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ALCOHOLIC
LIVER DISEASE
U.Sangeeta

1802001138
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DEFINITION

 Liver damage, caused by over consumption

of alcohol leading to fat accumulation,liver
inflammation and liver scarring.
 It is a spectrum of disease comprising of (1)
Alcoholic fatty liver (2) alcoholic hepatitis(3)
alcoholic cirrhosis.
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ETIOLOGY

 Alcohol- major hepatotoxin

 Gender predisposition-female more than

men.
 Hepatitis B or hepatitis C
 Pathophysiology
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CLINICAL FEATURES

 Usually seen in 2nd or 3rd decade.

 Often asymptomatic.

 Alcoholic hepatitis presents with

fatigue,fever, jaundice,right upper
quadrant pain.
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Digestive symptoms
 Pain in abdomen

 Nausea, vomiting

 Dry mouth and increased thirst

 Decreased appetite and weight loss.

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Nervous system symptoms

 Fainting, light headedness,
numbness in legs and feet.
 Problems with thinking,memory and
mood.
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 Severe alcoholic hepatitis may present

with ascites, encephalopathy, variceal
bleeding, hypoglycemia.
 Cirrhosis if compensated maybe
asymptomatic.
 If decompensated, features of liver cell
failure and portal hypertension are seen.
Signs of liver cell failure
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Investigations
 Liver function tests depending on stage
of disease.
 In Alcoholic Hepatitis , elevation of liver
enzymes is moderate <300IU/ml.
 AST:ALT ≥ 2

 Complete blood count.

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 IMAGING

(1)Ultrasound
(2)CT
(3)MRI to assess hepatic parenchymal
changes.
 Liver biopsy
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COMPLICATIONS
 Portal hypertension

 Varices

 Ascites

 Hepatic encephalopathy
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TREATMENT
 Complete abstinence from alcohol

 Nutritional supplementation

 Severe alcoholic Hepatitis- Prednisone

40mg/day (or) prednisolone
32mg/day/4weeks followed by steroid
taper.
 Non specific TNF inhibitors- pentoxphyllin
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 Liver transplantation in end-stage

cirrhosis.