Alcoholic liver disease history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

History should focus on the history of alcohol use by the patient, and the history of symptoms that may have developed. Pertinent symptoms that may be reported are; an increase in abdominal girth (due to ascites, loss of appetite, gynocomastia, skin changes, excessive thirst, fatigue, nausea, hematemesis, mental confusion, and jaundice.

History

• Recent history of heavy drinking
• Chronic alcohol intake i.e. > 80 g/d in men and 40 g/d in women with alcoholic hepatitis or cirrhosis.

Symptoms

• Abdominal pain and tenderness
• Dry mouth
• Excessive thirst
• Fatigue
• Fever
• Fluid collection in the abdomen (ascites)
• Jaundice
• Loss of appetite
• Mental confusion
• Nausea
• Unintentional weight gain (because of fluid collection)

Other symptoms that can occur with this disease:

• Abnormally dark or light skin
• Agitation
• Bloody, dark black, or tarry bowel movements (melena)
• Breast development in males (gynocomastia)
• Changing mood
• Confusion (encephalopathy)

• Changed level of consciousness
• Hallucinations
• Impaired short- or long-term memory

• Difficulty paying attention (attention deficit)
• Impaired ability to concentrate
• Impaired judgment
• Light-headedness or fainting, especially when standing
• Paleness
• Tachycardia when rising to standing position
• Redness on feet or hands
• Slow, sluggish, lethargic movement
• Hematemesis or coffee-ground emesis

Symptoms vary based on the severity of the disease. They are usually worse after a recent period of heavy drinking.

2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)

Abstinence : Guidelines (DO NOT EDIT)

Class I

1. " Clinicians should discuss alcohol use with patients, and any suspicion of possible abuse or excess should prompt use of a structured questionnaire and further evaluation. (Level of evidence: C) "

2. " Patients with alcoholic liver disease (ALD) and suggestive symptoms should be screened for evidence of other end-organ damage, as appropriate. (Level of evidence: C) "