NationMaster - Encyclopedia: Alcoholic hepatitis

Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... MedlinePlus (medlineplus. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... â€œGrain alcoholâ€ redirects here. ... Alcoholic beverages. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ...

Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C. The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis in Western countries. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... This page is for the disease. ...

Some alcoholics get an acute hepatitis or inflammatory reaction to the cells affected by fatty change. This is not directly related to the dose of alcohol. Some people seem more prone to this reaction than others. This is called alcoholic steatonecrosis and the inflammation probably predisposes to liver fibrosis.

Symptoms and signs

Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset. The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. ... Obtunded refers to a patient that has less than full mental capacity, typically as a result of a medical condition or trauma. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ...

Diagnosis

The ratio of aspartate aminotransferase to alanine aminotransferase is usually > 2.^[1]

Pathophysiology

If chronic liver disease is also present: Mallory bodies (also known as alcoholic hyaline or Mallorys hyaline) are pathologic inclusions found in the cytoplasm of liver cells. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Neutrophil granulocytes (commonly referred to as neutrophils) are a class of white blood cells and are part of the immune system. ... In anatomy, a lobe is a clear anatomical division or extension[1][2] which can be determined without the use of a microscope (at the gross anatomy level. ... Kupffer cells are reticulendothelial cells located in the liver. ... Parenchyma is a term used to describe a bulk of a substance. ...

Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...

Treatment/Management

Clinical practice guidelines by the American College of Gastroenterology recommend corticosteroids.^[3] A medical guideline (also called a clinical guideline, clinical protocol or clinical practice guideline) is a document with the aim of guiding decisions and criteria in specific areas of healthcare, as defined by an authoritative examination of current evidence (evidence-based medicine). ... Sworn enemy of the American Gastroenterological Association (AGA), The American College of Gastroenterology (ACG), founded in 1932, serves to advance the scientific study and medical practice of diseases of the gastrointestinal tract. ...

Corticosteroids

Patients with a discriminant function score > 32 or hepatic encephalopathy should be considered for treatment with prednisolone 40 mg daily for four weeks followed by a taper.^[3] Discriminant function (also called modified Maddreys discriminant function) was originally described by Maddrey and Boitnott[1] to predict prognosis in alcoholic hepatitis. ... Hepatic encephalopathy is a potentially reversible neuropsychiatic abnormality in the setting of liver failure, whether chronic (as in cirrhosis), or acutely. ... Prednisolone is the active metabolite of prednisone. ...

Pentoxifylline

A randomized controlled trial found that 5 patients with a discriminant function score > 32 and at least one of palpable tender hepatomegaly, fever, leukocytosis, hepatic encephalopathy, or hepatic systolic bruit must be treated with pentoxifylline 400 mg orally 3 times daily for 4 weeks for one to prevent one patient from dying. ^[4] Discriminant function (also called modified Maddreys discriminant function) was originally described by Maddrey and Boitnott[1] to predict prognosis in alcoholic hepatitis. ... The number needed to treat (NNT) is an epidemiological measure that indicates how many patients would require treatment with a form of medication to reduce the expected number of cases of a defined endpoint by one. ... Pentoxifylline is the International Nonproprietary Name(INN) of a drug sold by Aventis under the name Trental. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

See also

External links

Categories: Gastroenterology | Hepatitis | Inflammations The digestive system is the organ system that breaks down and absorbs nutrients that are essential for growth and maintenance. ... Gastroenterology (MeSH heading[2] ) is the branch of medicine where the digestive system and its disorders are studied. ... The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... Gastroesophageal Reflux Disease (GERD; or GORD when spelling Å“sophageal, the BrE form) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus[1]. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. ... Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, dyssynergia esophagus, and esophageal aperistalsis, is an esophageal motility disorder. ... Boerhaave syndrome (also called Boerhaaves syndrome) is rupture of the esophagus. ... In anatomy, Zenkers diverticulum is a diverticulum of the mucous membrane of the oesophagus through a defect in the wall of oesophagus. ... Mallory-Weiss Syndrome refers to bleeding from tears in the mucosa at the junction of the stomach and esophagus, usually caused by severe retching, coughing, or vomiting. ... Barretts esophagus (sometimes called Barretts syndrome, CELLO, columnar epithelium lined lower (o)esophagus or colloquially as Barretts) refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ... Gastritis is inflammation of the gastric mucosa. ... Infantile pyloric stenosis is a pediatric condition where there is a congenital narrowing of the pylorus (the opening at the lower end of the stomach). ... Achlorhydria or hypochlorhydria is decreased production of gastric acid by the stomach. ... In medicine, gastroptosis is the abnormal downward displacement of the stomach. ... Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. ... A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ... An intussusception is a situation in which a part of the intestine has prolapsed into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another. ... Abdominal angina (a. ... It has been suggested that this article or section be merged with Large intestine. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word Î´Î¹Î¬ÏÏÎ¿Î¹Î±; literally meaning through-flowing). Acute infectious diarrhea is a common cause... Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix[1]. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. ... Bowel obstruction is a mechanical blockage of the intestines, preventing the normal transit of the products of digestion. ... Diverticulitis is a common digestive disorder particularly found in the large intestine. ... Diverticulosis, otherwise known as diverticular disease, is the condition of having diverticula in the large colon which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. ... In medicine, inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. ... Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining between). ... Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). ... In gastroenterology, irritable bowel syndrome (IBS) or spastic colon is a functional bowel disorder characterized by abdominal pain and changes in bowel habits which are not associated with any abnormalities seen on routine clinical testing. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Megacolon is an abnormal dilatation of the colon (a part of the large intestines) that is not caused by mechanical obstruction. ... Toxic megacolon (megacolon toxicum) is a life-threatening complication of other intestinal conditions. ... An anal fissure is an unnatural crack or tear in the anus skin. ... An anal fistula kinda like anal fisting but you leak feces on your pants. ... An anal abscess is a abscess adjacent to the anus, characterized by extremely painful bowel movements. ... This does not adequately cite its references or sources. ... Look up hernia in Wiktionary, the free dictionary. ... Inguinal hernias are protrusions of abdominal cavity contents through an area of the abdominal wall, commonly referred to as the groin, and known in anatomic language as the inguinal area or the myopectineal orifice. ... An indirect inguinal hernia a inguinal hernia which results from the failure of embryonic closure of the internal inguinal ring after the testicle has passed through it. ... Inguinal hernias are the most common abdominal hernias (about 90%) and are seen most often in men. ... Femoral hernias occur just below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal. ... Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. ... This article or section is in need of attention from an expert on the subject. ... Diaphragmatic hernia is a defect or hole in the diaphragm that allows the abdominal contents to move into the chest cavity. ... A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm. ... For the bird, see Liver bird. ... In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. ... Mirizzis syndrome is a rare cause of acquired jaundice. ... Liver failure is the final stage of liver disease. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... This article or section does not cite its references or sources. ... Non-alcoholic fatty liver disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... Different stages of liver damage Fatty liver (also known as steatorrhoeic hepatosis or steatosis hepatis) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis. ... Peliosis Hepatis is an uncommon vascular condition characterised by randomly distributed multiple blood-filled cavities throughout liver. ... In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. ... Hepatorenal syndrome (HRS), also called hepatorenal failure, refers to acute renal failure that occurs in the setting of cirrhosis or fulminant liver failure associated with portal hypertension, usually in the absence of other disease of the kidney. ... In medicine (gastroenterology and hepatology), Budd-Chiari syndrome is the clinical picture caused by occlusion of the hepatic vein. ... The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that stores about 50 ml of bile (or gall) until the body needs it for digestion. ... A bile duct is any of a number of long tube-like structures that carry bile. ... This article does not cite any references or sources. ... Choledocholithiasis is the presence of a gallstone in the common bile duct. ... Cholecystitis is inflammation of the gall bladder. ... In surgical pathology, strawberry gallbladder, more formally cholesterolosis of the gallbladder and gallbladder cholesterolosis, is a change in the gallbladder wall due to excess cholesterol/cholesterol gallstones. ... Cholangitis is one of a number of problems associated with the bile duct. ... Primary sclerosing cholangitis (PSC) is an inflammatory disease of the bile duct, which leads to cholestasis (blockage of bile transport to the gut). ... A biliary fistula, a type of fistula where bile leaks from the bile ducts into outside areas, can occur as a complication following biliary trauma, either iatrogenic or a result of a penetrating injury. ... Cholangitis redirects here. ... The pancreas is a gland organ in the digestive and endocrine systems of vertebrates[2]. It is both exocrine (secreting pancreatic juice containing digestive enzymes) and endocrine (producing several important hormones, including insulin, glucagon, and somatostatin). ... Acute pancreatitis is rapidly-onset inflammation of the pancreas. ... Chronic pancreatitis can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. ... A pancreatic pseudocyst is a circumscribed collection of pancreatic fluid typically located in the lesser omentum. ... Hereditary Pancreatitis is a genetic disease affecting enzyme production in the pancreas. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Coeliac disease or celiac disease is an autoimmune disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. ... Whipples disease is a rare disease caused by the bacteria Thropheryma whipplei. ... Tropical sprue is a malabsorption disease commonly found in the tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. ... Hematemesis or haematemesis is the vomiting of fresh red blood. ... In medicine, melena or melaena refers to the black, tarry feces that are associated with gastrointestinal hemorrhage. ... Gastrointestinal bleeding describes every form of hemorrhage (blood loss) in the gastrointestinal tract, from the pharynx to the rectum. ... Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper GI hemorrhage. ... Lower gastrointestinal bleeding refers to any form of bleeding in the Lower gastrointestinal tract. ...

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