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__NOTOC__
{{Alcoholic liver disease}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{MKA}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{CMG}}
{{SK}} Alcoholic hepatitis; Alcoholic fatty liver disease; Fatty liver disease.
==Overview==
{{alcohealth}}
{{Infobox_Disease |
  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 |
}}
{{SI}}
'''Alcoholic liver disease''' is the major cause of [[liver disease]] in Western countries, (in Asian countries, viral [[hepatitis]] is the major cause). It arises from the excessive ingestion of [[Alcoholic beverage|alcohol]].  


==Pathophysiology==
The cause of fatty change is due to the the excess generation of NAD by the enzymes alcohol dehydrogenase and aldehyde dehydrogenase which cause shunting of normal substrates from catabolism towards lipid biosynthesis. Impaired assembly and secretion of lipoproteins and increased peripheral lipid catabolism may also contribute


The cause of alcoholic hepatitis are uncertain. The following reasons are presently consided<br>
*Acetaldehyde formed from alcohol induces lipid peroxidation and acetaldehyde protein adduct formation which disrupt cytoskeleton
*Directly affect microtubule organization, mitochondrial function and membrane fluidity
*Generation of ROS
*Neutrophil attack at the site of hepatocyte necrosis


Fatty change and alcoholic hepatitis are probably reversible. The later stages of fibrosis and cirrhosis tend to be irreversible but can usually be quite well managed for long periods of time.
==[[Alcoholic liver disease overview|Overview]]==


===Fatty change===
==[[Alcoholic liver disease historical perspective|Historical Perspective]]==
{{main|Fatty liver}}
Fatty change, or [[steatosis]] is the accumulation of fat in [[hepatocyte|liver cells]] which can be seen as fatty globules under the microscope. [[Alcoholism]] causes large fatty globules (macrovesicular steatosis). Small fatty globules have different causes. Other causes of macrovesicular steatosis include [[diabetes]], [[obesity]] and [[starvation]]. Alcoholic fatty change is probably dose related.


===Alcoholic hepatitis===
==[[Alcoholic liver disease classification|Classification]]==
{{main|Alcoholic hepatitis}}
Some people get an acute hepatitis or inflammatory reaction to the cells affected by fatty change. This is not directly related to the dose of alcohol. Some people seem more prone to this reaction than others.  This is called alcoholic steatonecrosis and the inflammation probably predisposes to liver fibrosis.


===Liver fibrosis===
==[[Alcoholic liver disease pathophysiology|Pathophysiology]]==


Liver fibrosis, in itself, is largely asymptomatic but as it progresses it can turn into [[cirrhosis]], where the fibrosis alters the architecture and impairs the function of the liver.
==[[Alcoholic liver disease causes|Causes]]==


===Cirrhosis ===
==[[Alcoholic liver disease differential diagnosis|Differentiating Alcoholic liver disease from other Diseases]]==
{{main|cirrhosis}}
[[Cirrhosis]] is a late stage of liver disease marked by fibrosis and altered liver architecture.  It is often progressive and may eventually lead to [[liver failure]]. Late complications of cirrhosis or liver failure include [[portal hypertension]], [[coagulopathy|coagulation disorders]], [[ascites]] and other complications including [[hepatic encephalopathy]] and the [[hepatorenal syndrome]].


[[Cirrhosis]] also has number of other causes, such as hepatitis and toxins.  The late stages of cirrhosis (say from viral hepatitis or alcohol) may look similar.  This phenomenon is termed a "final common pathway" for a disease.
==[[Alcoholic liver disease epidemiology and demographics|Epidemiology and Demographics]]==


[[Image:Pathogenesis alcoholic liver injury.jpg|thumb|left|Pathogenesis of alcohol induced liver injury]]
==[[Alcoholic liver disease risk factors|Risk Factors]]==


== References ==
==[[Alcoholic liver disease screening|Screening]]==
{{reflist|1}}


[[Category:Pathology]]
==[[Alcoholic liver disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==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]]
 
==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]]
 
==Case Studies==
[[Alcoholic liver disease case study one|Case #1]]
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[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Alcohol abuse]]
[[Category:Up-To-Date]]
[[Category:Hepatology]]
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Latest revision as of 20:19, 29 July 2020

Alcoholic liver disease Microchapters

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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

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Treatment

Medical Therapy

Surgery

Primary Prevention

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Cost-Effectiveness of Therapy

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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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