Definition
Alcoholic hepatitis indicates an inflammatory process affecting the liver. Along with alcoholic steatosis and cirrhosis, alcoholic hepatitis completes the trio of major forms of alcohol-induced liver disease. Alcoholic hepatitis can be considered as the stage following hepatic steatosis and the one immediately preceding cirrhosis; in severe cases, it can even compromise the patient's life.
Causes
Long-term alcohol abuse constitutes the main etiological element of alcoholic hepatitis; in addition to alcoholism, it is possible to identify additional risk factors for the manifestation of the disease: genetic predisposition, metabolic alterations, malnutrition of the patient.
Symptoms
The liver inflammation that accompanies alcoholic hepatitis can occur in an acute form, with abdominal pain, fever and loss of appetite, or become chronic; in the latter case, the symptoms are more vague (pain in the liver, low-grade fever, general malaise, nausea, vomiting). These prodrome can be associated with the typical signs of cirrhosis and its complications, such as ascites, gastroesophageal haemorrhage, jaundice.
The information on Alcoholic Hepatitis - Drugs for the Treatment of Alcoholic Hepatitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Alcoholic Hepatitis - Drugs for the Treatment of ' Alcoholic Hepatitis.
Medicines
Given the severity of the condition, stopping drinking alcohol is the first smart rule to put in place, both to reverse the condition and to avoid its degeneration into liver cirrhosis. It should be remembered that the prevention of alcoholic liver disease is possible, and involves the control or, better still, the abstention from drinking alcohol. Furthermore, the risk of serious complications is quite high: just think, for example, that 10-15% of patients with acute alcoholic hepatitis go to death.
As is often the case, most alcoholic hepatitis patients struggle to stop drinking; therefore, psychological support and the administration of drugs for the treatment of alcoholism are recommended.
Patients with alcoholic hepatitis are often malnourished; therefore they should follow a targeted and specific diet, in addition to taking any supplements of vitamins and minerals.
The most suitable drugs for the treatment of alcoholic hepatitis are corticosteroids and pentoxifylline, essential to reduce inflammation; in the circumstance in which not even the drugs are able to reverse the pathology, the patient can undergo a liver transplant.
The following are the classes of drugs most used in the therapy against alcoholic hepatitis, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the severity of the disease, the state health of the patient and his response to treatment:
Nutritional therapy and vitamin supplementation: it is essential in most patients with alcoholic hepatitis, given that malnutrition seems to be an omnipresent element in this type of patient. In general, alcoholic hepatitis sufferers are malnourished, anorexic due to altered metabolism of nutrients and liver deposits. It is recommended to follow a diet of at least 2,000 kcal (with a protein intake of 1g per kilo of body weight), enriched from vitamin supports (eg Multicentrum, Supradyn, Be-Total Plus). Folic acid supplements are also widely used in therapy for malnutrition in the context of alcoholic hepatitis.
In particular, the integration of s-adenosyl-methionine (ALC Dymatize Nutrition, useful for promoting the synthesis of glucagon, being a source of cysteine) and polyunsaturated lecithin (useful for protecting the hepatocyte membrane) is sometimes recommended. of soy lecithin seem to prevent the formation of cirrhosis and fibrosis in the context of alcoholic hepatitis.
Deepening: glucagon, being a liver growth factor, can ideally be used in therapy for the treatment of alcoholic hepatitis. In fact, unfortunately, the therapeutic activity of glucagon-based drugs does not seem to bring appreciable benefits.
Corticosteroids: the administration of steroids to patients with alcoholic hepatitis is useful for reducing inflammation by altering the synthesis of cytokines. In practice, the therapeutic use of corticosteroids does not always generate beneficial effects: the severity of the disease at the time of diagnosis seems to be a determining factor in predicting the success or failure of the treatment. Some of the drugs used in the treatment of alcoholic hepatitis are :
- Prednisolone (eg. Solprene, Deltamhydrin)
- Cortisone (eg. Cortis Acet, Cortone)
- Methylprednisolone (eg. Medrol, Urbason, Advantan, Depo-medrol, Solu-medrol)
The dosage of the drugs listed above must be carefully established by the doctor based on the severity of the condition.
Peripheral vasodilators:
- Pentoxifylline (eg Trental): the drug is a selective inhibitor of phosphodiesterases, capable of exerting a therapeutic anti-inflammatory action; for this very reason, it is used for the treatment of alcoholic hepatitis as a hepatic inflammatory agent. Ideally, the drug can replace corticosteroids. Consult your doctor. As an indicative dose, 400 mg of active is generally administered, three times a day, orally. Sometimes, pentoxifylline is associated with methylprednisolone.
Thionamides:
- Propylthiouracil (eg Propycil): the drug acts as an immunosuppressant. In an alcoholic or a patient with alcoholic liver disease, higher oxygen consumption in the liver is observed. Recently, it has been observed that administering this drug can reduce oxygen loss by promoting blood flow in the liver. The dosage should be carefully established by the doctor. Propylthiouracil is not the drug of choice for the treatment of alcoholic hepatitis; moreover, the benefits obtained are often conflicting, so the drug has not obtained a "univocal scientific approval."
Anabolic steroids: this class of drugs has also been identified as a possible remedy for the degeneration of alcoholic hepatitis in severe forms; in some patients, the administration of these drugs seems to have reduced the mortality from the disease. However, there are no results. satisfactory.
- Oxandrolone (eg Anavar): indicatively, the drug can be taken at a dose of 2.5-10 mg, orally, 2-4 times a day. In the context of alcoholic hepatitis, it is recommended not to exceed 20 mg per day.
