Alcoholic liver disease: Difference between revisions

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__NOTOC__
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{{alcohealth}}
{{Alcoholic liver disease}}
{{Infobox_Disease |
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{MKA}}
  Name          = {{PAGENAME}} |
 
  Image          = Alcoholic_hepatitis.jpg |
  Caption        = [[Microscopy]] of [[liver]] showing fatty change, cell necrosis, [[Mallory body|Mallory bodies]]|
  DiseasesDB    = |
  ICD10          = {{ICD10|K|70||k|70}}|
  ICD9          = {{ICD9|571.1}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 000281 |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = D008108 |
}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{Alcoholic liver disease}}
 
[[Image:Pathogenesis alcoholic liver injury.jpg|thumb|right|Pathogenesis of alcohol induced liver injury]]
{{SK}} Alcoholic hepatitis; Alcoholic fatty liver disease; Fatty liver disease.
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org], [[User: Prashanthsaddala|Prashanth Saddala M.B.B.S]]
 
 
 
==[[Alcoholic liver disease overview|Overview]]==
==[[Alcoholic liver disease overview|Overview]]==


==[[Alcoholic liver disease historical perspective|Historical Perspective]]==
==[[Alcoholic liver disease historical perspective|Historical Perspective]]==
==[[Alcoholic liver disease classification|Classification]]==


==[[Alcoholic liver disease pathophysiology|Pathophysiology]]==
==[[Alcoholic liver disease pathophysiology|Pathophysiology]]==
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==[[Alcoholic liver disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Alcoholic liver disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


== Diagnosis ==
==Diagnosis==
 
[[Alcoholic liver disease history and symptoms|History and Symptoms]] | [[Alcoholic liver disease physical examination|Physical Examination]] | [[Alcoholic liver disease laboratory findings|Laboratory Findings]] | [[Alcoholic liver disease electrocardiogram|Electrocardiogram]] | [[Alcoholic liver disease x ray|X Ray]] | [[Alcoholic liver disease CT|CT]] | [[Alcoholic liver disease MRI|MRI]] | [[Alcoholic liver disease echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Alcoholic liver disease other imaging findings|Other Imaging Findings]] | [[Alcoholic liver disease other diagnostic studies|Other Diagnostic Studies]]
[[Alcoholic liver disease history and symptoms|History and Symptoms]] | [[Alcoholic liver disease physical examination|Physical Examination]] | [[Alcoholic liver disease laboratory findings|Laboratory Findings]] | [[Alcoholic liver disease electrocardiogram|Electrocardiogram]] | [[Alcoholic liver disease x ray|X Ray]] | [[Alcoholic liver disease CT|CT]] | [[Alcoholic liver disease MRI|MRI]] | [[Alcoholic liver disease echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Alcoholic liver disease other imaging findings|Other Imaging Findings]] | [[Alcoholic liver disease other diagnostic studies|Other Diagnostic Studies]]


== Treatment ==
==Treatment==
 
[[Alcoholic liver disease medical therapy|Medical Therapy]] | [[Alcoholic liver disease Surgery|Surgery]] | [[Alcoholic liver disease primary prevention|Primary Prevention]] | [[Alcoholic liver disease secondary prevention|Secondary Prevention]] | [[Alcoholic liver disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Alcoholic liver disease future or investigational therapies|Future or Investigational Therapies]]
[[Alcoholic liver disease medical therapy|Medical Therapy]] | [[Alcoholic liver disease primary prevention|Primary Prevention]] | [[Alcoholic liver disease secondary prevention|Secondary Prevention]] | [[Alcoholic liver disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Alcoholic liver disease future or investigational therapies|Future or Investigational Therapies]]
 
== Case Studies ==


==Case Studies==
[[Alcoholic liver disease case study one|Case #1]]
[[Alcoholic liver disease case study one|Case #1]]
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===Ultrasonography===
[[Category:Surgery]]
* Used for excluding biliary obstruction
* Ascites
===CT scan===
* To exclude pancreatic disease
* To exclude Space occupying lesions
* Collateral vessels
===MRI===
* To exclude pancreatic disease
* To exclude space occupying lesions
* Collateral vessels
===Liver biopsy===
* '''Fatty liver'''
** Macrovesicular fat
* '''Alcoholic hepatitis'''
** Polymorphonuclear infiltration
** Hepatic necrosis
** [[Mallory bodies]] in hepatocytes
** Perivenular and perisinusoidal fibrosis
** Ballooning hepatocytes
** Steatosis,
* '''Alcoholic cirrhosis'''
** [[Micronodular cirrhosis]]
 
==Treatment==
===Medical therapy===
====General====
* Abstinence from alcohol
* Counseling and family support during alcohol abstinence
* [[Naltrexone]] or [[acamprosate]] to reduce relapse
* Nutritional support - Adequate amounts of carbohydrates and calories as alcoholics are commonly malnourished. This prevents endogenous protein catabolism, and [[hypoglycemia]]. Administration of [[thiamine]] is important with glucose supplements. This is so because glucose administration increases B1 consumption and B1 deficiency may lead to [[Wernicke–Korsakoff syndrome]].
* [[Folic acid]], thiamine, and [[zinc]] supplements are recommended.
====Drug therapy====
=====Alcoholic hepatitis=====
* '''Methylprednisolone'''
** Decreases short term mortality
** Usually given for 1 month
** Serum [[bilirubin]] is used as a predictor for treatment success. Failure of the serum bilirubin level to decline after 7 days of treatment predicts poor prognosis
** Another predictor of treatment is '''Lille model''' comprising, age, serum [[creatinine]], serum [[albumin]], [[prothrombin time]] (or INR), serum [[bilirubin]] on admission, and serum bilirubin on day 7
* '''Pentoxifylline'''
* It is a [[tumor necrosis factor]] inhibitor
* Used in patients with contraindications to steroids
* Usually given for 1 months
* Decreases mortality
* Decreases risk of [[hepatorenal syndrome]]
'''Other less commonly used drugs'''
* Steroids + [[N-acetylcysteine]]
* [[Propylthiouracil]]
* [[Oxandrolone]]
* [[S-adenosyl-L-methionine]]
* [[Infliximab]]
 
==References==
{{reflist|1}}
 
[[Category:Pathology]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Alcohol abuse]]
[[Category:Up-To-Date]]
[[Category:Hepatology]]
[[Category:Hepatology]]
{{WikiDoc Help Menu}}
[[Category:Medicine]]
{{WikiDoc Sources}}

Latest revision as of 20:19, 29 July 2020

Alcoholic liver disease Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Alcoholic liver disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M. Khurram Afzal, MD [2]

For patient information click here

Synonyms and keywords: Alcoholic hepatitis; Alcoholic fatty liver disease; Fatty liver disease.


Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Alcoholic liver disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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