What Is Alcohol?
Alcohol is a substance found in alcoholic beverages. The main type of alcohol in these drinks is ethanol, which directly affects the brain. Alcohol can affect:
- Speech
- Balance and coordination
- Thinking and judgment
- Other brain functions
After drinking alcohol, a person may temporarily feel relaxed or calm. However, drinking large amounts of alcohol can interfere with speech, balance, coordination, and normal brain function. With regular alcohol use, the brain can become accustomed to alcohol. This may lead a person to drink larger amounts over time to achieve the same effects.
Although alcohol may provide temporary pleasure or relaxation, heavy or long-term alcohol use can increase the risk of depression and other mental health problems.
Can Alcohol Damage the Liver?
Many people believe that alcohol is not very harmful and that it only provides temporary relaxation. Some may also think that minor health problems or a small amount of weight gain caused by drinking are not serious.
However, regular or heavy alcohol use can cause significant damage to the liver. Alcohol-related liver damage usually develops in three main stages:
1. Fatty Liver (Steatosis)
2. Alcoholic Hepatitis
3. Liver Cirrhosis
In severe cases, alcohol-related liver disease can progress to liver cancer and liver failure, which can be life-threatening.
Worldwide, approximately 500,000 people die each year from alcohol-related liver cirrhosis and in the United Kingdom alone approximately 300,000 people are affected by alcohol-related liver disease each year. According to World Health Organization reports, approximately 140 million people worldwide are affected by alcohol dependence, resulting in serious health, social, and economic consequences.
In India, alcohol is estimated to contribute to approximately 30% to 70% of cases of liver cirrhosis, and the number of alcohol-related cases is increasing. Alcohol-related liver disease is also reported to contribute substantially to around 30% deaths from liver disease in the country.
Accurate national statistics on alcohol-related liver disease in Bangladesh are not available. However, as lifestyles change and alcohol use becomes more common, alcohol consumption appears to be increasing among both men and women. As a result, the number of people affected by alcohol-related liver disease may also be increasing.
What Are the Symptoms of Alcohol-Related Liver Disease (Alcoholic Hepatitis)?
In its early stages, alcohol-related liver disease often causes no noticeable symptoms. In many cases, the condition is discovered during:
- A routine health checkup
- Blood tests performed for another health problem
- Tests performed because of suspected liver disease
Alcohol-related liver disease or alcoholic hepatitis may therefore be present even when a person feels healthy. As the disease progresses, symptoms may become more noticeable, especially when significant liver damage or cirrhosis develops.
Diagnosis
A thorough medical evaluation is important when alcohol-related liver disease is suspected. A doctor should take a detailed medical history and perform appropriate laboratory tests such as:
- Liver function tests (LFTs), which includes: ALT (SGPT), AST (SGOT), GGT (Gamma Glutamyl Transpeptidase) and other blood tests may be needed to assess liver health and determine the extent of liver damage.
- It is necessary to determine the quantity of Polymorphonuclear leucocyte and Platelet count by conducting a CBC (Complete Blood Count).
- An abdominal ultrasound is important for detecting changes in the liver and spleen and for identifying ascites, which is an abnormal buildup of fluid in the abdomen. Other than that, a FibroScan can be used to measure the stiffness of the liver. And in some cases, a liver biopsy may be necessary. A small sample of liver tissue is removed with a needle and examined to determine the extent and type of liver damage.
- People with liver cirrhosis may develop enlarged veins in the esophagus called esophageal varices. These veins can rupture and cause serious internal bleeding. An upper gastrointestinal endoscopy may be needed to check for esophageal varices and assess the risk of bleeding.
Preventing Alcohol-Related Liver Disease
Important Preventive Measures:
- Avoid alcohol completely.
- Eat enough nutritious and balanced food.
- Antioxidants may be considered in certain situations, but they should be used only with appropriate medical advice.
Treatment of Alcohol-Related Liver Disease
Treatment depends on the stage and severity of the disease.
- Diuretics: Diuretic medicines, also known as water pills, may be used to reduce excess fluid in the body and help control ascites and swelling.
- Treatment of Alcoholic Hepatitis: Patients with alcoholic hepatitis may require specialized medical treatment and close monitoring. The original treatment approach described the use of pentoxifylline to reduce kidney-related complications. However, treatment for severe alcoholic hepatitis should be determined by a specialist based on the patient's condition and current medical guidelines.
- Treatment of Esophageal Varices: If esophageal varices cause bleeding or there is a high risk of bleeding, urgent treatment is necessary. Treatment may include medicines to reduce the risk or severity of bleeding and endoscopic treatment to control bleeding or prevent future bleeding.
- Treatment of Liver Cirrhosis: Other complications of liver cirrhosis must also be treated appropriately.
- A liver transplant is essential as the final treatment for liver cirrhosis or end-stage liver disease (ESLD) caused by alcohol-related liver disease.