Alcohol-Related Liver Disease
Alcohol-related liver disease
Alcohol-related liver disease (ARLD) results from long-term excessive drinking, which damages the liver. Over time, alcohol abuse can lead to liver inflammation, swelling, and eventually scarring, known as cirrhosis, the final stage of liver disease.
ARLD is a significant public health issue, with 8 to 10 percent of Americans drinking heavily. Of these, 10 to 15 percent may develop ARLD. Heavy drinking is defined as consuming more than eight alcoholic drinks per week for women and more than 15 for men. Liver disease is a severe consequence of excessive alcohol consumption, as liver failure can be fatal. Understanding prevention and treatment is crucial.
Alcohol-Related Liver Disease Symptoms:
ARLD symptoms vary depending on the disease stage, which includes three stages:
- Alcoholic Fatty Liver Disease: The initial stage where fat accumulates around the liver. It can be reversed by abstaining from alcohol.
- Acute Alcoholic Hepatitis: Characterized by liver inflammation due to alcohol abuse. The severity determines the outcome, with treatment potentially reversing damage, but severe cases may lead to liver failure.
- Alcoholic Cirrhosis: The most severe form, where the liver is irreversibly scarred. This stage can result in liver failure.
Alcohol-Related Liver Damage
Risk factors for ARLD include:
- Family history of ARLD
- Frequent heavy drinking
- Binge drinking
- Poor nutrition
Binge drinking can also cause acute alcoholic hepatitis, which can be life-threatening, even developing after just a few instances.
Diagnosing Alcohol-Related Liver Disease
ARLD isn’t the only condition that damages the liver. To rule out other diseases, a doctor may conduct:
- Complete blood count (CBC)
- Liver function tests
- Abdominal CT scan
- Abdominal ultrasound
- Liver biopsy
Liver enzyme tests are part of the liver function test, measuring enzymes like gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). An AST level twice as high as the ALT level is indicative of ARLD, present in over 80 percent of cases according to the National Institute on Alcohol Abuse and Alcoholism.
Alcohol-Related Liver Disease Treatment
Treatment for ARLD has two main goals: to stop alcohol consumption and improve liver health. Potential treatments include:
- Alcoholic Rehabilitation Programs: Programs like Alcoholics Anonymous can assist in quitting alcohol.
- Multivitamins: B-complex vitamins, often deficient in heavy drinkers, can address anemia and malnutrition.
- Liver Transplant: Necessary if cirrhosis has severely damaged the liver.
- Vitamin A Supplements: For those who are deficient, but only for individuals who have stopped drinking, as combining alcohol and vitamin A can be fatal.
Complications of Alcohol-Related Liver Disease
ARLD complications may involve:
- Permanent liver scarring and loss of function
- High blood pressure in liver blood vessels (portal hypertension)
- Loss of brain function due to toxin buildup in the blood (hepatic encephalopathy)
Outlook of Alcohol-Related Liver Disease
ARLD can shorten life expectancy, but quitting drinking can improve the outlook. Recovery from malnutrition is possible with dietary changes and appropriate supplements. Changing lifestyle habits can make a significant difference, even for those who have been drinking excessively for years. Consult a doctor if you believe you have a drinking problem or are at risk for liver disease. They can guide you to programs that can help you stop drinking and improve liver health.
FAQ?
Risk factors include the amount and duration of alcohol consumption, genetic factors, gender (women are more susceptible), and co-existing liver conditions.
Diagnosis involves a combination of medical history review, physical examination, blood tests (like liver function tests), imaging studies (such as ultrasound or CT scan), and sometimes a liver biopsy.
Treatment includes alcohol cessation, medications to manage symptoms and complications, nutritional support, and in severe cases, liver transplantation.