What is the test for hepatitis? How is alcoholic hepatitis diagnosed?

April 9, 2021

What is the test for hepatitis? How is alcoholic hepatitis diagnosed?

This time we talk about hepatitis. Hepatitis has been discussed several times on this site, and among the hepatitis, NASH, or non-alcoholic steatohepatitis, is now on the rise.

If you have been diagnosed with non-alcoholic hepatitis, how does your diagnosis differ from alcoholic hepatitis in alcohol drinkers?

Difference between Alcoholic Hepatitis and NASH

The test for hepatitis is basically a blood test.

This blood test looks at the levels of special “enzymes” that are released when liver cells break down, namely GOT (GOT) and GTP (GTP).

In addition, there is another “enzyme” that tends to go up very much when you drink alcohol.

This enzyme is secreted by the epithelium of the bile ducts in the liver, and is called gamma-GTP. This is also expressed as a numerical value.

Blood tests to check liver condition and types of enzymes


Roughly speaking, a blood test checks these three numbers in your blood, and if your gamma-GTP is high, your doctor will ask you, “Have you been drinking a lot? 

If you answer, “Yes, I do,” the doctor will give you a diagnosis of alcoholic hepatitis.

However, for those who do not drink alcohol and are not infected with the hepatitis virus, but have high hepatitis parameters (reference values) for GOT, GTP, and γ-GTP, a criterion called “non-alcoholic, non-viral hepatitis” (NASH) has been established.

It is said that how to deal with this NASH will be the future of liver treatment.

How to distinguish between NASH and alcoholic hepatitis

The only difference between NASH and alcoholic hepatitis is whether you are drinking alcohol or not.

We humans also have a fixed amount of alcohol that our body can metabolize in a day. A normal person can metabolize 80 grams of alcohol per day. This means, for example, that if the alcohol concentration in a 500ml can of beer is 5%, then the amount of alcohol is 20g.

In other words, if a normal person can metabolize 80 grams of alcohol per day, then one can of beer will not cause hepatitis.

So, if the amount of alcohol you consume is small, hepatitis is usually not likely to occur. Nonetheless, if your GOT, GTP, and γ-GTP values are very high, you are most likely suffering from NASH, not alcoholic hepatitis.

However, even in this case, we will ask the patient to stop drinking alcohol for, say, one month, and then measure the GOT, GTP, and γ-GTP values in the blood again. If the GOT, GTP, and γ-GTP values go down at that time, it may be that the high values were caused by alcohol.

However, NASH is currently on the rise.

One of the main causes of NASH is lack of exercise and the other is overeating. Whether you are overweight or underweight, you can get NASH.

It is also thought that liver cells are more prone to NASH when they are exposed to oxidative stress.


The difference between the diagnosis of alcoholic hepatitis and NASH is simply that if the GOT, GPT, and γ-GTP values of a person who does not drink alcohol are high, there is a possibility of NASH.

However, instead of simply thinking about it, the disease is diagnosed based on various data and reference values (parameters) through detailed examinations. Therefore, if you are concerned, please visit a specialized medical institution.

It is also possible to improve the values by adjusting your lifestyle, so please try to lead a healthy lifestyle and keep oxidative stress at bay.