VA AM Report 11.14: Alc hep!


Updates in alc hep management: Up to a third of the 18 million Americans with an alcohol use disorder will experience some degree of acute alcoholic hepatitis. The diagnosis is clinical and matches other causes of acute hepatitis in causing fever, malaise, jaundice, nausea, vomiting, and epigastric/RUQ pain. The Maddrey Discriminant function can risk stratify and provide indication for treatment with steroids, it uses the prothrombin time and bilirubin. There is a short term and long term survival benefit to steroids in acute alc hep but the effect wanes one year out from starting treatment. Abstinence from alcohol is critical. Pentoxifylline can be used as an alternative to steroids, there is no benefit to using both and the efficacy of pentoxifylline is questionable.



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