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Exam Cram
Exam Cram
Alcoholic Liver Disease (ALD) describes the liver damage from persistent excessive alcohol consumption
Alcohol results in hepatitis and ultimately cirrhosis
LFTs: ALT double AST, Raised MCV, GGT
Management
Acute decompensation: alcohol cessation + addictions services + liver decompensation bundles, consider ascitic drain
Chronic: addictions, dieticians; complications- OGD/ betablocker for varices, encephalopathy- laxatives/ rifampicin, ascites- spironolactone/ furosemide
Scope
Scope
Other pages related to alcohol disorders:
Wernicke-Korsakoff Disorders
Decompensated Liver Cirrhosis
Alcholic Hepatitis
Alcholic Hepatitis
Background
Background
Alcoholic Hepatitis is caused by persistent excessive alcohol consumption
Alcohol is metabolised to acetaldehyde, which is toxic and which causes an inflammatory response within the liver
Severe alcoholic hepatitis has a significant mortality rate
Assessment
Assessment
Symptoms
Nausea, vomiting
Malaise
Fevers
Signs
Jaundice
Hepatomegaly
RUQ pain
Investigations
Raised bilirubin
Deranged coagulations, AST 2x > ALT
AUSS- liver: fatty or cirrhotic
Diagnosis
Diagnosis
Diagnostic criteria: clinical- severely deranged LFTs (particularly bilirubin & coagulation) in context of alcohol
Severity scores: Glasgow Alcoholic Hepatitis (GAH) Score
Management
Management
Acute
Corticosteroids can be used if raised GAH score
Abstinence of alcohol
Long term
Addictions
Consider liver transplant referral if UKELD > 47
Nutrition
Manage complications of liver decomp- ascites, portal htn bleeding, jaundice, encephalopathy
Written in 2025
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