What you Need to Know About Alcohol
By Gastroenterology Associates of S.W. Florida, P.A. –
Alcoholic liver disease continues to be one of the leading causes of liver disease in the U.S. Alcoholic liver disease includes alcoholic steatosis (fatty liver), alcoholic hepatitis and alcohol induced cirrhosis. Not everybody who drinks alcohol will develop liver disease, however, the risk of developing alcoholic liver disease increase with certain risk factors. Ultimately alcoholic liver disease can be avoided with alcohol abstinence. Once alcoholic liver disease is diagnosed, alcohol abstinence has shown to improve outcomes of liver disease.
Heavy alcohol consumption leads to higher rates of alcoholic liver disease. Men who consume 30-60g of alcohol daily over 20 years and women who consume more than 20g of alcohol for 20 years are at increased risk of developing liver disease including cirrhosis. One standard drink contains 14g of alcohol and includes one 12oz beer, 5oz of wine or one shot of liquor (1.5oz). Other factors that increase risks of developing liver disease with heavy alcohol consumption include gender (women more likely), genetics, drinking outside of meal times, concomitant liver disease(ie heptitis C, hemochromitosis, or fatty liver disease), smoking or obesity.
Overall, only 1% of those who drink >30g daily and 6% of those who drink >120g daily will develop cirrhosis. It is estimated that 10-20% of those with alcoholic fatty liver disease will progress to cirrhosis with continued alcohol consumption. 10-35% of all heavy drinkers will develop alcoholic hepatitis.
Once liver disease is diagnosed the best treatment is alcohol abstinence. Best results are seen with alcoholic rehabilitation and programs that support those with alcohol dependence. If cirrhosis is diagnosed, alcohol abstinence will lead to a decreased risk of liver decompensation and an increase in survival. Generally, those with alcoholic cirrhosis who are referred for liver transplant will have to demonstrate a period of sobriety prior to being considered for a transplant. Those with alcoholic fatty liver disease who abstain from alcohol may see resolution of their fatty liver disease. Patients with fibrosis or hardening of the liver may see improvement in fibrosis and decreased risk of progression to cirrhosis with alcohol abstinence.
Nutritional therapy is important in the treatment of alcohol disease as well. Alcoholism is usually associated with nutritional deficiencies. Patients with alcoholic liver disease should undergo a nutritional assessment. It is recommended that those diagnosed with alcoholic cirrhosis should eat multiple times a day including a night time snack. Increased protein and caloric intake will help to reduce the risk of major complications such as infection, encephalopathy and ascites. Management of acute alcoholic hepatitis is generally treated with treatment of alcohol withdrawl, replacement of vitamin deficiencies and good nutritional therapy. Other medications and detoxifying agents have been studied for alcoholic liver disease, some with promising results. More studies are necessary to determine the overall benefit of these products, however.
Since alcohol still remains one of the leading causes of liver disease, drinking in moderation or alcohol abstinence helps to reduce the risk of liver disease. Alcohol abstinence is the best treatment for any alcohol induced liver disease. Those with a history of chronic heavy alcohol consumption, especially those with risk factors, may benefit from assessment for liver disease.
Gastroenterology Associates of SW Florida, PA
www.giaswfl.com | 239.275.8882