Alcoholic Liver Disease

 

 

What is it?
This liver disease is caused by drinking alcohol. The liver is an organ that is housed in the right upper side of your abdomen, mostly behind the ribs. It is about the size of a football. The liver makes proteins and processes all foods that we eat into glucose, a form of sugar that can be used as energy throughout the body. The liver stores glucose. The liver also serves to detoxify substances that enter our body. It processes and filters used red blood cells.

Why does it happen?
The liver breaks down the majority of the alcohol that a person drinks. Many people who abuse alcohol over time develop liver disease. The amount of alcohol and how long you have been drinking are other factors leading to liver injury. The first step is development of a “fatty liver” or steatosis. This means just what it says: the cells of the liver have a buildup of fat. It can happen within hours after binge drinking. Contributing factors to steatosis are: overweight, diabetes, and high levels of triglycerides. It is not normal for fat to build up in the liver. “Steatohepatitis,” or inflammation of the liver, can cause scarring of the liver. Scarring, also known as fibrosis, results in loss of healthy liver cells and can cause the liver to not function as well as it should. When the scarring is widespread, it is called cirrhosis and can lead to failure of the liver.

Signs that the liver is not working properly:

  • A yellowing of the skin (jaundice)
  • Increased bleeding risk (coagulopathy). The liver makes many of the necessary components for the blood to clot.
  • Issues with brain function (encephalopathy). The liver filters out many chemicals that are toxic to the body. When it is not functioning properly, these substances remain in the blood and can travel to the brain, causing confusion and memory loss.

What are the symptoms?
The frightening thing about this disorder is often people do not develop symptoms until there is severe, even life threatening, liver disease.

There also may be NO triggering cues that are noticed when your health care professional examines you. Sometimes there are problems with other organ systems such as the heart, nerves, blood, or pancreas that show up first and then the liver disease is diagnosed.

Alcoholic hepatitis (inflammation of the liver)

  • May have no symptoms
  • Fever
  • Enlargement of the liver
  • Yellowing of the skin (jaundice)
  • Lack of appetite
  • Abdominal discomfort
  • Bleeding
  • Hepatic encephalopathy
  • Ascites
  • Cirrhosis or fibrosis (scarring of the liver)

How is it diagnosed?

  • History. Your health provider will question you regarding your drinking history.
  • Lab work. Several blood tests help to assess the degree of the disease
  • Imaging of the liver: To determine if fatty changes, injury, scarring or cancerous changes are present. Ultrasound, CT scan or MRI may be used.
  • Liver biopsy: a small tissue sample of the liver itself might be obtained to be examined under the microscope to evaluate for damage on a cellular level.

How is it treated?
The first and most important thing is to completely STOP drinking.

Fatty liver can begin to develop after a single large binge drinking episode or may develop slowly due to frequent alcohol use. This may continue on to active inflammation (hepatitis) or scarring (cirrhosis) if you continue to drink.

The specific treatment for this disease is the avoidance of alcohol. Even at the end stages of the disease when transplant of a new liver is the only option, it is important to avoid alcohol because continued drinking will disqualify you as a candidate for liver transplantation.

Oftentimes, alcoholics are deficient in nutrients. A protein rich diet along with vitamins (such as thiamine, folate, pyridoxine, vitamin K) and minerals (magnesium, phosphate) is needed.

People hospitalized with inflammation of their liver due to alcohol are often very ill. This condition is often life-threatening. Individuals will be closely monitored and a variety of medications may be used including those for treatment of alcohol withdrawal.

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