Alcohol is the most widely abused agent in
the world and its excessive intake is the leading cause of
liver disease. It is consumed as beer, wine or distilled
spirit and a blood level of 100 mg/dl is the legal
definition for drunk driving in India. A blood concentration
of 200 mg/dl causes inebriation while a level of 300-400
mg/dl can lead to coma, respiratory arrest and death.
Alcohol ingestion affects the liver, nervous system,
cardiovascular system, gastrointestinal system, muscles and
the reproductive system. There is also an increased risk of
cancer of the mouth, pharynx, food pipe, and liver
associated with prolonged alcohol abuse.
The liver bears the greatest brunt of alcoholic injury
leading to 3 distinctive, but overlapping forms of liver
disease:
Fatty change (hepatic steatosis)
Acute alcoholic hepatitis
Cirrhosis
What is the cause?
Daily ingestion of 80 gm or more of ethanol
poses a significant risk for serious liver damage while a
daily intake of 160 gm or more for 10-20 years is
consistently associated with severe liver injury. Only
10-15% of chronic alcoholics, however, develop cirrhosis.
Women are more prone to hepatic injury and this may be
related to reduced breakdown of alcohol and differences in
body composition, possibly a genetic susceptibility. No
genetic markers are known that can identify susceptible
individuals.
The relation between fatty change or alcoholic hepatitis and
progression to cirrhosis is not yet clear with cirrhosis
developing without preceding evidence of fatty change or
hepatitis in some individuals. In the absence of a clear
understanding of the different factors responsible for liver
injury, no safe upper limit for alcohol intake can be
stated.
Fatty change:
This is an acute, reversible effect of alcohol ingestion
and, in chronic alcoholism, may lead to a massive
enlargement of the liver. This occurs because of increased
breakdown of fat in the body causing more fatty acids to
be delivered to the liver; excess lipid biosynthesis in
the liver; reduced fat breakdown by the liver; and
decreased transport of fat out of the liver.
Acute alcoholic hepatitis:
This liver injury is also potentially reversible. It is
caused by the direct toxic effect of alcohol and is due to
injury to the liver cell; reduced protective chemicals in
the liver cells; increased production of toxic substances
within the liver; and stimulation of the immune system.
Reduced oxygen supply within the liver also contributes to
the injury. If alcohol ingestion is continued, about
10-15% of patients from this stage will develop cirrhosis
of liver. This occurs acutely, usually after a bout of
heavy drinking. Patient may have minimal symptoms or may
come in a fulminant liver failure. The usual symptoms,
however, are malaise, loss of appetite, weight loss,
fever, liver pain and jaundice. Each bout of hepatitis
carries a risk of death of 10%-20% and repeated episodes
lead to cirrhosis in 1/3rd of patients in a few years.
Cirrhosis:
This stage is characterised by a hard, shrunken liver and
is a serious, potentially fatal condition. The patient has
weakness, wasting of muscles, fluid in the abdominal
cavity (ascites), bleeding in the intestinal tract and
coma. Jaundice, ascites, portal hypertension and other
features like grossly bloated abdomen and wasting of
extremities clinically manifest this state.
End-stage alcoholic:
The causes of death include hepatic coma, profuse
intestinal bleeding, unremitting infection, involving
kidney failure and cancer of the liver.
In case of fatty change the patient is
usually asymptomatic with only a mild liver enlargement.
Blood tests may be normal or there may be a mild increase
in bilirubin and alkaline phosphatase enzyme.
In case of acute alcoholic hepatitis,
blood tests reveal elevated bilirubin level, increase in
alkaline phosphatase and rise in white cell count.
Blood tests are grossly abnormal and
biopsy of liver may be indicated in case of cirrhosis.
What is the treatment?
Stopping alcohol and a well balanced diet
helps reverse the liver injury in case of fatty change.
In case of acute alcoholic hepatitis
total abstinence from alcohol and proper nutrition usually
allow it to improve slowly. In some cases, however, it
progresses to cirrhosis despite stopping alcohol.
There is no treatment for cirrhosis.
Liver transplant is the only available option.
Liver Cells
Alcohol Liver Disease - treatment of Alcohol
Liver Disease, Alcohol Liver Disease types, Disease medicines, Alcohol Liver
Disease symptoms, Alcohol Liver Disease and Disease symptoms, Alcohol Liver
Disease symptoms Disease and diagnosis, Symptoms and Solutions, Signs and
Symptoms, type of Alcohol Liver Disease, cause common, common Alcohol Liver
Disease, Alcohol Liver Disease List, causes list, Infectious Alcohol Liver
Disease, Causes, Diseases , Types, Prevention, Treatment and Facts, Alcohol
Liver Disease information, Alcohol Liver Disease: Definition, Alcohol Liver
Disease names, medical Alcohol Liver Disease, medical Alcohol Liver Disease
and disorders, cell Alcohol Liver Disease, Alcohol Liver Disease Worldwide,
Alcohol Liver Disease Research, Alcohol Liver Disease Control, Alcohol Liver
Disease Center, Digestive Alcohol Liver Disease Week, Information about
Alcohol Liver Disease, causes of different Alcohol Liver Disease, Alcohol
Liver Disease Articles, Alcohol Liver Disease and conditions, Health and
Alcohol Liver Disease, Alcohol Liver Disease Patients, Alcohol Liver Disease
and Sciences, causes of alzheimer's Alcohol Liver Disease, Alcohol Liver
Disease causes, alternative medicine heart Alcohol Liver Disease, body
ailments, Alcohol Liver Disease medicines, medical antiques, type of blood
Alcohol Liver Disease
Quality
