Liver cells accumulate fat as a result of alcohol intake being high. Usually, fatty liver is reversible and soon resolves if individuals stop drinking alcohol. There are usually no symptoms and most people will be unaware of any changes unless they undergo a routine inspection of their liver, usually for other reasons, with for example, an ultrasound scan. Liver function tests (LFT) which test for liver enzymes by taking a blood sample, are usually normal, suggesting that no damage of liver cells has taken place.
If however, alcohol abuse continues, there is a higher risk of progression of liver changes from fatty liver to the more serious stage of alcoholic hepatitis
Hepatitis means “inflammation of the liver”. LFT’s can be abnormal with elevated liver enzymes. The higher these levels, the more damage has taken place. This therefore represents a more serious stage than simple fatty change
Mild hepatitis: this may cause no symptoms and may simply be diagnosed by a routine blood test, perhaps taken for other reasons. Liver damage may be reversible at this stage providing alcohol consumption is stopped. However, in some people, the hepatitis becomes chronic (longer standing), if alcohol intake continues unabated. These people risk development of liver cirrhosis( scarring or fibrosis of liver cells).
Clearly, for those with any alcohol related illness, complete abstinence from alcohol must be strongly advised – patients must stop drinking alcohol completely. Poor dietary intake is a common problem amongst heavy drinkers. Therefore, this needs to be addressed also, perhaps by a dietician. Supplements may be required also with vitamin B complex, vitamin E and selenium.
These steps alone may be enough for those with mild hepatitis. More intensive hospital treatment will be needed for those with severe hepatitis. In those with cirrhosis diagnosed early and if alcohol intake is stopped, further liver damage may be avoided and the patient can remain stable as enough normal liver remains to carry out the vital roles required.
Moderate hepatitis: this occurs as liver enzymes levels continue to climb as more liver damage occurs
In a recent multi-center trial in Europe, 44 percent of the hepatitis C patients were found after 18 months that their elevated liver enzymes return to normal.