Alcoholic liver disease: Symptoms, treatment, and causes

With the latter two regimens, beneficial effects usually can be seen by day 10 of therapy and, if not successful, the treatment usually is discontinued after 15 days. Patients who do respond can complete at least 2 weeks of therapy, and after that, therapy can be discontinued, usually without deterioration of kidney function. VA Cooperative Study 275 found that the combination of an anabolic steroid and an oral nutritional supplement reduced the mortality rate of patients who had moderate protein–energy malnutrition (Mendenhall et al. 1995).

• Thus, all patients with ALD should be encouraged to abstain from alcohol consumption.
• People who have developed alcohol-related hepatitis and alcohol-related cirrhosis are often malnourished, which can lead to worse health outcomes.
• In its early stages, liver cancer may not have symptoms that can be seen or felt.
• Although there are mixed results from various studies, corticosteroids are overall currently considered to have survival benefit in patients with severe alcoholic hepatitis.
• Still, around 10 to 20% of people who develop alcohol-related fatty liver disease go on to develop cirrhosis.

Treatment of autoimmune hepatitis

Initial positive studies by Kershenobich and colleagues (1988) led to a large VA Cooperative Study evaluating colchicine therapy in patients with alcoholic cirrhosis. Results showed no beneficial effect on either overall mortality or liver-related mortality (Morgan et al. 2002). A recent smaller study from Europe also showed no beneficial effects of colchicine (Cortez-Pinto et al. 2002). Thus, despite initial enthusiasm and biochemical rationale for use of this drug, it does not appear to be effective in ALD treatment. Whether outcomes of transplant recipients of HCV infected drinkers will improve with the advent of newer potent and safer anti-HCV therapy, remains a testable hypothesis, yet to be answered.

Help to Stop Drinking

Most transplantation centers require 6-months of sobriety prior to be considered for transplantation. This requirement theoretically has a dual advantage of predicting long-term sobriety and allowing recovery of liver function from acute alcoholic hepatitis. This rule proves disadvantageous to those with severe alcoholic hepatitis because 70% to 80% may die within that period. alcoholic liver disease Mathurin et al found that early liver transplant in patients with severe alcoholic hepatitis versus those who were not transplanted had higher 6-month survival, and this survival benefit was maintained through 2 years of follow-up. Relapse after transplantation appears to be no more frequent than it is in patients with alcoholic cirrhosis who do not have alcoholic hepatitis.

ALCOHOLIC HEPATITIS

However, treating the causes of cirrhosis may prevent cirrhosis or slow the liver damage. Treating the complications of cirrhosis may keep them from getting worse and prevent liver failure. Complications of alcoholic hepatitis are caused by scar tissue on the liver. That can raise pressure in a major blood vessel called the portal vein and cause a buildup of toxins.

Diagnosis of alcoholic hepatitis

Living with cirrhosis?

• Although alcohol use is necessary for ALD, excessive alcohol use does not necessarily promote ALD.
• People with alcohol-induced liver disease are also at greater risk for liver cancer.
• Different treatments are needed for different complications and symptoms of alcoholic liver disease.
• There is a need for more effective treatment of alcoholic liver disease as the severe form of the disease is life-threatening.