From the Guidelines
Jaundice after a drinking binge is a medical emergency that requires immediate attention, as it may indicate alcoholic hepatitis or other serious liver damage, and patients should seek emergency care right away. The condition is characterized by rapid onset of jaundice, elevated serum aspartate transaminase (AST), and a history of heavy alcohol use, with an average consumption of more than 3 drinks (40 g) per day for women and 4 drinks (50–60 g) per day for men 1.
Key Considerations
- The diagnosis of alcoholic hepatitis (AH) is based on clinical presentation, laboratory tests, and liver biopsy, which can confirm the diagnosis and provide prognostic information 1.
- Patients with AH typically have a history of heavy alcohol use, and the condition is often accompanied by malaise, tender hepatomegaly, and decompensation (ascites, encephalopathy, bacterial infection, and variceal bleeding) 1.
- The treatment of AH involves complete abstinence from alcohol, nutritional support, and possibly corticosteroids like prednisolone (40mg daily for 28 days) in severe cases, as recommended by the EASL clinical practice guidelines 1.
Management
- Corticosteroids, such as prednisolone 40 mg/day or methylprednisolone 32 mg/day, should be considered in patients with severe AH to reduce short-term mortality 1.
- N-acetylcysteine (for five days, intravenously) may be combined with corticosteroids in patients with severe AH 1.
- A careful evaluation of nutritional status should be performed, and patients should aim to achieve a daily energy intake ≥35–40 kcal/kg BW and 1.2–1.5 g/kg protein, with the oral route as first-line intervention 1.
- Systematic screening for infection should be performed before initiating therapy, during corticosteroid treatment, and during the follow-up period 1.
From the Research
Jaundice after a Drinking Bing
- Jaundice is a indication of hyperbilirubinemia and is caused by derangements in bilirubin metabolism, which can be caused by alcoholic liver disease 2.
- Alcoholic liver disease is a potential cause of jaundice, and a comprehensive medical history, review of systems, and physical examination are essential for differentiating potential causes 2.
- Laboratory evaluation should include assays for bilirubin, liver function tests, and other tests to determine the underlying cause of jaundice 2.
- Binge drinking is a drinking pattern characterized by the intake of large amounts of alcohol in a short period of time, which can lead to alcohol intoxication and other negative effects on health 3.
- The negative effects of binge drinking can affect the drinker themselves, as well as others, and can be acute or chronic, even among those who adopt binge drinking sporadically 3.
Potential Causes of Jaundice after a Drinking Bing
- Alcoholic liver disease is a potential cause of jaundice, and can be caused by binge drinking 2, 3.
- Vitamin B6 deficiency has been found in patients with chronic liver disease, including those with alcoholic liver disease 4, 5.
- However, the relationship between vitamin B6 deficiency and jaundice is not well established, and more research is needed to determine the potential role of vitamin B6 deficiency in the development of jaundice after a drinking binge.
Diagnosis and Treatment of Jaundice after a Drinking Bing
- A comprehensive medical history, review of systems, and physical examination are essential for differentiating potential causes of jaundice 2.
- Laboratory evaluation should include assays for bilirubin, liver function tests, and other tests to determine the underlying cause of jaundice 2.
- Treatment of jaundice after a drinking binge will depend on the underlying cause, and may include supportive care, medication, and other interventions 2.