peritonitis managed in alcoholic hepatitis?

How is iron overload managed in alcoholic hepatitis?

What should be included in patient education for alcoholic hepatitis?

Presentation

What is a prerequisite for the development of alcoholic hepatitis?

What are symptoms of alcoholic hepatitis?

What are the guidelines for screening and diagnosis of alcoholic hepatitis?

What are the physical findings characteristic of alcoholic hepatitis?

DDX

Which conditions need to be distinguished from alcoholic hepatitis?

What are the differential diagnoses for Alcoholic Hepatitis?

Workup

What is the role of lab testing in the evaluation of alcoholic hepatitis?

What is the role of imaging studies in the evaluation of alcoholic hepatitis?

Which complete blood count (CBC) results are characteristic of alcoholic hepatitis?

Which screening blood tests are indicated in the workup of alcoholic hepatitis?

What is the role of liver tests in the workup of alcoholic hepatitis?

Which liver function tests are performed in the workup of alcoholic hepatitis?

Which serum biomarkers are performed in the workup of alcoholic hepatitis?

What is the role of ultrasonography in the workup of alcoholic hepatitis?

What is the role of liver biopsy in the workup of alcoholic hepatitis?

How is percutaneous liver biopsy performed in the workup of alcoholic hepatitis?

When is a transjugular liver biopsy indicated for evaluation of alcoholic hepatitis?

Which histologic features are characteristic of alcoholic hepatitis?

Treatment

What are the treatment options for alcoholic hepatitis?

Why should surgery be avoided during an episode of acute alcoholic hepatitis?

When is transfer to a tertiary care center indicated in the treatment of alcoholic hepatitis?

What is the mainstay of treatment for alcoholic hepatitis?

Which dietary modifications are beneficial in the treatment of alcoholic hepatitis?

What is the role of parenteral hyperalimentation in the treatment of alcoholic hepatitis?

When is protein restriction indicated in the treatment of alcoholic hepatitis?

What is the role of drug treatment for alcoholic hepatitis?

What is the role of liver transplantation in the treatment of alcoholic hepatitis?

What are the controversies surrounding liver transplantation policies for alcoholic hepatitis?

What are the American Association for the Study of Liver Diseases (AASLD) alcoholic liver disease (ALD) guidelines for liver transplantation evaluation in patients with alcoholic hepatitis?

Which specialist consultations are needed for the treatment of alcoholic hepatitis?

What is the role of the gastroenterologists and hepatologist in the treatment of alcoholic hepatitis?

What is the role of the nephrologist in the treatment of alcoholic hepatitis?

What is the role of the neurologist in the treatment of alcoholic hepatitis?

When should an infectious disease specialist be consulted in the treatment of alcoholic hepatitis?

What is included in long-term monitoring of alcoholic hepatitis?

Medications

When are medications indicated for the treatment of alcoholic hepatitis?

What is the role of infliximab (Remicade) in the treatment of alcoholic hepatitis?

What is the role of pentoxifylline (Trental) in the treatment of alcoholic hepatitis?

What is the role of anabolic steroids in the treatment of alcoholic hepatitis?

What is the role of propylthiouracil (PTU) in the treatment of alcoholic hepatitis?

What is the role of hepatotropic hormones in the treatment of alcoholic hepatitis?

What is the role of colchicine in the treatment of alcoholic hepatitis?

What is the role of penicillamine in the treatment of alcoholic hepatitis?

What is the role of S-adenosyl-l-methionine (SAM) in the treatment of alcoholic hepatitis?

What is the role of N-acetyl-L-cysteine (NAC) in the treatment of alcoholic hepatitis?

What is the role of antioxidants in the treatment of alcoholic hepatitis?

What is the role of polyunsaturated lecithin (PPC, phosphatidyl choline) in the treatment of alcoholic hepatitis?

What is the role of calcium channel blockers in the treatment of alcoholic hepatitis?

What is the role of ursodeoxycholic acid (Ursodiol) in the treatment of alcoholic hepatitis?

What is the role of herbal agents in the treatment of alcoholic hepatitis?

Which medications in the drug class Corticosteroids are used in the treatment of Alcoholic Hepatitis?