The most common sign of alcoholic hepatitis is yellowing of the skin and whites of the eyes (jaundice).

Other signs and symptoms include:

• Loss of appetite
• Nausea and vomiting
• Abdominal tenderness
• Fever, often low grade
• Fatigue and weakness

Malnutrition is common in people with alcoholic hepatitis. Drinking large amounts of alcohol suppresses the appetite, and heavy drinkers get most of their calories from alcohol.

Additional signs and symptoms that occur with severe alcoholic hepatitis include:

• Fluid accumulation in your abdomen (ascites)
• Confusion and behavior changes due to a buildup of toxins normally broken down and eliminated by the liver
• Kidney and liver failure

Alcoholic hepatitis develops when the alcohol you drink damages your liver. Just how alcohol damages the liver — and why it does so only in some heavy drinkers — isn't clear.

These factors are known to play a role in alcoholic hepatitis:

• The body's process for breaking down alcohol produces highly toxic chemicals.
• These chemicals trigger inflammation that destroys liver cells.
• Over time, scars replace healthy liver tissue, interfering with liver function.
• This irreversible scarring (cirrhosis) is the final stage of alcoholic liver disease.

Other factors that can contribute to alcoholic hepatitis include:

• Other types of hepatitis. If you have hepatitis C and also drink — even moderately — you're more likely to develop cirrhosis than if you don't drink.
• Malnutrition. Many people who drink heavily are malnourished because they eat poorly or because alcohol and its byproducts prevent the body from properly absorbing nutrients. Lack of nutrients contributes to liver cell damage.

The major risk factor for alcoholic hepatitis is the amount of alcohol you consume. How much alcohol it takes to put you at risk of alcoholic hepatitis isn't known. But most people with the condition have a history of drinking more than 3.5 ounces (100 grams) — equivalent to seven glasses of wine, seven beers or seven shots of spirits — daily for at least 20 years.

However, alcoholic hepatitis can occur among those who drink less and have other risk factors.

Other risk factors include:

• Your sex. Women seem to have a higher risk of developing alcoholic hepatitis possibly because of differences in the way alcohol is processed in women.
• Obesity. Heavy drinkers who are overweight might be likelier to develop alcoholic hepatitis and to progress from that condition to cirrhosis.
• Genetic factors. Studies suggest there may be a genetic component in alcohol-induced liver disease although it's difficult to separate genetic and environmental factors.
• Race and ethnicity. Blacks and Hispanics might be at higher risk of alcoholic hepatitis.
• Binge drinking. Having five or more drinks within two hours for men and four or more for women might increase your risk of alcoholic hepatitis.

Complications of alcoholic hepatitis, which result from severe liver damage, relate to scar tissue. Scar tissue can slow blood flow through your liver, increasing pressure in a major blood vessel (portal vein), and the buildup of toxins. Complications include:

• Enlarged veins (varices). Blood that can't flow freely through the portal vein can back up into other blood vessels in the stomach and esophagus. These blood vessels have thin walls and are likely to bleed if filled with too much blood. Heavy bleeding in the upper stomach or esophagus is life-threatening and requires immediate medical care.
• Ascites. Fluid that accumulates in the abdomen might become infected and require treatment with antibiotics. Ascites isn't life-threatening but are usually a sign of advanced alcoholic hepatitis or cirrhosis.
• Confusion, drowsiness and slurred speech (hepatic encephalopathy). A damaged liver has trouble removing toxins from your body. The buildup of toxins can damage your brain. Severe hepatic encephalopathy can result in coma.
• Kidney failure. A damaged liver can affect blood flow to the kidneys, resulting in damage to those organs.
• Cirrhosis. This scarring of the liver can lead to liver failure.