Alcoholic Liver Disease

Inflammation of the liver caused by excess alcohol intake is known as Alcoholic hepatitis. Normally ingested alcohol is rapidly absorbed and metabolized in the liver. When alcohol intake is in excess, in susceptible patients, it can damage the liver cells. This inflammation can lead to scarring (fibrosis) and cirrhosis (formation of nodules).

The big question remains – what is excess alcoholic intake? The rate of alcohol metabolism is variable from individual to individual. A genetic predisposition to develop alcoholic liver disease exists. Among people who drink, women are more likely to develop liver disease due to their differential metabolism of alcohol.

What Are the Symptoms and Signs of Alcoholic Liver Disease?

Early in the disease, patients have no symptoms and the only abnormalities are elevated liver function tests. As the disease progresses, patients may develop abdominal distention due to fluid accumulation, jaundice, swelling of the feet due to fluid, abdominal pain etc. The dreaded complication of alcoholic cirrhosis is Gastrointestinal Bleeding from varicose veins that develop at the lower end of the esophagus. Some patients develop confusion due to ammonia accumulation in the body (Hepatic Encephalopathy; ammonia formation is normal but a healthy liver rapidly metabolizes the ammonia). Liver Biopsy remains the best method of establishing the diagnosis.

How is Alcoholic Liver Disease Treated?

The most important measure in Alcoholic Liver disease is to STOP DRINKING COMPLETELY. The liver can regenerate cells and there can be reversal of the process that can lead to cirrhosis. Drug treatment with steroids, insulin sensitizers (Actos) are at best experimental. Patients who have developed cirrhosis carry the risk of liver cancer (Hepatoma) and are good candidates for liver transplant but the problem of resumption of alcohol use after liver transplantation exists.