Alcoholic Liver Disease
Alcoholic Liver Disease
Do you drink alcohol? You need to know how alcohol may silently damage your liver.
People might consider themselves as asocial drinker but studies have shown that even a single drink in a day is going to be harmful for your health. Consuming no alcohol in a day minimizes the overall risk of health loss. To be more specific, adults who consumed a single alcoholic beverage in a day increase their risk of around 23 health problems caused by alcohol.
Alcohol is the most common cause of liver cirrhosis in most parts of the world. Alcohol-related liver injury passes through three distinct clinical phases such as acute fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. In a given patient these may occur in varying combinations. Acute fatty change of alcohol abuse may progress to cirrhosis in 20% of patients. Alcoholic hepatitis develops only in a small proportion of patients after decades of abuse. This condition may progress to cirrhosis. Once cirrhosis develops it is irreversible and progresses at the rate of 10% annum if there is no further insult. Liver cancer can develop in 20% of these cirrhotic.
Alcoholic fatty liver disease
Fatty change occurs after the consumption of large amounts of alcohol over a short period of time. The liver tests and clinical liver swelling returns to normal after abstaining from alcohol. The fat clearance from the liver takes place in 2-6 weeks. With continued abuse of alcohol, this may progress to hepatitis and cirrhosis. Fatty change may persist in some after abstaining from alcohol when they have obesity, diabetes, or pancreatitis.
This is a state with a wide spectrum of presentations ranging from mild swelling of the liver to severe jaundice, fluid in the abdomen including hepatic coma. The symptoms include lethargy, anorexia, fatigue, vague abdominal pain, and rarely jaundice. Women tend to have a more florid illness. Approximately 50% may have a fluid collection in the abdomen. The bleeding tendency may manifest as easy bruising of the skin. Blood tests will reveal a rise in liver enzymes, bilirubin, and alkaline phosphatase. Low hemoglobin and high white cell counts are common. In the more severely ill, the platelet count will be low and the prothrombin time will be elevated and incompletely corrected with treatment.
Alcoholic Liver Cirrhosis
This is end-stage of alcohol-induced liver disease and many patients will need liver transplantation.
Dr. Rakesh Rai. MS, FRCS, MD, CCST, ASTS Fellow (USA).
Senior Consultant HPB & Transplant Surgery