While the occasional alcoholic drink is not usually harmful, excessive alcohol consumption can lead to a number of health consequences. It can raise your risk for heart disease, various types of cancer, high blood pressure and, of course, alcohol use disorder. Drinking can also lead to injuries and death by accidents, including motor vehicle crashes and falls, and can result in social and legal problems. Each time your liver is injured — whether by excessive alcohol consumption or another cause, such as infection — it tries to repair itself. As cirrhosis gets worse, more and more scar tissue forms, making it difficult for the liver to do its job.
- Supporting features on physical examination include an enlarged and smooth, but rarely tender liver.
- Duration of survival in both groups is considerably less than that of an age-matched population.
- Cirrhosis is considered end stage liver disease as it cannot be reversed and can lead to liver failure.
- With alcohol abstinence, morphologic changes of the fatty liver usually revert to normal.
In these cases, treatment focuses on preventing further damage and treating other factors that can make the disease worse, such as infection and malnourishment. However, if the person drinks alcohol again heavily, the fatty deposits will reappear. Though rare, liver cancer can develop from the damage that occurs with cirrhosis. Most people with this condition have had at least seven drinks a day for 20 years or more.
Medical Treatment
A drug screen is recommended and in selected patients imaging of the head and cerebral spinal fluid studies may be required (53). Once advanced cirrhosis has occurred with evidence of decompensation (ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, variceal bleeding), the patient should be referred to a transplantation center. The overall clinical diagnosis of alcoholic liver disease, using a combination of physical findings, laboratory values, and clinical acumen, is relatively accurate (Table 3). However, liver biopsy can be justified in selected cases, especially when the diagnosis is in question.
- The first stage of alcoholic liver disease is hepatic steatosis, which involves the accumulation of small fat droplets under liver cells approaching the portal tracts.
- It may start with fatty liver disease, progressing to alcohol-related hepatitis, and then to alcohol-related cirrhosis.
- Having a high body mass index (BMI, a calculation based on height and weight but not taking into account other variables affecting weight) has been shown to increase mortality rates (being subject to death) and the risk of liver cancer.
Even if you have been a heavy drinker for many years, reducing or stopping your alcohol intake will have important short-term and long-term benefits for your liver and overall health. Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time (binge drinking). In advanced cases of cirrhosis, when the liver stops working properly, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor.
Treatment for the underlying cause of cirrhosis
Supporting features on physical examination include an enlarged and smooth, but rarely tender liver. In the absence of a superimposed hepatic process, stigmata of chronic liver disease such as spider angiomas, ascites, or asterixis are likely absent. The signs and symptoms of ALD can vary significantly depending on the severity of liver damage.
Cirrhosis has historically been considered an irreversible outcome following severe and prolonged liver damage. However, studies involving patients with liver disease from many distinct causes have shown convincingly that fibrosis and cirrhosis might have a component of reversibility. For patients with decompensated alcoholic cirrhosis who undergo transplantation, survival is comparable to that of patients with other causes of liver disease with a 5-year survival of approximately 70%. In addition to enhanced hepatic lipogenesis, fat (i.e., adipose) tissue contributes to the development of steatosis.
Clinical trials
Although awaiting further studies, the use of non-invasive tests of fibrosis (i.e., serum markers or elastography) may be useful in patients with AUD and abnormal liver tests. Granulocyte-colony stimulating factor has been proposed as an agent to stimulate liver regeneration in patients with alcoholic hepatitis by promoting migration of bone marrow derived stem cells into the liver. alcoholic liver disease A single center study from India showed a survival benefit in patients treated with granulocyte-colony stimulating factor at 90 days. Its use in patients with alcoholic hepatitis is however experimental. The classic histologic features of alcoholic hepatitis include inflammation and necrosis, which are most prominent in the centrilobular region of the hepatic acinus(Figure 2).
- It’s important to identify the trigger whenever possible in case the condition is reversible.
- Outside medical treatment, patient education is the key to treatment for patients with alcoholic liver disease.
- Imaging studies of the abdomen such as an ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI), allow doctors to see the liver and check for abnormalities that may be indications of alcohol-related liver disease.
