What causes alcohol related liver disease?
Alcohol related liver disease can regenerate itself but prolonged alcohol misuse can lead to permanent damage. More than nine million people in England drink more than the recommended daily amounts of alcohol and an estimated 7.5 million are unaware of the damage their drinking could cause, according to the charity Alcohol Concern.
Being overweight or obese can add to the risk along with having a pre-existing liver condition such as hepatitis C.
The symptoms of alcohol related liver disease (ARLD) is where the liver is damaged by drinking too much alcohol. often don’t appear until after the liver has been badly damaged. The initial symptoms range from abdominal pain through loss of appetitive, feeling nauseous to fatigue and diarrhea and general feeling of being unwell. As the condition deteriorates, the symptoms can include jaundice, swollen legs, weight loss, brain function problems, itchy skin, hair loss, nosebleeds and bleeding gums.
A GP will ask about alcohol intake levels to determine if it could be the prime factor of the problems. It is important to be honest about consumption levels as it will have a bearing on timely treatment.
Blood tests to check liver function and an ultrasound scan will help the diagnosis and patients are referred to a hepatologist who specializes in liver conditions.
A liver biopsy, where a small piece of tissue is removed and examined under a microscope, may be required and CT and MRI scans may also be used. A consultant may also arrange for an endoscopy, a thin, flexible tube with a light and camera that is down the oesophagus to check for swollen veins (varices) which are a sign of advanced liver damage.
The most important first step is to stop drinking alcohol which may need to be a permanent measure depending on the level of disease and damage. If the condition has advanced to alcoholic hepatitis or cirrhosis, then drinking must cease otherwise no medical intervention will prevent total liver failure.
Psychological support may be needed to contend with the withdrawal symptoms from giving up alcohol and medication may be prescribed to help the detox process.
A balanced diet with reduced salt intake is often recommended and a range of medications can be used to reduce the impact of the symptoms, such as calcium and vitamin D to reduce the risk of osteoporosis.
The swollen veins often associated with ARLD can be removed by band ligation which involves applying small elastic bands around the sites to prevent bleeding. A hepatologist can also employ a procedure to create a new channel in the liver to relieve blood pressure.
A liver transplant is the final option but it is a huge undertaking which involve total abstinence and a lifelong medical regimen to ensure the new organ is not rejected. At any one time, around 600 people are on the waiting list for a new liver, according to NHS Blood and Transplant, with the average wait 145 days.