Alcohol-Related Liver Disease Hepatic and Biliary Disorders

Doctors can diagnose alcohol-related cirrhosis by first taking a medical history and discussing your drinking history. The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as having 5 or more drinks in 1 day on at least 5 days out of the past month. In the early stages of the disease, your body can compensate for your liver’s limited function. As the disease progresses, symptoms will become more noticeable. During the physical exam, the doctor will feel the abdomen to assess the size and tenderness of the liver. They can also determine whether the spleen is enlarged, which may be a sign of advanced liver disease.

What Stages Aren’t Reversible?

On average, 1 in 3 people with the most advanced stage of liver disease and cirrhosis are still alive after 2 years. When the body can compensate alcoholic liver disease and manage cirrhosis, the typical lifespan is 6–12 years. Those with less severe diseases will survive longer if they abstain from alcohol.

Liver Failure Stages

• In a network meta-analysis of 22 studies including the STOPAH study, there was low-quality evidence for benefit of pentoxifylline in reducing the short-term mortality at 28 days by 30% (121).
• Doctors use the Model for End-Stage Liver Disease (MELD) score to help determine ALD severity and prognosis.
• It also will review modifiers of alcoholic liver disease (ALD) and discuss currently used treatment approaches for patients with ALD.
• Fibrosis is a buildup of certain types of protein in the liver, including collagen.
• Alcoholic fatty liver disease appears early on as fat deposits accumulate in the liver.
• It’s important to have protein intake, and that can be from lean sources of protein such as beans or lentils, and salt restriction is also very important.

More advanced disease is characterized by marked steatosis, hepatocellular necrosis, and acute inflammation, known as alcoholic hepatitis. There is a need for more effective treatment of alcoholic liver disease as the severe form of the disease is life-threatening. This activity reviews the evaluation and management of alcoholic liver disease and highlights the role of the interprofessional team in the recognition and management of this condition.

What are the risk factors for alcohol-related liver disease?

Most people with this condition have had at least seven drinks a day for 20 years or more. This can mean 7 glasses of wine, 7 beers, or 7 shots of spirits. Make an appointment with your healthcare professional if you have any lasting symptoms that worry you. Seek medical help right away if you have belly pain that is so bad that you can’t stay still. But support, advice and medical treatment may be available through local alcohol addiction support services.

Support links

• There are three stages—alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis.
• Discontinuation of alcohol intake may cause regression of all the above stages.
• Steatosis can progress to steatohepatitis, which is a more severe, inflammatory type of liver injury.
• Acetaminophen, on the other hand, is safe to take, but at smaller doses.
• Alcoholic cirrhosis is a progression of ALD in which scarring in the liver makes it difficult for that organ to function properly.

When you make the appointment, ask if there’s anything you need to do before certain tests, such as not eating or drinking. Your healthcare professional might suggest a special diet to fix poor nutrition. You might be referred to an expert in diet to manage disease, called a dietitian. A dietitian can suggest ways to eat better to make up for the vitamins and nutrients you lack.

• People with signs of malnourishment may need to increase the number of calories and amount of protein they consume, as well as take nutrient or vitamin supplements.
• However, due to its high sensitivity, it can yield false-positive results with exposure to alcohol containing medications and hand sanitizers containing small amounts of ethanol (37).
• Scientists are working to expand current treatments for cirrhosis, but success has been limited.
• A daily intake of 80 grams of alcohol increases liver-cancer risk 5-fold over that of nondrinkers, whereas heavy alcohol use by HCV-infected individuals increases cancer risk by 100-fold over uninfected heavy drinkers.

Coexisting iron accumulation or chronic hepatitis C increases risk of hepatocellular carcinoma. Alcohol biomarkers, such as urine or hair ethyl glucuronide, urine ethyl sulfate, and phosphatidylethanol (PEth), can be used to support patient history and aid in recovery. Hepatocellular carcinoma may also develop in patients with cirrhosis, especially if iron accumulation coexists. A wide range of diseases and conditions can damage the liver and lead to cirrhosis. The liver damage caused by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the underlying cause is treated, further damage can be limited.

Untreated Alcoholic Liver Disease Complications

Progressive Symptoms

• Learn more about resources, support, and treatment for alcohol use disorder.
• Moderate alcohol consumption for women means that no more than one alcoholic beverage is consumed each day.
• The following therapies currently are used for optimal ALD management.
• Urine ethyl glucuronide and phosphatidyl ethanol are commercially available for use in routine clinical practice (36).
• In addition to SIRS criteria, tender hepatomegaly and occasionally, hepatic bruit may be present.
• Reasons someone might relapse into alcohol misuse after a transplant include a history of mental health conditions, limited access to treatment options, or a lack of social support.