Alcoholic Liver Disease
Alcoholic Liver Disease (ALD), also known as Alcohol-Related Liver Disease (ARLD) is a medical condition that often comprehends various liver related conditions, primarily associated with the overconsumption of alcohol.
The various stages in Alcohol Liver Disease are Alcoholic Hepatitis, Alcoholic Fatty Liver Disease and Chronic Hepatitis with Liver Cirrhosis. Liver is an incredible yet a complex organ in the human body which is responsible for regulating over 500 functions.
It not only detoxifies several metabolites, but also stores energy, stimulates hormones and proteins, regulates the storage of glycogen, blood sugars and cholesterol, to name a few.
Located in the right upper quadrant of the abdomen, which approximately weighs around 1.5 kg with a width of 6 inches, it is both the heaviest organ and a gland. Often termed as an ‘accessory digestive organ’ it produces bile, which plays a crucial role in breaking down of fat, aiding the process of digestion through emulsification.
Owing to its multidimensional functions, Liver is a vital organ in the human body and its functions can be affected by various factors including viral infections causing Hepatitis – A, Hepatitis B, Hepatitis C, D and E and many more conditions, but let’s discuss about the negative effects of alcohol on the liver.
The toxic effects of alcohol on liver need no introduction. It is also a major health and economic problem curbing millions of lives and families worldwide. Consuming alcohol up to 60 – 80 grams per day for around 2 decades,would increase the risk of developing various ARLD conditions by 47% and women are more prone to developing ARLD than men.
It is because 80% of the alcohol passes through the liver to get detoxified and it aggravates inflammation by stimulating the production of cytokines, causing oxidative stress, acetaldehyde toxicity, lipid peroxidation and leading to further swelling of the liver. Easy availability and affordability, the components in alcoholic beverages that couldlead to addiction are few deterring factors for millions of liquor consumers, to give up the habit. As a result, it is causing constant and permanent damage of this vital organ.
Alcohol liver disease has three stages and it can overlap between each stage.
- Alcoholic Fatty Liver Disease
- Alcoholic Hepatitis
- Liver Cirrhosis
Alcoholic Fatty Liver Disease
Alcoholic Fatty Liver Disease is a result of alcohol overconsumption for a longer period. It damages the organ by accelerating fat deposition in liver cells, causing inflammation and making it tender. Damage of the liver affects the whole body and could interfere with the functioning of other vital organs, as well. In most cases, the symptoms are unnoticeable till the condition worsens. The initial signs could be loss of appetite, diarrhea, fatigue, nausea and pain in the stomach region.
As the condition worsens, it can lead to jaundice, fever with chills, severe itching, unintended weight loss, edema in the lower extremities of the body, blood in stools and vomit.
The above symptoms are often an indication of an advanced stage in Alcoholic Fatty Liver Disease.
The next stage in Alcohol Liver Disease is Alcoholic Hepatitis in which abnormal amounts of fat gets deposited in the liver cells causing inflammatory response. It is often seen in binge boozers, as liver undergoes enormous amounts of stress while filtering highly toxic substances.
The major reason behind this condition is in those who overconsume liquor in a short period of time, like few months or a year and the liver can fail due to acute illness. It can also happen in those who may not be regular drinkers and other factors like obesity, genetics, sex, ethnicity could be the triggers.
The adverse effects of Alcoholic Hepatitis are quite severe as it can lead to enlarged veins that obstruct the flow of blood causing heavy bleeding in the upper abdominal regionand mimic flu-like symptoms.
The patient may also suffer from ascites or fluid buildup in the stomach, confusion, slurred speech, kidney failure and finally cirrhosis or scarring of the liver.
The worsening of Alcoholic Hepatitis can be prevented by completely staying away from liquor and other alcoholic substances. The patients are strictly required to take all medications and keep up with the doctor’s appointment.
Liver Cirrhosis is a final stage in Alcohol Related Liver Disease. At this stage, the healthy liver tissue gets replaced by scar tissue which interferes with its functioning. It is often a result of cycles of liver damage caused due to excessive consumption of alcohol and in other words, a healthy liver is scarred for life.
As the condition worsens, more and more scar tissues replace the liver causing severe swelling in legs and abdominal regions and it is often a result in to massive fluid buildup. Splenomegaly or enlargement of the spleen, internal bleeding and portal hypertension or high blood pressure in the veins that facilitate blood supply to the liver from spleen and intestines are other complications.
Portal Hypertension is a condition in which the blood pressure builds up in the intestinal veins, collectively known as Portal Venous System. Cirrhosis can cause severe damage to the liver, blocking blood flow from intestines, causing increasing pressure in the Portal Venous System.
As pressure builds up, blood finds other ways of bypassing obstructed liver, causing these veins to become turgid and rupture. An internal rupture in the intestine leads to blood vomiting or blood in the stools and it is life-threatening emergency.
The patient suffering from this condition should be immediately wheeled into the hospital. The expert doctor can perform a minimally invasive procedure called endoscopy to arrest the bleeding.
The further course of treatment would depend upon taking stock of complete situation after running other diagnostic tests.
The first line of treatment in Alcohol Related Liver Disease is staying away from alcoholic substances completely. Abstaining from alcohol can reverse the early stages in this condition within 2 weeks as Liver clears out all deposited fat.
It is quite crucial not to resume the habit of drinking as the symptoms can recur, soon after alcohol enters the body. However, in the case of addicts the withdrawal should be done with guidance of the expert doctor as sudden stoppage could lead to withdrawal syndrome, which could be life threatening. In cases of extreme alcohol addiction, the expert may also recommend counselling, Cognitive Behavioral Therapy to come out of the habit completely.
Besides abstaining from alcohol, the patient should also take all the prescribed medications on time and keep up with the regular appointments with the doctors.
Lifestyle changes are equally important in dealing with this condition. The overweight patients would be advised to lose weight, eat healthy and quit smoking for faster recovery.
However, if any of the above conditions worsen, the treatment depends on what stage patient is in.Unless the last stage of cirrhosis has set in, stopping alcohol is key.
If cirrhosis has already set in, then it is extremely crucial to stop the intake of alcohol and do a careful evaluation by means of various diagnostic tests like blood tests and CT scan of the abdomen to rule of malignancy, as its common in a Cirrhotic Liver.
If the patient is diagnosed any of the complications and suggest that there is little or no hope of reversing the damage to Liver, transplantation of liver is to be considered as a life-saving measure
The criteria for offering liver transplantation to these patients is multifactorial and involves continued abstinence as a key. Also, it is crucial to identify which patients will benefit from transplantation as liver transplant in itself is a major undertaking and requires a lifelong commitment from patient to remain abstinent and to adhere to immunosuppression medication.
Rela Institute of Liver Disease & Transplantation, equipped with advanced liver care facilities and highly skilled liver specialists for treatment of alcoholic liver diseases, offers comprehensive disease management program to prevent liver damage due to alcohol consumption. In cases of severe alcohol abuse, liver is likely to develop a fatal stage called cirrhosis. As liver cirrhosis leads to high risk of mortality due to scarring of liver, liver transplant is opted as treatment for patients to improve their life expectancy. Rela Hospital, with 1400 liver transplants in Tamil Nadu to its credit, is acknowledged as one of the best liver transplant centres in India. The best liver transplant surgeons in Chennai with world class expertise in liver transplantation offer coordinated multidisciplinary liver transplant program at Rela Hospital making it the best multispeciality hospital for liver transplantation in Chennai, India.