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Alcoholic Hepatitis.
Kester I. Crosse1, Frank A. Anania
1University of Maryland School of Medicine, Department of Medicine, Division of Gastroenterology, Hepatology Section, University of Maryland Hospital, Liver Center, Room N3W50, 22 South Greene Street, Baltimore, MD 21201, USA. fanania@medicine.umaryland.edu
Current Treatment Options in Gastroenterology
|November 1, 2002
Summary
Early recognition and treatment are crucial for alcoholic hepatitis (AH). Key therapies include nutrition, alcohol abstinence, and corticosteroids for select patients identified by the modified Maddrey discriminant function.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Alcoholic hepatitis (AH) is a prevalent clinical challenge.
- Accurate diagnosis is fundamental for effective management.
- Key indicators include chronic alcohol abuse, fever, jaundice, and encephalopathy.
Purpose of the Study:
- To outline the essential components of alcoholic hepatitis management.
- To identify patient subsets eligible for corticosteroid therapy.
- To review ineffective treatments for AH.
Main Methods:
- Diagnosis relies on clinical presentation and specific signs.
- Therapeutic cornerstones are nutrition and alcohol abstinence.
- Corticosteroid eligibility is determined by the modified Maddrey discriminant function.
Main Results:
- Nutrition is vital due to the catabolic state and malnutrition associated with AH.
- Oral, nasogastric, or parenteral nutrition is essential.
- Corticosteroids (prednisone/prednisolone) are effective in a select group of patients without active bleeding or infection.
Conclusions:
- Effective management of alcoholic hepatitis involves prompt diagnosis, nutritional support, and alcohol cessation.
- Corticosteroid therapy should be guided by the modified Maddrey discriminant function.
- Patients require continued abstinence support post-discharge, often in rehabilitation units.