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Q&A Alcoholic Hepatitis

1. What is Alcoholic hepatitis (AH)?

Alcoholic Hepatitis is inflammation of the liver caused by drinking alcohol.

2. Who is most at risk for Alcoholic Hepatitis ?

Alcoholic hepatitis is most likely to occur in people who drink heavily over many years. However, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately.

3. How long can a person continue drinking before develop Alcoholic Hepatitis?

Alcoholic hepatitis usually develops over time with continued drinking. But severe alcoholic hepatitis can develop suddenly. It can quickly lead to liver failure and death.

4. What is medical definition of Alcoholic Hepatitis according to The National Institute on Alcohol Abuse and Alcoholism (NIAAA)?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), Alcoholic Hepatitis Consortia defines AH to include the following:

  • The onset of jaundice within 60 days of heavy alcohol consumption (more than 50 g/day) for a minimum of 6 months
  • with serum bilirubin more than 3 mg/dL
  • elevated aspartate aminotransferase (AST) to 50 U/L to 400 U/L
  • AST: ALT (alanine aminotransferase) ratio of more than 1.5, and
  • No other cause of acute hepatitis.

5. What are risk factors for Alcoholic Hepatitis ?

The major risk factor for alcoholic hepatitis is the amount of alcohol you consume. How much alcohol it takes to put you at risk of alcoholic hepatitis isn’t known. But most people with the condition have a history of drinking more than 3.5 ounces (100 grams) — equivalent to seven glasses of wine, seven beers or seven shots of spirits — daily for at least 20 years.

However, alcoholic hepatitis can occur among those who drink less and have other risk factors.

Other risk factors include:

  • Your sex. Women seem to have a higher risk of developing alcoholic hepatitis possibly because of differences in the way alcohol is processed in women.
  • Obesity. Heavy drinkers who are overweight might be likelier to develop alcoholic hepatitis and to progress from that condition to cirrhosis.
  • Genetic factors. Studies suggest there may be a genetic component in alcohol-induced liver disease although it’s difficult to separate genetic and environmental factors.
  • Race and ethnicity. Blacks and Hispanics might be at higher risk of alcoholic hepatitis.
  • Binge drinking. Having five or more drinks within two hours for men and four or more for women might increase your risk of alcoholic hepatitis.

6. How to reduce risk for Alcoholic Hepatitis?

  • Drink alcohol in moderation, if at all. For healthy adults, moderate drinking means up to one drink a day for women of all ages and men older than 65, and up to two drinks a day for men age 65 and younger. The only certain way to prevent alcoholic hepatitis is to avoid all alcohol.
  • Protect yourself from hepatitis C. Hepatitis C is an infectious liver disease caused by a virus. Untreated, it can lead to cirrhosis. If you have hepatitis C and drink alcohol, you’re far more likely to develop cirrhosis than if you didn’t drink.
  • Check before mixing medications and alcohol. Ask your doctor if it’s safe to drink alcohol when taking your prescription medications. Read the warning labels on over-the-counter medications. Don’t drink alcohol when taking medications that warn of complications when combined with alcohol — especially pain relievers such as acetaminophen (Tylenol, others).

7. We’re supposed to be keeping an eye on how much we drink, but how many of us really know what a unit of alcohol is?

With so many different drinks and glass sizes, from shots to pints – not to mention bottles – it’s easy to get confused about how many units are in your drink.

Units are a simple way of expressing the quantity of pure alcohol in a drink.

One unit equals 10ml or 8g of pure alcohol, which is around the amount of alcohol the average adult can process in an hour.

This means that within an hour there should be, in theory, little or no alcohol left in the blood of an adult, although this will vary from person to person.

The number of units in a drink is based on the size of the drink, as well as its alcohol strength.

8. How to calculate alcohol unit?

Using units is a simpler way of representing a drink’s alcohol content – usually expressed by the standard measure alcohol by volume (ABV).

ABV is a measure of the amount of pure alcohol as a percentage of the total volume of liquid in a drink.

You can find the ABV on the labels of cans and bottles, sometimes written as “vol” or “alcohol volume”, or you can ask bar staff about particular drinks.

For example, wine that says “12% ABV” or “alcohol volume 12%” means 12% of the volume of that drink is pure alcohol.

You can work out how many units there are in any drink by multiplying the total volume of a drink (in ml) by its ABV (measured as a percentage) and dividing the result by 1,000.

strength (ABV) x volume (ml) ÷ 1,000 = units

For example, to work out the number of units in a pint (568ml) of strong lager (ABV 5.2%):

5.2 (%) x 568 (ml) ÷ 1,000 = 2.95 units

9. How many alcohol units can we drink in order to keep health risks ?

Ideally, none.

But if you drink alcohol, here are the guide:

  • men and women are advised not to drink more than 14 units a week on a regular basis
  • spread your drinking over 3 or more days if you regularly drink as much as 14 units a week
  • if you want to cut down, try to have several drink-free days each week
Alcohol unit calculator
Drink type Unit per week
Beer 330ml(7%)
Beer 330ml(5%)
Beer 330ml(2%)
Wine 175ml (12%) – Standard
Spirit 35ml (40%) – Standard
Spirit 35ml (70%) – Standard

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