Diagnosis and management of alcoholic liver disease, a review

Abstract

Alcohol consumption in the United Kingdom has risen dramatically over the last fifty years and there has been an associated increase in cirrhosis secondary to alcohol. In western society the most common cause of cirrhosis is secondary to alcohol. Alcoholic liver disease has become an increasing financial burden upon the NHS. Ten percent of hospital admissions are thought to relate in part to alcohol. This review examines the pathogenesis of alcoholic liver disease and the three stages of fatty liver, alcoholic hepatitis and cirrhosis. The clinical presentations of alcoholic liver disease and management will be discussed in detail. Evidence based treatments available for patients with alcoholic liver disease and their clinical effectiveness are also summarized. The systemic complications of alcoholic liver disease primarily malnutrition, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome and oesophageal varices will be discussed, as well as new approaches to management of these complications.