Alcoholic Liver Disease: Pathogenesis and Current Management PMC

This plan will help manage the condition as well as the withdrawal symptoms that may occur with abstinence. Alcohol consumption is one of the leading causes of liver damage. When liver damage has happened due to alcohol, it’s called alcohol-related liver disease. Hepatitis C infection can increase the likelihood of alcohol-induced liver damage. Alcoholic liver disease is treatable if it is caught before it causes severe damage.

• Consideration of micronutrient deficiencies in alcohol-induced liver disease (Table 2), the following are affected by chronic alcohol consumption and advised to maintain these essential substances in ALD [94].
• When necessary, high-energy fat then can be used to fulfill energy requirements during times of low nutrition (e.g., fasting) or high calorie utilization (e.g., exercise).
• However, outcomes with steroids have been variable (Thursz et al. 2015).
• People who keep drinking alcohol have a high risk of serious liver damage and death.
• If you don’t have liver cirrhosis yet, your liver can actually heal itself, that is, if you stop drinking alcohol.

The gender-dependent differences in the gastrointestinal and hepatic metabolism of alcohol are likely to contribute towards the increased susceptibility of women to alcohol-induced liver injury [34]. Furthermore, overexpression of TNF-α mRNA in the liver activates the liver cell functions and macrophages and this caused the pro-inflammatory response and ROS elevation to reveal the liver toxicity. The mechanism of liver toxicity has been reported with activation of ROS, IL-6, and IL-8 [35].

Alcoholic Liver Disease

Treatment focuses on minimizing additional liver damage while addressing any complications that arise. In mild alcoholic hepatitis, liver damage occurs slowly over the course of many years. The early stages of alcohol-related liver disease often have no symptoms. Because of this, you may not even know that you’ve experienced liver damage due to alcohol.

As the condition progresses, your liver can’t function as it should, causing you to feel sick. At UC Davis Health, you receive services from liver experts (hepatologists) who care about you. Our team understands the challenges that alcohol-induced liver disease can bring to your health and daily life. Till now baclofen has been proven safe for the treatment of patients with alcohol-use disease but other drugs suggested by the Food and drug administration (FDA) such as disulfiram and naltrexone can induce hepatotoxicity. So those are not a well-appropriate treatment option for alcohol-induced liver disease patients.

Progressive Symptoms

Beverage alcohol (i.e., ethanol) is chiefly metabolized in the main parenchymal cells of the liver (i.e., hepatocytes) that make up about 70 percent of the liver mass (Jones 1996). These cells express the highest levels of the major ethanol-oxidizing enzymes, alcohol dehydrogenase (ADH), which is located in the cytosol, and cytochrome P450 2E1 (CYP2E1), which resides in the alcoholic liver disease smooth endoplasmic reticulum (ER) (figure 1). Hepatocytes also express very high levels of catalase, an enzyme that inhabits peroxisomes. Catalase normally carries out the detoxification of hydrogen peroxide (H2O2) to water and oxygen. However, when ethanol is present, catalase has an accessory role in ethanol metabolism by using H2O2 to oxidize ethanol to acetaldehyde.

The fat that is accumulated within the perivenular hepatocytes actually coincides with the presence of alcohol dehydrogenase, which is the major enzyme that is responsible for alcohol metabolism. Continuous ingestion of alcohol leads to fat accumulation all through the entire hepatic lobule [61]. Alcoholic liver disease most often occurs after years of heavy drinking. Symptoms of alcohol-related cirrhosis typically develop around the mean age of 52, with alcohol-related fatty liver disease and alcohol-related hepatitis often showing up about 4 to 8 years before this.

Healthy liver vs. liver cirrhosis

Steatosis was formerly considered a benign consequence of alcohol abuse. If the affected individual ceases drinking, steatosis is a reversible condition with a good prognosis. However, patients with chronic steatosis are more susceptible to fibrotic liver disease (Teli et al. 1995), because the presence of fat likely represents a greater risk for lipid peroxidation and oxidative damage. Monozygotic twins have a higher concordance rate for alcohol-related cirrhosis than dizygotic twins (23). Genetic factors may influence susceptibility to alcohol consumption or predisposition to development of ALD among those with AUD.

If you don’t have liver cirrhosis yet, your liver can actually heal itself, that is, if you stop drinking alcohol. You may need an alcohol rehabilitation https://ecosoberhouse.com/ program or counseling to break free from alcohol. Vitamins, especially B-complex vitamins and folic acid, can help reverse malnutrition.