Alcohol related liver disease: an under-recognized killer

Alcohol related liver disease: an under-recognized killer

Alcohol-related liver disease is a problem caused by drinking too much alcohol, but symptoms usually only show when the organ has been severely damaged. It’s important to recognize these signs as repeated damage can lead to cirrhosis – permanent scarring of the liver. One way to avoid the condition developing in the first place is to avoid drinking regularly.

Liver disease that’s been caused by excess alcohol intake has several stages of severity. There are three main stages – alcoholic fatty liver disease, alcoholic hepatitis, and cirrhosis. Alcoholic fatty liver disease is caused by drinking a large amount of alcohol, even for a few days, and the build-up of fats in the liver. Alcoholic hepatitis is caused by alcohol misuse over a longer period, and cirrhosis is where the liver has become significantly scarred. Cirrhosis can lead to liver failure, which will eventually stop the liver working and can have fatal consequences.

It is advised that men and women should not regularly drink more than 14 and 7 units in a week respectively. It is also advisable to take 48 consecutive hours off drinking a week to allow your liver to recover.

If the liver becomes severely damaged, symptoms of alcohol-related liver disease may begin to show which includes: feeling sick, weight loss, loss of appetite, yellowing of the eyes and skin (jaundice), swelling in the ankles and tummy, confusion or drowsiness, and vomiting blood or passing blood in your stools.

Alcohol consumption has increased across all social, age and gender groups. More and more young people with advanced alcohol-related liver disease are seen in clinics now. Anyone regularly drinking alcohol in excess, should be evaluated by a liver specialist to check if the liver is damaged. The advent of fibroscan makes the evaluation of liver damage possible without a liver biopsy.

For alcohol-related liver disease, there is currently no cure available. Quitting alcohol completely is the most effective treatment. If people with alcohol-related disease stop drinking, there’s an excellent chance that the liver will repair itself. Many organs have the ability to regenerate to some degree, but none have the same capacity as the liver.

Compared to its burden, the alcohol-related liver disease receives 10 times less attention it deserves. Every year, 1 lakh people die in India due to liver failure, of which a significant proportion suffer from alcoholic liver diseases. The social stigma attached to drinking makes it difficult to garner research and funding. However, in the last few years, initiatives have been made to develop newer therapies. Stool microbiota transplant has been studied in patients with alcoholic hepatitis with promising early results.

But the most important thing is to create awareness about alcohol consumption in combating alcohol-related liver disease. Even Mahatma Gandhi had identified alcohol consumption as a major social evil and had encouraged prohibition.

Dr. Naveen Kumar I Consultant – Gastroenterology I Dharamshila Narayana Superspeciality Hospital, Delhi

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