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 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 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, patient 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.

LJ Bean, a British physician described the signs and symptoms of Alcoholic liver disease in the 19th century in a nice jingle. These findings still stand.

An elderly Miss Muffett
Decided to rough it
On Whiskey and Gin
Red Palms and little spiders
Developed outside her
Such are the wages of sin

How is Alcholic liver Disease treated?

The most important measure in Alcoholic Liver disease is to STOP DRINKING COMPLETELY. The liver can regenerate cells 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.