The Guide To Alcoholic Steatohepatitis?

Last Edited: December 3, 2020

Andrew Lancaster, LPC, MAC

Clinically Reviewed

All of the information on this page has been reviewed and certified by an addiction professional.

Your liver is one of your most important organs.  As the largest body organ, it has over 500 vital functions. It helps process blood, metabolize drugs into easier forms to use, stores energy, helps detox your body from poisons, and much more.

You want your liver to operate at an optimal level.  When the liver starts to become sluggish or not function properly, it could be a sign that it’s headed toward liver disease.

You may have heard of “fatty liver disease” but aren’t too sure what it is.  There’s Alcoholic Steatohepatitis (alcoholic fatty liver disease), as well as Nonalcoholic Steatohepatitis (non-alcoholic fatty liver disease).

Alcoholic fatty liver disease is linked to excessive alcohol use over the years.

Nonalcoholic fatty liver disease (NAFLD) is not linked to alcohol intake. According to Medline Plus, non-alcoholic steatohepatitis affects around a quarter of the world population, largely influenced by the increase in obesity, type 2 diabetes, hepatitis C, certain medications, and high cholesterol.

What Is Alcoholic Steatohepatitis?

Alcoholic steatohepatitis is a chronic and progressive disease caused by long-term alcohol use. The liver is what is responsible for breaking down and removing toxins associated with alcohol.  In the process of breakdown, harmful substances are formed that can cause damage and inflammation to liver cells.  This is the earliest stage of liver diseases caused by alcohol, followed by alcoholic hepatitis and cirrhosis.

According to the National Institute on Alcohol Abuse and Alcoholism, women that drink more than three drinks per day, and men that drink more than four drinks per day are considered moderate to heavy drinkers. Those that drink like this for over five years are more prone to developing alcoholic steatohepatitis.

Disease Progression

The job of the liver is to detox the body of toxins.  If you have fatty liver disease, your liver won’t work as well as it should.  As a result, you’re likely to struggle with obesity, jaundice, or feeling lethargic.

If you’re diagnosed with alcoholic steatohepatitis and continue to drink, you can suffer some complications. Complications include blood flowing slower through your liver due to scar tissue. This can result in more toxins and pressure in major blood vessels. From there, you can experience enlarged veins, ascites, which is an infection in the abdomen, hepatic encephalopathy, or swelling in the brain due to toxic buildup, kidney failure, and cirrhosis, or liver failure.

Alcoholic Steatohepatitis Symptoms

Most people don’t show any symptoms of alcoholic steatohepatitis. An abnormal liver blood test result may cause a red flag, so the doctor may run more tests to see what’s going on. Whether it’s alcoholic or non-alcoholic steatohepatitis, there may be some symptoms. As the disease progresses, more common symptoms may include:

  • Nausea
  • Weight loss
  • Jaundice (the yellowing of eyes and skin)
  • Fatigue
  • Enlarged liver resulting in tender, painful abdomen

To determine if you have alcoholic steatohepatitis, typically, a liver biopsy will be performed. To see how far along the progression is, an ultrasound, CT scan, or MRI may be performed. Your doctor will likely look at your medical history and inquire about your drinking habits.  If alcohol intake is limited, it could be nonalcoholic fatty liver disease.

How To Manage Alcoholic Steatohepatitis

The liver is an incredible organ and may be able to reverse a good bit of the damage with its self-healing capabilities. However, if the disease has progressed into the final stages of liver disease, the chances of reversing the damage decrease significantly.

Abstaining from drinking all forms of alcohol is the first step to manage alcoholic steatohepatitis.  Your physician may refer you to an alcohol recovery program if you’re struggling with quitting on your own.

To date, there are no medications that specifically treat this disease. To manage symptoms for both alcoholic and nonalcoholic fatty liver disease, physicians recommend:

  • A healthy diet supplemented with vitamin B-12.
  • To combat inflammation, corticosteroids may be prescribed to reduce the swelling.
  • If obesity is an issue, weight loss may help reduce inflammation and fat in the liver.
  • Regular exercise.

If the disease leads to cirrhosis, your physician may treat it with various medications or surgery.  If the liver starts to fail, there is the option of having a liver transplant.


If you’re wondering, “How serious is a fatty liver?”, the answer is it can be very serious. Alcoholic steatohepatitis is a progressive disease that can ultimately lead to death.  If you’re a moderate to heavy drinker, it’s best if you stop drinking entirely. If you cannot quit on your own, reach out for help.

If you’re concerned about the health of your liver, see your doctor, and get a check-up. The liver is one of your most important organs, so take good care of it for an optimal, healthy life.