ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Alcoholic liver disease (hepatitis--cirrhosis)

Alcoholic liver disease (hepatitis--cirrhosis)

Causes and Risks:
Alcoholic hepatitis usually occurs after years of excessive drinking. The longer the duration of alcohol use and the larger the consumption of alcohol, the greater the probability of developing liver disease . Malnutrition develops as a result of empty calories from alcohol, reduced appetite, and malabsorption (inadequate absorption of nutrients from the intestinal tract). Malnutrition contributes to liver disease. The toxicity of ethanol to the liver, individual susceptibility to alcohol-induced liver disease, and genetic factors also contribute to the development of alcoholic liver disease.

Alcoholic liver disease does not affect all heavy drinkers, and women may be more susceptible than men. Drunkenness is not essential for the development of the disease. In some drinkers, the rate of alcohol metabolism can be high enough to allow for the consumption of large quantities of alcohol without raising the blood alcohol level to detectable concentrations by conventional breath analyzer. Changes start within the liver as inflammation (hepatitis), and progress to fatty liver, and cirrhosis . Cirrhosis is the final phase of the disease. Symptoms may not be present until the disease is relatively advanced. Serious complications are associated with advanced disease such as alcoholic encephalopathy (damage to brain tissue) and portal hypertension ( high blood pressure within the liver). The disease usually affects those older than 30. The incidence is 3 out of 10,000 people.

Prevention:
Limit alcohol consumption to moderate levels.

Symptoms:

loss of appetite
nausea
swollen abdomen or increased abdominal circumference (from enlarged liver )
jaundice
abdominal pain and tenderness
fever
ascites (fluid collection in the abdomen)
unintentional weight gain (because of the fluid collection)
mental confusion
excessive thirst
dry mouth
fatigue

Additional symptoms that may be associated with this disease:

vomiting blood
vomiting containing coffee ground material
bloody or dark black or tarry bowel movements ( melena )
abnormally dark or light skin
redness on feet or hands
paleness
lightheadedness or fainting , especially with upright posture
rapid heart rate ( tachycardia ) when rising to standing position
slow, sluggish, lethargic movement
breast development in males
impaired ability to concentrate
agitation
fluctuating mood
difficulty paying attention (attention deficit)
impaired judgment
memory loss ( amnesia )
- impaired short-term memory
- impaired long-term memory
hallucinations

Note: Symptoms vary with the severity of the disease and are usually worse after a recent period of heavy drinking.

Signs and Tests:

A CBC test may show anemia and other abnormalities.
Liver function tests such as ALP are abnormal.
Liver biopsy shows typical findings for alcoholic liver disease.

Tests to rule out other diseases include:

ultrasound of the abdomen
CT scan - abdominal

This disease may also alter the results of the following tests:

Treatment:
The objective of treatment is to discontinue alcohol, and to provide a high-carbohydrates, high-calorie diet to reduce protein breakdown in the body. Vitamins , especially B1 and folic acid , are associated with improvement. An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction.

Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See alcoholism - support group and liver disease - support group .

Prognosis:
Continued excessive drinking is associated with a shorter life expectancy. The probable outcome is poor if drinking continues.

Complications:

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms suggestive of alcoholic liver disease develop.

Call for an appointment with your health care provider if symptoms develop after prolonged or heavy drinking.

This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.