Excessive alcohol consumption is the third leading preventable cause of death in the United States.Alcohol-associated mortality is disproportionately high among young people, and approximately 30 years of life are lost per alcohol-associated death — or, in the aggregate, 2.3 million years of potential life lost in 2001 in the United States.¹ Excess consumption of alcohol is associated with both short-term and long-term liver damage, several types of cancer, unintentional injuries both in the workplace and on the road, domestic and social violence, broken marriages, and damaged social and family relationships.

The association between alcohol intake and alcoholic liver disease has been well documented, although cirrhosis of the liver develops in only a small proportion of heavy drinkers.The risk of cirrhosis increases proportionally with consumption of more than 30 g of alcohol per day; the highest risk is associated with consumption of more than 120 g per day. The point prevalence of cirrhosis is 1% in persons drinking 30 to 60 g of alcohol a day and up to 5.7% in those consuming 120 g daily. It is presumed that other factors, such as sex,genetic characteristics, and environmental influences (including chronic viral infection),play a role in the genesis of alcoholic liver disease.

Chronic alcohol use may cause several types of liver injury. Regular alcohol use, even for just a few days, can result in a fatty liver (also called steatosis), a disorder in which hepatocytes contain macrovesicular droplets of triglycerides. Although alcoholic fatty liver resolves with abstinence, steatosis predisposes people who continue to drink to hepatic fibrosis and cirrhosis. This review focuses on alcoholic hepatitis, a treatable form of alcoholic liver disease. Since up to 40% of patients with severe alcoholic hepatitis die within 6 months after the onset of the clinical syndrome, appropriate diagnosis and treatment are essential.