Alcoholic Liver Disease

Overview

The liver is the second largest organ in your body. It performs a whole host of functions including filtering the blood of toxins, manufacturing proteins, clotting factors, bile, cholesterol and plays a part in blood glucose control and immunity. When a person continuously drinks alcohol heavily over the course of years, this often leads to fatty liver and can cause inflammation (alcoholic hepatitis) in the liver and eventually the formation of scar tissue. This is called alcoholic liver cirrhosis.

As cirrhosis progresses, more of your healthy liver tissue is replaced with scar tissue. This leads to distortion of the liver architecture and deterioration of its manufacturing capability. It is these factors which eventually lead to the complications associated with alcoholic liver cirrhosis including those related to portal hypertension (oesophageal varices, ascites, splenomegaly, hepatic encephalopathy) as well as laying the ground for an increased risk of liver cancer.

Symptoms Of Alcoholic Liver Disease

Early stages of alcoholic liver disease largely have no symptoms. Sometimes, symptoms may include right-sided upper abdominal pain that is dull in nature. The person may have tiredness. The disease can progress along right up to advanced cirrhosis of the liver without major symptoms.

Symptoms of alcoholic liver cirrhosis typically develop only when the liver is no longer able to compensate for its functional loss. As the disease progresses, symptoms will become more noticeable and numerous. These may include jaundice, pruritus or itch, abdominal bloating due to ascites, encephalopathy or confusion, wasting of muscles and gastrointestinal bleeding.

Sometimes, the liver may go into a severe inflammatory state known as alcoholic hepatitis. This can occur regardless of the fibrotic stage of the liver. Typically patient with alcoholic hepatitis has jaundice. Fever and right-sided upper abdominal pain could also be present. This entity can be life-threatening.

People At Risk Of Getting Alcoholic Liver Disease

New guidelines suggest that both men and women should drink no more than 14 units of alcohol in a week. Hence, people who drink more than this over many years are potentially at risk of alcoholic liver cirrhosis.

How Many Units Of Alcohol Are In Each Drink?

  • Single shot of spirits (25ml): 1 unit
  • Standard (175ml) glass of wine: 2.1 units
  • Large (250ml) glass of wine: 3 units
  • Pint of 4%-strength beer: 2.3 units
  • Pint of 5%-strength beer: 2.8 units
  • Pint of strong cider (8%): 4.5 units

Diagnosis

Diagnosis of alcoholic liver cirrhosis is based on a history of excessive alcohol intake over many years, the exclusion of other causes of liver diseases including hepatitis B, hepatitis C, autoimmune hepatitis etc. It can be diagnosed based on ultrasound scan, fibroscan liver stiffness measurement or liver biopsy. Laboratory investigations also help to corroborate evidence that you may have liver cirrhosis.

Treatment

There is currently no treatment that actively reverses alcoholic liver cirrhosis. However, patients who stop drinking alcohol completely may see a reversal or improvement in their livers over time. This typically can only happen in the early stages of liver cirrhosis when portal hypertension has not set in. Once portal hypertension is established, cirrhosis is irreversible. Patients who have abstained from drinking for more than 6 months are considered for liver transplantation. Patients with alcoholic liver cirrhosis who undergo liver transplantation have excellent survival rates post-transplant.

The first step in treatment is to stop drinking. Those with alcoholic liver cirrhosis are often so dependent on alcohol that they could experience severe health complications if they try to quit without being in the hospital. Your gastroenterologist can work with a psychologist to get you on your road to sobriety.

Nutritional Counseling

Alcohol abuse often leads to malnutrition and muscle wasting. Patients often require advice from a dietician for the replacement of vitamins and a balanced diet.

If you are fighting alcohol abuse and potentially alcoholic liver cirrhosis, speak to one of our gastroenterologists at gutCARE today who have an interest in liver disease for advice on assessing the state of your liver. gutCARE provides a comprehensive liver service including state-of-the-art Fibroscan liver stiffness measurement as well as specialized allied health services including psychological and dietetics consultations. Your prognosis will depend on your overall health and whether you have developed any complications associated with liver cirrhosis. But there isn’t a better time to start approaching the issue than now!

Category
digestive illnesses, Services

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