Alcoholic Hepatitis Vs. Cirrhosis: What's the Difference?

The liver is the second largest organ in the human body and helps remove toxins. It also produces different essential enzymes that are necessary for digestion. However, consuming toxic food and alcoholic beverages hamper liver function and cause diseases such as alcoholic hepatitis and cirrhosis.

They're also major warning signs of alcoholism.

Discussed further are the symptoms, risk factors, treatment, and diagnosis of alcoholic hepatitis vs. cirrhosis.

Alcoholic Hepatitis Vs. Cirrhosis: An Overview

Consumption of alcohol may generate different effects on different people. For example, those who drink moderately may also get alcoholic hepatitis; however, the chances of getting cirrhosis are quite less for them. Drinking heavily, on the other hand, causes a lot of health problems, especially over the long term.

Thus, depending on the effects of alcohol on the liver, there are different stages of alcoholic liver disease. These are as follows:

Fatty Liver

The earliest and most common stage of alcoholic liver disease is a fatty liver. This refers to storing excessive fat in the liver that makes it swollen.

Alcoholic Hepatitis

Alcoholic hepatitis is a liver disease that occurs because of the harmful effects of alcohol. Excessive consumption of alcohol causes inflammation and the death of liver cells which further causes permanent scarring in the liver. This is called alcoholic hepatitis.

Cirrhosis

Cirrhosis is a progressive step of alcoholic liver disease where affected liver scar tissues replace and accumulate healthy tissues of the liver. Diseases like alcoholic hepatitis destroy liver cells, which further leads to cirrhosis.

Alcoholic Hepatitis Vs. Cirrhosis: Differences and Similarities

The differences between alcoholic hepatitis and cirrhosis are as follows:

Reversibility

• Alcoholic Hepatitis: Depending on the cause and severity, the scars of alcoholic hepatitis are reversible.

• Cirrhosis: Cirrhosis, however, is quite fatal; by definition, its scars are irreversible.

Symptoms

• Alcoholic Hepatitis: Fatigue, weakness, jaundice, and swollen abdomen are some of the symptoms of alcoholic hepatitis.

• Cirrhosis: In cirrhosis, along with the symptoms of alcoholic hepatitis, other symptoms like dark stool and urine, swollen legs, and low platelet follow.

Treatment

• Alcoholic Hepatitis: As alcoholic hepatitis is treatable, drugs can alleviate the issues and treat the scars.

• Cirrhosis: Cirrhosis, on the other hand, is not curable. Moreover, the scars are permanent, so the only treatment possible is to manage the symptoms.

Blood Tests

• Alcoholic Hepatitis: For alcoholic hepatitis, the levels of liver enzymes such as AST and ALT are tested.

• Cirrhosis: For cirrhosis, a more in-depth test is performed to identify the acute reasons behind abnormal liver functioning.

Causes

• Alcoholic Hepatitis: Overconsumption of alcohol lead to alcoholic hepatitis.

• Cirrhosis: Conditions such as alpha-1 antitrypsin deficiency and hemochromatosis can lead to cirrhosis along with prolonged heavy alcohol abuse.

The similarities between alcoholic hepatitis and cirrhosis are as follows:

• Both alcoholic hepatitis and cirrhosis are conditions that cause serious liver dysfunction.

• Both of these diseases can lead to liver failure and raise the need for a liver transplant.

• Both alcoholic hepatitis and cirrhosis are caused due to alcohol abuse in addition to other factors.

Alcoholic Hepatitis Vs. Cirrhosis: Causes, Symptoms, Diagnosis and Treatment

Both these liver diseases are fatal to human health; however, they share some differences in symptoms, diagnoses, and treatments. Therefore, an elaborative discussion on this topic has been provided.

Causes of Alcoholic Hepatitis

The main cause of alcoholic hepatitis is excessive alcohol consumption. However, malnutrition also makes one's body vulnerable to alcoholic hepatitis.

Causes of Cirrhosis

The conditions that can lead to cirrhosis are:

• Alcohol abuse

• Cystic fibrosis

• Alpha-1 antitrypsin deficiency

• Chronic viral hepatitis

• Hemochromatosis

• Alagille syndrome

• Brucellosis and Syphilis

• Primary biliary cirrhosis

• Nonalcoholic fatty liver disease

• Wilson's disease

• Glycogen storage or Galactosemia

• Different medicines such as isoniazid, methotrexate

• Primary sclerosing cholangitis

Symptoms of Alcoholic Hepatitis

There are two stages of alcoholic hepatitis, the early stage, and the advanced stage.

In the early stage, one may have symptoms like:

• Nausea

• Soreness and tenderness in the upper abdomen

• Storing of fluid in the abdomen

• Swollen liver

• Appetite and weight loss

• Light-colored stool

In the advanced stage, a patient may face symptoms like:

• Fast heartbeat

• Malaise and fatigue

• Fever

• Jaundice

• Thrombocytopenia

• Hepatic Encephalopathy

Symptoms of Cirrhosis

Cirrhosis is a deadly liver disease, which takes a serious toll on the body. From the aspect of symptoms, there is no such significant discussion on alcoholic hepatitis vs. cirrhosis. Cirrhosis has the same symptoms as alcoholic hepatitis, but the symptoms are more severe and acute.

They include:

• Acute ascites

• Reddish hands and palm

• Appetite and weight loss

• Slurred speech, drowsiness, confusion

• Itchy skin

• Jaundice

• Visible spider-like structure of blood vessels on the skin

• For women, the absence of menstruation

• For men, loss of sex drive, testicular atrophy, gynecomastia

• Thrombocytopenia

Diagnosis of Alcoholic Hepatitis and Cirrhosis

The diagnosis process has different levels as discussed below.

Blood Tests: Blood tests for alcoholic hepatitis include complete liver function studies, electrolyte tests, bleeding times, blood cell counts, and tests for other chemicals.

MRI: Sometimes, doctors may also ask to do an MRI to get a detailed analysis of the internal organs of a patient's body.

CT Scan: A CT scan is a beneficial diagnosis process for understanding the internal organs more than a regular X-ray.

Liver Biopsy: A liver biopsy is needed to check the condition of the liver. During surgery, a small section of the liver is procured which goes under microscopic observation to find out the type of liver disease.

USG of Abdomen: An ultrasound of abdominal organs may also be needed for a complete understanding of the severity of the disease.

The diagnosis process for alcoholic hepatitis vs. cirrhosis is quite similar; however, depending on the intensity of symptoms, a medical practitioner will ask the patient to conduct the respective testing procedure.

Treatment of Alcoholic Hepatitis

The treatment of alcoholic hepatitis involves the following processes.

Stop Drinking

To heal alcoholic hepatitis, one should stop drinking and aim to recover from alcohol addiction. This will reduce the chances of liver inflammation and speed up the healing process. However, there might be serious psychological problems at this stage that are equally harmful to individuals.

Hence, to prevent this, patients have often suggested a dual diagnosis treatment program that provides targeted treatment for the substance use disorder alongside the mental illness.

Medicines

Generally, two types of medicines are necessary for treating alcoholic hepatitis. These are:

• Corticosteroids: This is for short-term benefit and increases the survival rate from this disease. However, physicians do not prescribe this medicine if a patient has other complications, such as gastrointestinal infection and kidney issues, due to its adverse side effects.

• Pentoxifylline: This is a supportive medicine for corticosteroids. However, the function of this medicine is still under research.

Treating Malnutrition

Malnutrition is one of the causes that worsens the condition of alcoholic hepatitis. Hence, it is a common habit among alcohol addicts to get into a faulty diet schedule. Further, alcoholic hepatitis causes appetite loss, which also leads to malnutrition. Thus, patients need a complete nutrient-rich diet plan to ensure quick recovery from alcoholic hepatitis.

Treatment of Cirrhosis

Cirrhosis is permanent liver damage; thus, there is significantly less chance of recovering from it completely. What one can do is control and manage the symptoms to provide relief. Physicians provide treatment as per the causes and the severity of liver damage. The treatment of cirrhosis is as follows:

Treating Alcohol Dependency

Alcohol addiction is a major lifestyle disorder that leads to harmful diseases like cirrhosis. So, caregivers should be aware of a patient's history of alcohol addiction and try to restrict it. For this, an alcohol addiction treatment center is the right choice. Treatment for alcohol abuse should always start with alcohol detoxrgerecovery.com/alcohol-detox-what-you-can-expect/.

They can give complete support so that people refrain from excessive drinking and return to a healthier state.

Weight Loss

Another cause of cirrhosis is a fatty liver which makes the body more prone to serious harm like cirrhosis. Thus, losing weight can help significantly in this part and reduce the chance of cirrhosis.

Medication

If a person already has alcoholic hepatitis, then it should be treated with proper medicines. Further, if there is a chance of getting cirrhosis, medicines will slow down the process. For instance, the early stages of cirrhosis, such as primary biliary cirrhosis, can be treated if one takes medicine at the right time.

For active complications of cirrhosis, a physician will prescribe advanced treatment methods. These are as follows:

Treatment for Excess Fluid

Due to cirrhosis, the human body may accumulate excess fluid, which causes organ failure. To treat this, doctors may prescribe a low-sodium diet and necessary medicine to prevent this fluid build-up. However, if this build-up goes to an extreme level, doctors may also perform surgery to drain the fluid.

Portal Hypertension

It is a process of lowering blood pressure in the liver to prevent excessive bleeding. Certain medicines can do this by reducing the blood pressure in veins that send blood to the liver. For this, doctors first will diagnose the enlarged veins in the stomach or esophagus. Then, if they find varices or bleeding, they will run band ligation to restrict bleeding.

Further, in severe cases, they insert a transjugular intrahepatic portosystemic shunt, a type of tube to prevent excessive bleeding.

Infection Treatment

Patients may also have antibiotics for infection treatment as these infections may weaken the human body and raise more complications. Thus, treatment for infections such as hepatitis, pneumonia, or influenza is necessary as a supportive treatment for cirrhosis.

Regular Blood Test

There is a high chance of growing cancer from cirrhosis. Thus, physicians may also prescribe blood tests within short intervals to track the progress of cirrhosis and treat it accordingly.

Liver Transplant

In the advanced stage of cirrhosis, patients may need a liver transplant. It is a process of transferring damaged liver with another from a living donor. However, people who want a liver transplant should check the donor's condition and the other factors beforehand.

Alcoholic Hepatitis Vs. Cirrhosis: How to Prevent Both

Prevention is always better than cure. People can prevent these deadly diseases by maintaining certain precautions from the very beginning. Therefore, the ways for alcoholic hepatitis and cirrhosis prevention are as follows:

• Maintaining healthy body weight

• Eating nutritious food

• Quitting smoking and drinking or drinking moderately

• Do not consume alcohol being under medication

• Take vaccines to protect the liver from hepatitis

Alcoholic Hepatitis Vs. Cirrhosis: Death Rate

Research proves that 40% of people who drink alcohol in heavy amounts develop Alcoholic Hepatitis (AH). Further, cirrhosis is also a global cause of mortality, which has increased to 47.15%.

However, these diseases can be treated or managed if patients go to doctors at the right time and indulge in a healthy lifestyle.

This article has discussed in detail alcoholic hepatitis vs. cirrhosis. Both these diseases share some similarities and differences; however, both diseases can be deadly if one does not take proper care or follow preventive measures. Thus, if one identifies any of the given symptoms, one should immediately contact professional treatment centers for help.

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Frequently Asked Questions

What are the risk factors of alcoholic hepatitis?

The risk factors of alcoholic hepatitis are alcohol addiction, genetics, obesity, ethnicity, race, excessive, etc.

What is hemochromatosis?

Hemochromatosis is a condition of over-accumulation of iron in the human body. The body stores this excess iron in the liver, pancreas, and heart which causes serious trouble.

Alcoholic hepatitis vs cirrhosis: which one is the deadliest?

As per the severity of complications, both these diseases can be deadly and cause mortality. However, cirrhosis leaves permanent scars, which is more dangerous and has no permanent cure; only the symptoms are treatable.

What is Alagille syndrome?

Alagille syndrome happens due to over build-up of bile ducts in the liver. It is a kind of genetic disorder of the digestive system.

What is primary biliary cirrhosis?

This is a chronic disease where the bile ducts of the liver are slowly destroyed making the liver vulnerable to a severe stage of cirrhosis.

Written by

Brian Moore

Content Writer

Reviewed by

Jeremy Arzt

Chief Clinical Officer

January 11, 2023