Alcoholic liver disease overview: Difference between revisions
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==Differentiating Alcoholic liver disease from other Diseases== | ==Differentiating Alcoholic liver disease from other Diseases== | ||
Alcoholic liver disease should be differentiated from other diseases that produce similar symptoms, and other types of liver diseases. It should also be differentiated from diseases of the gallbladder. Conditions that may present in a similar manner to alcoholic liver disease are; [[cholecystitis]], [[cholelithiasis]], drug toxicity, non-alcoholic fatty liver disease, and other forms of hepatitis (eg. viral, autoimmune). | Alcoholic liver disease should be differentiated from other diseases that produce similar symptoms, and other types of liver diseases. It should also be differentiated from diseases of the gallbladder. Conditions that may present in a similar manner to alcoholic liver disease are; [[cholecystitis]], [[cholelithiasis]], drug toxicity, non-alcoholic fatty liver disease, and other forms of hepatitis (eg. viral, autoimmune). | ||
==Risk Factors== | |||
Risk factors for alcoholic liver disease include female gender, excessive alcohol use, [[malnutrition]], and individual susceptibility towards liver injury due to the toxic effects of alcohol. | |||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
Alcoholic liver disease progresses through three stages (steatosis, alcoholic hepatitis, and cirrhosis) with the continued use of alcohol. Serious complications begin to occur with the development of alcoholic hepatitis, when [[portal hypertension]], [[coagulopathy|coagulopathies]], and intractable [[jaundice]]. Complications of [[cirrhosis]] include [[hepatic encephalopathy]] and [[hepatocellular carcinoma]]. Prognosis varies dependent on level of progression of illness, and whether treatment is given. Prognosis can be measured using laboratory values, and three prognostic scores: the MELD score, the Glasgow Alcoholic Hepatitis Score, and the ABIC score. | Alcoholic liver disease progresses through three stages (steatosis, alcoholic hepatitis, and cirrhosis) with the continued use of alcohol. Serious complications begin to occur with the development of alcoholic hepatitis, when [[portal hypertension]], [[coagulopathy|coagulopathies]], and intractable [[jaundice]]. Complications of [[cirrhosis]] include [[hepatic encephalopathy]] and [[hepatocellular carcinoma]]. Prognosis varies dependent on level of progression of illness, and whether treatment is given. Prognosis can be measured using laboratory values, and three prognostic scores: the MELD score, the Glasgow Alcoholic Hepatitis Score, and the ABIC score. | ||
==References== | ==References== | ||
Revision as of 15:46, 28 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Alcoholic liver disease is the major cause of liver disease in Western countries, (in Asian countries, viral hepatitis is the major cause). It arises from the excessive ingestion of alcohol and can present as fatty liver, alcoholic hepatitis, and cirrhosis. Fatty liver and alcoholic hepatitis may be asymptomatic and reversible with abstinence from alcohol. Alcoholic hepatitis involves acute or chronic inflammation of liver parenchyma and is the most common precursor of cirrhosis in the United States.
Pathophysiology
Alcoholic liver disease can vary in level of severity. Fatty liver occurs by the excess generation of NAD by enzymes aldehyde dehydrogenase and alcohol dehydrogenase, leading to shunting of substrates into lipid biosynthesis. This can worsen into alcoholic hepatitis when inflammation, necrosis, and the generation of ROS occurs at the sites of fatty change. Cirrhosis is the final and irreversible stage of the progression of alcoholic liver disease, and is marked by fibrosis and disruption of liver architechture.
Differentiating Alcoholic liver disease from other Diseases
Alcoholic liver disease should be differentiated from other diseases that produce similar symptoms, and other types of liver diseases. It should also be differentiated from diseases of the gallbladder. Conditions that may present in a similar manner to alcoholic liver disease are; cholecystitis, cholelithiasis, drug toxicity, non-alcoholic fatty liver disease, and other forms of hepatitis (eg. viral, autoimmune).
Risk Factors
Risk factors for alcoholic liver disease include female gender, excessive alcohol use, malnutrition, and individual susceptibility towards liver injury due to the toxic effects of alcohol.
Natural History, Complications and Prognosis
Alcoholic liver disease progresses through three stages (steatosis, alcoholic hepatitis, and cirrhosis) with the continued use of alcohol. Serious complications begin to occur with the development of alcoholic hepatitis, when portal hypertension, coagulopathies, and intractable jaundice. Complications of cirrhosis include hepatic encephalopathy and hepatocellular carcinoma. Prognosis varies dependent on level of progression of illness, and whether treatment is given. Prognosis can be measured using laboratory values, and three prognostic scores: the MELD score, the Glasgow Alcoholic Hepatitis Score, and the ABIC score.