Alcoholic Liver Disease

Alcoholic Liver Disease

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Overview

It is a kind of liver disease where the liver is damaged due to overconsumption of alcohol, leading to fat build-up, inflammation, and scarring. Alcohol liver disease can be fatal.

What are the early signs of alcoholic liver disease?

The early signs of alcoholic liver disease are quite vague and affect the various system in the body. These signs include:

  • A feeling of being unwell
  • Abdominal pain
  • Nausea and vomiting
  • Diarrhea
  • Decreased appetite

What are the symptoms related to Alcoholic liver disease?

Symptoms are visible once the condition has progressed. The more common signs and symptoms of later-stage liver disease include the following:

  • Yellowing of eyes and skin (Jaundice)
  • Edema, or swelling of lower limb
  • Fluid build-up in the abdomen (Ascites)
  • Extremely itchy skin
  • Fever and shivering
  • Excessive curving of fingernails, known as clubbing
  • Unintentional weight loss
  • Weakness and muscle wasting
  • Bruising and bleeding more easily
  • Blood in stool and vomit
  • More sensitive reactions to drugs and alcohol

What causes alcoholic liver disease?

Not every heavy regular drinker develops liver damage. It is unknown why alcoholic liver disease affects some people and not all. Acetaldehyde is a toxic chemical that is produced by the body’s breakdown of alcohol. This damages the liver and leads to inflammation and scarring. This chemical tends to affect some people more in comparison to others.

How is an alcoholic liver disease diagnosed?

Some of the tests that help in the diagnosis of the alcoholic liver disease include:

  • Blood tests: A liver function test helps in accessing the liver. However, it can be normal in various stages of liver disease. A blood test may also help look for the signs of abnormal blood clotting, which indicate significant liver damage.
  • CT scan: This test uses a special dye medium that helps with a clear image of the body parts from different angles. It can help in seeing detailed images of soft tissue and blood vessels. CT scan helps in finding any abnormality related to the liver.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields to produce detailed body images.
  • Biopsy: In this procedure, a sample tissue is taken from the site and sent to the laboratory to look for any abnormality. There are various ways to doing a biopsy:
  • Fine needle aspiration (FNA): Small amount of tissue is removed with the help of the fine needle.
  • Core biopsy: This procedure is similar to FNA. However, instead of a fine needle, a thick needle is used to remove small cylinder-shaped samples.
  • Laparoscopic biopsy: In this procedure, a small incision is made in the abdomen, and then a thin tube light and camera are inserted into the stomach to look for abnormalities.
  • Surgical biopsy: The process of removal of tissue during the operative procedure is known as a surgical biopsy.
  • Endoscopy: This procedure uses an instrument with a camera attached to a tube that goes down the throat and allows your doctor to look for swollen veins (varices), which is a sign of cirrhosis.

What are the stages of alcoholic liver disease?

Alcoholic liver diseases occur in 3 stages:

  • Fatty liver: This is the first stage and is also known as steatosis. It is characterized by excessive accumulation of fat in the liver, making it hard for the liver to function properly. Heavy drinkers develop this during their early days of alcohol consumption. However, this stage is reversible if alcohol consumption is stopped.
  • Alcoholic Hepatitis: This is the second stage and is characterized by the inflammation of the liver that leads to degeneration of the liver cells. This stage might last for years; however, it will eventually progress to absolute liver damage if the person consumes alcohol. In critical cases, it may turn into life-threatening complications like absolute liver damage and liver cirrhosis. At this stage, jaundice is the most common symptom, along with other symptoms like nausea, vomiting, weight loss, fatigue, weakness, loss of appetite, abdominal tenderness, etc.
  • Liver cirrhosis: This is the final stage of alcoholic liver disease where permanent scarring of the liver tissue occurs. This is a severe and irreversible condition.

How is alcohol liver disease treated?

The first major step in the treatment of alcoholic liver disease is the removal of alcohol from life.

  • Abstinence: Abstaining from alcohol is one and the only way to make alcoholic liver disease reversible. This can help in reversing some early stages of liver disease. For example, stopping alcohol consumption after being diagnosed with fatty liver disease may be able to reverse the condition within two to six weeks. However, it also depends on the severity. It is recommended to quit alcohol intake after diagnosis as any changed conditions will typically return if one starts drinking again. In the case of regular drinkers, it is advisable to seek medical help for quitting alcohol.
  • Lifestyle changes: Bringing some lifestyle modifications like weight loss and quitting smoking might also be recommended since being overweight and smoking have both been considered making the alcoholic liver disease worse. It is recommended to take a multivitamin daily after a doctor's consultation.
  • Medications: Your doctor may prescribe certain medications that will help in reducing the inflammation in patients with acute alcoholic hepatitis while being treated in a hospital.
  • Liver transplant: In patients with liver failure, the liver does not function properly, which means the patient needs a liver transplant for long survival. Patients who have stopped alcohol intake for the last 6 months and those who have all other organs healthy enough to undergo surgery will be considered for transplant. As liver transplant is a last resort, it is the best way to quit alcohol and treat this condition early to increase their chances of reversing or slowing the disease.

Tips for prevention

Below are some tips that help reduce the risk of acute liver failure by taking care of your liver.

  • Follow instructions on medications: Avoid taking any excessive medicine. It is always suggested to follow a doctor’s prescription.
  • Tell your doctor about all your medicines: Some herbal medicines and over-the-counter can interfere with certain prescribed drugs.
  • Drink alcohol in moderation: It is always advisable to limit alcohol consumption.
  • Avoid risky behavior: Avoid risky practices like sharing a needle, having unprotected sex, etc. If you are planning to have tattoos or body piercings, ensure to choose a place that offers safe practices.
  • Get vaccinated: Get yourself vaccinated for hepatitis A and hepatitis B as this reduces the risk of liver failure.
  • Get medical attention if you’re exposed to blood: Immediately consult your doctor if you come into contact with someone else’s blood.
  • Take care with aerosol sprays: Ensure the room is ventilated or wear a mask whenever you use an aerosol cleaner. Take similar protective measures while spraying insecticides, fungicides, paint, and other toxic chemicals. Follow instructions given on the product carefully.
  • Maintain a healthy weight: Being obese can lead to a non-alcoholic fatty liver disease, which may include fatty liver, cirrhosis, and hepatitis.

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