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REMEMBER, LIVER DISEASE IS NOT THE ONLY LIFE-THREATENING
COMPLICATION OF ALCOHOL USE DISORDERS. OTHER ALCOHOL-RELATED MEDICAL,
SOCIAL AND PSYCHOLOGICAL PROBLEMS CAN LEAD TO MORBIDITY AND MORTALITY.
Alcohol abuse generally leads to three pathologically distinct liver diseases. In clinical practice, any or all of these three conditions can occur together, at the same time, in the same patient. These three conditions are: Fatty Liver (Steatosis): Alcohol abuse can lead to the accumulation of fat within hepatocytes, the predominant cell type in the liver. A similar condition can also be seen in some obese people who are not alcohol abusers. Fatty liver is reversible if the patient stops drinking, however, fatty liver can lead to steatohepatitis. Steatohepatitis is fatty liver accompanied by inflammation and this condition can lead to scarring of the liver and cirrhosis. Hepatitis: Alcoholic hepatitis can range from a mild hepatitis, with abnormal laboratory tests being the only indication of disease, to severe liver dysfunction with complications such as jaundice, neurological dysfunction caused by liver failure, fluid accumulation in the abdomen, varicose veins in the esophagus, abnormal blood clotting and coma. Alcoholic hepatitis is reversible if the patient stops drinking, but it usually takes several months to resolve. Alcoholic hepatitis can lead to liver scarring and cirrhosis, and very frequently occurs in alcoholics who already have cirrhosis of the liver. Cirrhosis: Cirrhosis is characterized anatomically by widespread nodules in the liver combined with fibrosis. In the United States, alcohol abuse is the leading cause of liver cirrhosis. Cirrhosis can result from many causes other than alcohol such as chronic viral hepatitis, metabolic and biliary diseases. The co-existence of another chronic liver disease in a patient who abuses alcohol likely increases the risk of developing cirrhosis (eg. an alcoholic with chronic viral hepatitis C). Cirrhosis can lead to end-stage liver disease. Some of the complications of cirrhosis are jaundice, ascites, edema, bleeding esophageal varices, blood coagulation abnormalities, coma and death. TreatmentTotal and immediate abstinence from alcohol is the first step. This will sometimes require admission to an in-patient medical ward for prophylactic treatment of withdrawal symptoms such as delirium tremens and seizures. Treatment of other associated neurological conditions may also be required. Chronic alcohol abusers often need treatment with vitamins, especially thiamin, to correct the deficiencies that may have resulted from chronic alcohol abuse. Intensive medical treatment of the complications of acute alcoholic hepatitis or cirrhosis is also sometimes necessary, as is the treatment of concurrent infectious and/or metabolic disorders. Cessation of alcohol use will reverse fatty liver and alcoholic hepatitis. Although cirrhosis is irreversible, alcohol abusers who stop drinking will often have a good prognosis in that progressive liver deterioration can be avoided. Malnutrition develops as a result of empty calories from alcohol, reduced appetite, and malabsorption (inadequate absorption of nutrients from the intestinal tract). Malnutrition contributes to liver disease. The toxicity of ethanol to the liver, individual susceptibility to alcohol-induced liver disease, and genetic factors also contribute to the development of alcoholic liver disease. Symptoms
Additional symptoms that may be associated with this disease:
Treatment The objective of treatment is to discontinue alcohol, and to provide a high-carbohydrates, high-calorie diet to reduce protein breakdown in the body. Vitamins, especially B1 and folic acid, are associated with improvement. An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Management of the complications of chronic liver disease may be needed. If cirrhosis develops, liver transplant may be necessary. ALCOHOLIC LIVER DISEASE (ALD) is a serious and potentially fatal consequence of drinking alcohol. Another disorder, hepatitis C, often is found in patients with ALD. ALCOHOLIC LIVER DISEASE The liver is one of the largest and most complex organs in the body. It stores vital energy and nutrients, manufactures proteins and enzymes necessary for good health, protects the body from disease, and breaks down (or metabolizes) and helps remove harmful toxins, like alcohol, from the body. Because the liver is the chief organ responsible for metabolizing alcohol, it is especially vulnerable to alcohol-related injury. Even as few as three drinks at one time may have toxic effects on the liver when combined with certain over-the-counter medications, such as those containing acetaminophen.
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