Whether you’ve been drinking alcohol for years or you’re just thinking about it, there are a few things you need to know about alcohol-related liver disease. This article will cover some of the most common symptoms, as well as the diagnosis and treatment options available.
Cirrhosis
Using the MELD (Model for End-Stage Liver Disease) classification, researchers analyzed data on the causes of cirrhosis in a cohort of patients from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). They found that alcoholism was the leading cause of cirrhosis in the United States. It was followed by other conditions.
Researchers found that the prevalence of alcohol-related liver disease increased during the study period. Approximately 90 to 100 percent of heavy drinkers develop fatty livers. These livers are unable to process the alcohol, resulting in a buildup of fat. The liver may also become swollen, which causes difficulty breathing and dehydration. The liver is also more likely to become infected.
Researchers found that the mucosally adherent microbiota of patients with cirrhosis was altered. The abundance of Enterobacteriaceae (E. coli) was decreased, while the abundance of Proteobacteria (P. bacteria) and Fusobacteria (F. bacteria) increased. This could be explained by host-derived metabolites that influence mucosal immune defenses.
Researchers found that the incidence of cirrhosis has increased in recent years, likely due to an increase in alcohol consumption. Approximately 25-75% of cirrhosis is caused by hepatitis C and hepatitis B.
Researchers at Odense University Hospital in Denmark collected plasma samples and liver tissue samples from 659 patients with alcohol-related liver disease. They used these samples to profile the plasma proteome and found 46 dysregulated proteins. Using these proteins, researchers can identify the alcohol-related liver disease and indicate its severity.
Researchers are interested in developing effective therapies for alcohol-related liver disease and cirrhosis. The increased prevalence of these diseases is likely to result in more patients on the liver transplant waitlist.
Alcohol is a powerful agent that can damage all living cells. However, it can only be processed in measured doses. When the liver is overloaded, it cannot form the proteins necessary to fight infection.
Fatty liver
Often, people don’t know they have the alcohol-related liver disease until they have severe liver damage. The disease can be life-threatening. It is best to get treated early to avoid permanent liver damage. You should also make sure you don’t drink too much alcohol. Alcohol can cause cirrhosis and liver failure.
Alcoholic fatty liver disease is the result of heavy drinking. A large amount of alcohol can collect in the liver, causing swelling. This makes it difficult to break down food.
People who have an alcohol-related liver disease can be cured by stopping drinking. They may have to go to an inpatient rehabilitation facility. A doctor may recommend medicines to help with withdrawal symptoms and to reduce the cravings for alcohol. They may also recommend a daily multivitamin and weight loss to help with the damage caused by alcohol.
The liver is a complex organ. It breaks down food, filters alcohol, and produces acids and other byproducts. During the process, the liver cells die and are replaced with scar tissue. If left untreated, the scar tissue may form into cirrhosis, a chronic liver disease. The liver may need to be transplanted if it becomes too damaged.
Alcohol-related fatty liver disease is often reversible if you stop drinking. This is because the liver is able to repair itself. It is also important to remember that the disease is not a direct result of alcohol consumption.
The liver is the most complex organ in the body. It filters alcohol and makes proteins. But when it is damaged by alcohol, it can affect the whole body. This can result in inflammation, fibrosis, and cirrhosis. It may also increase a person’s risk of developing hepatitis. Symptoms of alcoholic liver disease may include jaundice and yellowing of the skin. Some people also have pain in the upper right side of their belly.
Nonalcoholic steatohepatitis (NASH)
Approximately one-quarter of US adults have nonalcoholic fatty liver disease (NAFLD). People who drink alcohol on a regular basis are also at risk. A liver biopsy may be needed to confirm NASH, and further testing can help determine the extent of the condition.
NAFLD and NASH are not life-threatening conditions, but they can increase your risk of other liver-related conditions. People with NASH are at greater risk for heart attack, stroke, diabetes, and liver cancer. Managing NASH can prevent or reverse some of the damage.
Managing NASH requires a combination of lifestyle changes and medication. People with NASH can prevent the condition from progressing by avoiding excessive alcohol, losing weight, and maintaining a healthy diet. Regular exercise, too, can improve liver health.
Symptoms of NASH include fatigue, abdominal discomfort, itchy skin, and jaundice. NASH may also cause a buildup of fat in the liver, which can cause inflammation.
Having a balanced diet that is low in saturated fats and high in fruits and vegetables is essential for good health. You should also get regular exercise to help with stress and weight management. A medically supervised detox program can help you stop drinking safely.
Those at risk for NAFLD and NASH should work with their healthcare provider to develop a treatment plan. For example, people with diabetes or insulin resistance may benefit from insulin-resistance drugs.
In addition to taking medication, people with NASH should also avoid excessive alcohol. Alcohol is known to increase the risk of hepatocellular carcinoma, and chronic hepatitis B and C may also increase this risk.
If your liver has been damaged by NASH, a liver transplant is usually recommended. In some cases, mild NASH can be prevented from progressing to more severe liver disease.
Hepatocellular carcinoma
Several studies have shown that alcohol is a contributing factor to the development of hepatocellular carcinoma. These studies also revealed the role of oxidative stress in alcohol-related hepatocarcinogenesis. Alcohol induces oxidative stress by altering hepatic metabolism, leading to the accumulation of reactive oxygen species. These ROS then promote DNA and cellular macromolecule damage.
Alcohol-related HCC has a poorer prognosis compared to non-alcohol-related HCC. It is more likely to be multifocal and diffuse. The median overall survival is shorter than that of non-alcohol-related HCC. In addition, patients with alcohol-related HCC have lower survival rates than those with HCV-related HCC.
Genetic polymorphisms have also been shown to increase the risk of HCC. However, it is still unknown how these polymorphisms affect oncogenic pathways.
Some studies have shown that hepatocellular carcinoma is associated with a variant of the TM6SF2 gene. In a study of a European case-control cohort, TM6SF2 polymorphism was associated with increased rates of liver cancer. The study subjects were biopsy-proven cirrhotic patients who had not been previously exposed to hepatitis viruses. They were referred to a liver unit and agreed to follow up.
Another study studied the effect of PNPLA3 polymorphism on fibrosis progression. This study also demonstrated a higher rate of HCC in cirrhotic patients. However, the study subjects were Caucasians, and their cirrhosis was biopsy-proven.
Chronic alcohol intake leads to steatotic changes in the liver, which may trigger cirrhosis. Chronic alcohol intake also promotes a number of immune cell changes. Alcohol promotes the production of pro-inflammatory cytokines such as IL6 and TNFa. It also decreases the recruitment of CD8+ cells. Alcohol also affects immune surveillance. Alcohol may play a role in hepatocarcinogenesis by reducing the amount of CD8+ cells in the liver.
Liver transplantation
During the past decade, mortality rates for alcohol-related liver disease (ALD) have increased. The reason for this is not completely understood, but it is thought that the COVID-19 pandemic has increased the prevalence of the alcohol-related liver disease. Among patients with alcohol-related hepatitis, early transplantation may improve survival.
Liver transplantation is the standard therapy for end-stage liver disease. However, patients with ALD are at high risk for alcohol relapse after transplantation. This relapse increases the risk of graft rejection and advanced allograft fibrosis. It also impairs patient compliance with immunosuppressant medications.
The incidence of relapse in liver transplant patients has varied over the past several decades. A recent meta-analysis identified relapse as a risk factor for post-transplant survival. Several studies suggested that psychiatric assessment and treatment may be important in lowering relapse rates.
In the United States, liver transplantation for ALD has been on the rise. In fact, there was a 50 percent increase in the number of referrals for liver transplantation following the COVID-19 pandemic.
Alcohol-related liver disease (ALD) is a major cause of death in the United States. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol-related mortality will rise from 25 percent in 2019 to 35 percent in 2020. Despite this, many clinicians continue to support liver transplantation as a treatment for alcohol-related liver disease. However, due to the shortage of organs for transplant, this practice is controversial.
The most common risk factor for the progression of alcohol-related liver disease is alcohol consumption. The NIAAA defines heavy alcohol consumption as 14 drinks or more per week for men, and 7 drinks per week for women. Other risk factors include cirrhosis, liver injury, metabolic syndrome, and type 2 diabetes.
Health Sources:
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
