Alcohol Related Liver Disease - What is new (Part 1)

 


Alcohol Related Liver Disease – What is new (Part 1)

Alcohol is known to be associated with liver disease to everyone. There are lot many misconceptions about liver disease and alcohol. Let us break these misconceptions about alcohol disease. Also, I have tried to include the recent changes in terminology and have included some aspects of management.

How big is Alcohol a problem?

About 30% males and 5% Indian Females take alcohol. Alcohol consumption is the seventh leading risk factor for both death and the burden of disease and injury. Except for tobacco, alcohol accounts for a higher burden of disease than any other drug.Alcohol use accounts for 6.8% of age-standardized deaths in men and 2.2% in women, with a disproportionate effect on young people. In a multi-center study from India, published 4 years back, off 13014 patients of liver cirrhosis, 2253 had alcohol as their chief risk factor. Almost all patients were male.

Does everyone who take alcohol develop liver disease?

Neither everyone who drinks alcohol develops liver disease nor all those who develop liver disease have history of alcohol. The following diagram simplifies this understanding.


If not all, then who develops liver disease because of alcohol?

Nearly 5-20% individuals who take significant alcohol develop liver disease. There are many factors which decide who will develop liver disease. Those who drink daily, have binge drinks (more than 5 drinks for males), do not take adequate nutrition, have additional liver disease (fatty liver, hepatitis B,hepatitis C) and females have higher risk for developing liver disease. Genetics also play a role and Indians as compared to Caucasians seem to have lower threshold for developing liver disease. Individuals who have sudden large intake of alcohol in spite ofalcohol-free weeks and months have high likelihood of developing liver fibrosis as per recent research.

Is beer safe?

All alcohol is similar. One drink means 10 grams of alcohol. The following table explains why beer is as dangerous as any other liquor.So, beer is safe is the biggest misconception

330 ml beer (1 can)10–15-gram alcohol
125 ml wine (one glass wine)10–15-gram alcohol
45 ml whiskey10–15-gram alcohol

What do you mean by drinking?

Whenever alcohol is used, based on the amount of alcohol consumed and the way it is consumed, different terminologies are used. The following terms harmful drinking, binge drinking and heavy drinking.

Standard Drink10 grams of alcohol
Harmful DrinkingAlcohol causes physical or mental damage
Heavy drinkingMore than 60-gram alcohol on single occasion
Binge DrinkingConsumption within about 2 hours of four or more drinks for women and five or more drinks for men

 

What is alcohol use disorder?

The term “Alcoholic” is no longer used. Instead, the term used is alcohol use disorder.The term ‘alcoholic’ is stigmatizing. It undermines patient dignity and self-esteem. Following are new terminology



How do you identify individuals with alcohol use disorder?

There are many scoring systems which can be used to individuals with AUD. The simplest and effective tool is AUDIT-C scoring system. We just need to ask the following three questions. A score of 8 or more should be considered as fulfilling to be labelled as Alcohol Use Disorder.


What are the clinical signs of alcohol related liver disease? 


If you know someone who is suffering from alcohol-related liver disease, kindly contact your local hepatologist. The second part will discuss the management of these individuals.

Dr Pathik Parikh
Liver Specialist / hepatologist in Ahmedabad
Contact no.: +91 86521 19730

Website : drpathikparikh.com 



Comments

Post a Comment

Popular posts from this blog

fibroscan for liver inflammation - overview

  FibroScan is a non-invasive medical procedure used to assess liver health by measuring liver stiffness and determining the degree of liver fibrosis. While it's not specifically designed to detect liver inflammation, it can provide valuable information about overall liver health. Liver inflammation, also known as hepatitis, can result from various causes such as viral infections (like hepatitis B or C), alcohol consumption, fatty liver disease, autoimmune disorders, and other factors. It's a crucial aspect of liver health assessment as chronic inflammation can lead to liver damage and fibrosis over time. Although FibroScan primarily evaluates liver stiffness and fibrosis, it indirectly reflects liver inflammation. Inflammation can contribute to liver fibrosis, which in turn affects liver stiffness. Therefore, higher levels of liver stiffness detected by FibroScan may suggest the presence of inflammation. However, FibroScan alone may not provide a complete picture of liver infl
Read more

Understanding Drug-induced Liver Injury (DILI): Symptoms, Causes, and Treatment

  "Understanding Drug-induced Liver Injury (DILI): Symptoms, Causes, and Treatment" is a clear and informative title that covers the essential aspects of DILI. Here's an outline of what each section might include: Symptoms of Drug-induced Liver Injury (DILI): Overview of common symptoms such as fatigue, jaundice (yellowing of the skin and eyes), abdominal pain, nausea, vomiting, and loss of appetite. Discussion on the variability of symptoms depending on the severity and type of liver injury caused by different drugs. Causes of Drug-induced Liver Injury (DILI): Explanation of how certain medications and drugs can lead to liver injury. Classification of DILI based on mechanisms, such as direct hepatotoxicity, idiosyncratic reactions, and immune-mediated responses. Risk Factors for Drug-induced Liver Injury (DILI) : Identification of factors that increase the likelihood of developing DILI, including specific drug characteristics, patient-related factors (e.g., age, genetics
Read more

Liver Disease

Image
Liver is a complex organ with more than 500 functions. Liver diseases are not just limited to alcohol. Over the last two decades, liver diseases besides alcohol have been considered as a cause for liver failure. The list below is just to name a few. Non-Alcoholic Fatty Liver Disease Alcoholic Fatty Liver disease Viral Hepatitis Metabolic liver disease Autoimmune hepatitis Drug induced liver injury Vascular liver disease Congenital liver disease Primary biliary cholangitis Primary sclerosing cholangitis Infectious liver disease Granulomatous liver disease Fatty Liver disease is the most common cause of liver disease in India and worldwide. Alcohol related liver disease is constant through these years while viral hepatitis thanks to good treatment availability is decreasing. These liver diseases can present as any of the following manner. Asymptomatic – Incidental finding on investigations Acute hepatitis with or without jaundice Acute Liver failure Chronic hepatitis Cirrhosis of liver A
Read more