Alcoholic Steatohepatitis


Alcoholic hepatitis is a syndrome of progressive inflammatory liver injury associated with long-term heavy intake of ethanol. It is a combination of hepatic steatosis, diffuse liver inflammation, and liver necrosis all in various degrees of severity.

Symptoms and Signs

Symptoms usually become apparent in patients during their 30s or 40s; severe problems appear about a decade later.

Hepatic steatosis is often asymptomatic. In one third of patients, the liver is enlarged and smooth,
but it is not usually tender.

Alcoholic hepatitis ranges from mild and reversible to life threatening. Most patients with moderate disease are undernourished and present with fatigue, fever, jaundice, right upper quadrant pain, tender hepatomegaly, and sometimes a hepatic bruit.


  • Confirmed history of alcohol use
  • Liver function tests and complete blood count (CBC)
  • Sometimes liver biopsy


Prognosis is determined by the degree of hepatic fibrosis and inflammation. Hepatic steatosis and alcoholic hepatitis without fibrosis are reversible if alcohol is avoided.
With abstinence, hepatic steatosis may completely resolve within 6 weeks. Fibrosis and cirrhosis are usually irreversible.


  • Abstinence
  • Supportive care
  • Corticosteroids and enteral nutrition for severe alcoholic hepatitis
  • Liver transplantation