Apr 25, 2000

Alcoholic liver disease

Postgraduate Medical Journal
K Walsh, G Alexander

Abstract

Alcohol is a major cause of liver cirrhosis in the Western world and accounts for the majority of cases of liver cirrhosis seen in district general hospitals in the UK. The three most widely recognised forms of alcoholic liver disease are alcoholic fatty liver (steatosis), acute alcoholic hepatitis, and alcoholic cirrhosis. The exact pathogenesis of alcoholic liver injury is still not clear but immune mediated and free radical hepatic injury are thought to be important. There is increasing interest in genetic factors predisposing to hepatic injury in susceptible individuals. Diagnosis is based on accurate history, raised serum markers such as gamma-glutamyltransferase, mean corpuscular volume, and IgA and liver histology when obtainable. Abstinence is the most important aspect of treatment. Newer drugs such as acamprosate and naltrexone are used to reduce alcohol craving. Vitamin supplements and nutrition are vital while corticosteroids have a role in acute alcoholic hepatitis where there is no evidence of gastrointestinal haemorrhage or sepsis. Liver transplantation has excellent results in abstinent patients with end stage liver disease but there are concerns about recidivism after transplant.

  • References33
  • Citations12

References

  • References33
  • Citations12

Mentioned in this Paper

Septicemia
Biological Markers
Acute Alcoholic Liver Disease
Pathogenic Aspects
Pathogenesis
Histology Procedure
Fatty Degeneration
End Stage Liver Disease
Liver Cirrhosis, Alcoholic
Hepatitis

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