Alcoholic Liver Disease
ALCOHOLIC liver disease is damage to the liver that results from excessive drinking of alcohol.
It is a common but preventable health problem.
In general, the amount of alcohol consumed determines the risk and the degree of liver damage.
Women are more vulnerable to liver disease than men. In women who drink over a period of years, the equivalent of as little as 2/3 of an ounce of pure alcohol a day can cause liver damage.
In men who drink over a period of years, the equivalent of as little as two ounces per day can cause liver damage.
However, the amount of alcohol that causes liver damage varies from person to person.
Alcohol can cause three types of liver damage: fat accumulation (fatty liver), inflammation (alcoholic hepatitis) and scarring (cirrhosis).
Alcohol also provides calories without essential nutrients, decreases appetite, and causes poor absorption of nutrients because of its toxic effects in the intestines and pancreas.
As a result, people who regularly drink alcohol without eating properly develop malnutrition.
In general symptoms depend on how long and how much a person has been drinking.
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Heavy drinkers usually first develop symptoms during their 30s and tend to develop severe problems by their 40s.
In men, alcohol may produce effects similar to those produced by too much oestrogen and too little testosterone such as shrunken testes and breast enlargement.
People with liver damage from fat accumulation (fatty liver) usually have no symptoms.
Inflammation of the liver induced by alcohol (alcoholic hepatitis) may cause fever and jaundice (yellowing of the eyes and skin). The skin may develop spider-like veins.
To confirm this diagnosis of alcoholic liver disease in some cases a doctor performs a liver biopsy.
In this procedure, a hollow needle is inserted through the skin and a tiny piece of liver tissue is removed for examination under a microscope.
The doctor may also take a blood sample to perform liver function tests in the laboratory.
If the person continues to drink alcohol, liver damage will progress and probably be fatal.
If the person stops drinking, some of the liver damage may repair itself, and chances are good that the person will live longer.
The only treatment for alcoholic liver disease is to stop drinking alcohol. Doing so can be difficult, and many people need to participate in a formal rehabilitation programme in order to stop drinking.
Cirrhosis is the destruction of normal liver tissue that leaves non-functioning scar tissue surrounding areas of functioning liver tissue.
The most common cause of this is alcohol abuse.
In the United States, among people aged between 45 and 65, cirrhosis is the third most common cause of death after heart disease and cancer.
Many people with mild cirrhosis have no symptoms and appear to be well for years. Others may feel weak, have a poor appetite, feel sick, and lose weight.
The person may become jaundiced and can start having itchy skin.
Malnutrition commonly results from a poor appetite and impaired absorption of fats and vitamins caused by reduced production of bile salts.
Occasionally, the person may cough up or vomit large amounts of blood because of bleeding from varicose veins at the lower end of the oesophagus.
These enlarged blood vessels result from high blood pressure in the veins that run from the intestines to the liver.
Along with poor liver function, there can be resultant bleeding disorders because the substances or factors that enable clotting are mostly manufactured in the liver.
As we mentioned, there may be fluid accumulation in the abdomen, kidney failure and the brain may also be affected.
Other symptoms of long standing liver disease may develop, such as muscle wasting, redness of palms, curling up of the fingers, small spider-like veins in the skin, breast enlargement in men, hair loss, shrinking of the testes and abnormal nerve function.
The doctor may perform a scan that may show the changes in the liver, or may perform liver function tests and biopsy.
Cirrhosis is usually progressive. If someone with early alcoholic cirrhosis stops drinking, the process usually stops, but scar tissue remains indefinitely.
Liver cancer is common in people with cirrhosis. No cure exists for cirrhosis.
The treatment includes withdrawal from toxic agents such as alcohol, receiving proper nutrition including supplemental vitamins and treating complications as they arise.