Dr. Pathik Parikh Hepatologist and Liver Transplant Physician

  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

  Acute liver failure Ms V, a 25-year-old girl from Maninagar, an associate professor in premier engineering college, a pHD student and a girl who is soon to get hitched to the man of his dreams. With loving parents, life could not get better for her. Like most of the youngsters, she also used to have occasional outside food. Unfortunately, she developed vomiting, fever, muscle pain and she consulted her primary doctor. On investigations she was found to have hepatitis A virus. Hepatitis A is the most common form of acute viral hepatitis worldwide. The virus most commonly gets transmitted by contaminated food and water. The infection is asymptomatic in 84% of children 1 and 2 years of age, 50% of children 3 and 4 years of age and 20 % of children over 5 years of age. But age increases, the severity of infection increases. The clinical illness starts with prodromal phase with symptoms of malaise, weakness, fever, anorexia and non-specific symptoms and lasts from a period of days to week

  How to treat alcohol associated liver disease Treatment of alcohol related liver disease encompasses multiple steps. Just asking to stop alcohol is not enough. Here are the things which we need to look at while dealing with alcohol related liver disease Abstinence Counselling Alcohol withdrawal Alcohol Craving Alcohol associated fatty liver and hepatitis Fibrosis and Cirrhosis – Complication of cirrhosis Liver Transplant General Measures Alcohol abstinence is the cornerstone of therapy Early management of Alcohol dependence is recommended in all patients Considering the potential risk of Wernicke’s encephalopathy supplementation with B-complex vitamins is recommended Behavioural Treatment Cognitive behavioural Therapy Motivational enhancement Contingency management Nutritional Therapy High protein diet – Do not restrict proteins High calorie diet – Can eat routine home-made foods including roti, sabzi, dal and rice Can have milk and milk products – add protein powder to it Low salt d