Alcoholic liver disease – causes, symptoms and types
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Alcoholic Liver Disease
The main cause is the toxic effects of
ethanol and ethanol metabolism products
such as acetaldehyde. Genetic predispositions are equally important.
Statistically, alcoholic liver disease
most often occurs in men
aged 40-55 and in women
aged 30-45. Men are affected three times more often.
Alcoholic liver disease
can be divided into
Alcoholic fatty liver disease
Alcoholic hepatitis
Alcoholic cirrhosis
Alcoholic Fatty liver disease accounts for 90% of all alcoholic liver diseases. It is characterized by the accumulation of lipids, or fat droplets, in hepatocytes. Alcoholic hepatitis is characterized by progressive liver fibrosis. Alcoholic cirrhosis is characterized by the formation of regenerative nodules. This is an irreversible condition resulting from long-term fatty liver disease and fibrosis.
Fatty liver disease is usually asymptomatic, while hepatitis is characterized by jaundice, fever, edema, and ascites.
Cirrhosis is characterized by:
Hepatic spider veins on the skin,
permanently dilated blood vessels,
hypogonadism, or testicular atrophy in men,
and menstrual irregularities in women,
the appearance of a chestnut man,
muscle atrophy in the limbs and abdominal enlargement.
As well as a Medusa head,
dilated veins in the abdomen.
The most important element in diagnosing the disease is the history. A questionnaire can be used. AUDIT
The AUDIT questionnaire consists of up to 10 questions, with each question receiving from 0 to 4 points. A score of 0-40 points can be obtained.
A score above 7 points indicates suspected alcoholism.
Additionally, laboratory tests can be performed.
Ultrasound, CT (computed tomography)
and elastography (measurement of the elasticity of liver tissue)
The basic and most important element of treatment
is alcohol abstinence. In severe cases, corticosteroids and N-acetylcysteine are used.
Prognosis depends on maintaining abstinence
and on whether cirrhosis has already occurred.
Without cirrhosis and with abstinence, the survival rate is approximately 85%.
Without cirrhosis and with abstinence, the survival rate is approximately 60%.
With cirrhosis and with abstinence, the survival rate is approximately 50%.
With cirrhosis and without abstinence, the survival rate is approximately 30%.
Additionally, indicators are helpful in prognosis. The most commonly used include:
Madrey index
Where PT is the prothrombin time
(PT – normal PT) x 4.6 + Bilirubin
The Lille Index is used to assess the effectiveness of glucocorticoid treatment and the MELD scale, which assesses the severity of chronic liver disease.