Alcoholic hepatitis: Current trends in management

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Purpose of review Alcohol consumption is increasing globally, as are complications of alcohol-related liver disease, including the most severe manifestation, alcoholic hepatitis. Despite the increased prevalence, many patients hospitalized with alcoholic hepatitis are either not diagnosed or inadequately treated leading to significant morbidity and high mortality rates. The purpose of this review is to discuss current challenges in the diagnosis and management of this frequently fatal condition. Recent findings Recent studies and meta-analyses have improved our understanding of both the evaluation and treatment of alcoholic hepatitis including the diagnostic criteria, appropriate use of glucocorticoids and other therapeutic modalities including novel disease-specific therapeutic agents and indications for considering liver transplantation. Summary Glucocorticoid therapy and enteral nutrition represent the best options for reducing short-term mortality in patients with the severe form of acute alcoholic hepatitis. The efficacy of other medications such as pentoxifylline as currently used does not support a role for use outside clinical trials. While the current management options for alcoholic hepatitis remain insufficient, improvements in diagnosis, determining prognosis and severity and the potential role of novel treatments provides encouragement that outcomes from this devastating condition will improve.

Original languageEnglish (US)
Pages (from-to)142-148
Number of pages7
JournalCurrent Opinion in Gastroenterology
Volume33
Issue number3
DOIs
StatePublished - May 1 2017

Fingerprint

Alcoholic Hepatitis
Glucocorticoids
Therapeutics
Pentoxifylline
Mortality
Enteral Nutrition
Alcohol Drinking
Liver Transplantation
Meta-Analysis
Liver Diseases
Alcohols
Clinical Trials
Morbidity

Keywords

  • alcohol
  • corticosteroids
  • nutrition
  • PNPLA3
  • steatosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Alcoholic hepatitis : Current trends in management. / Aday, Ariel W.; Mitchell, MacK C.; Casey, Lisa C.

In: Current Opinion in Gastroenterology, Vol. 33, No. 3, 01.05.2017, p. 142-148.

Research output: Contribution to journalReview article

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N2 - Purpose of review Alcohol consumption is increasing globally, as are complications of alcohol-related liver disease, including the most severe manifestation, alcoholic hepatitis. Despite the increased prevalence, many patients hospitalized with alcoholic hepatitis are either not diagnosed or inadequately treated leading to significant morbidity and high mortality rates. The purpose of this review is to discuss current challenges in the diagnosis and management of this frequently fatal condition. Recent findings Recent studies and meta-analyses have improved our understanding of both the evaluation and treatment of alcoholic hepatitis including the diagnostic criteria, appropriate use of glucocorticoids and other therapeutic modalities including novel disease-specific therapeutic agents and indications for considering liver transplantation. Summary Glucocorticoid therapy and enteral nutrition represent the best options for reducing short-term mortality in patients with the severe form of acute alcoholic hepatitis. The efficacy of other medications such as pentoxifylline as currently used does not support a role for use outside clinical trials. While the current management options for alcoholic hepatitis remain insufficient, improvements in diagnosis, determining prognosis and severity and the potential role of novel treatments provides encouragement that outcomes from this devastating condition will improve.

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