Alcoholic liver disease history and symptoms: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
{| class="wikitable" | |||
!Alcoholic steatosis | |||
!Alcoholic hepatitis | |||
!Compensated cirrhosis | |||
!Decompensated cirrhosis | |||
|- | |||
|Asymptomatic | |||
|Yellow discoloration of skin | |||
|Asymptomatic | |||
|Yellow discoloration of skin | |||
|- | |||
| | |||
|Loss of appetite | |||
|Loss of appetite | |||
|Itchy skin | |||
|- | |||
| | |||
|Fever | |||
|Loss of weight | |||
|Blood in vomitus / stool | |||
|- | |||
| | |||
|Abdominal pain | |||
|Weakness / fatigue | |||
|Abdominal distention / Weight gain | |||
|- | |||
| | |||
|Abdominal distention | |||
|Muscle cramps | |||
|Sleep disturbances / Confusion | |||
|- | |||
| | |||
|Proximal muscle weakness | |||
|Irregular menstruation | |||
|Leg swelling | |||
|- | |||
| | |||
|Confusion (hepatic encephalopathy) | |||
|Impotence / infertility/ loss of sexual drive | |||
|Easy bruisability | |||
|} | |||
==2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>== | ==2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>== | ||
===Abstinence : Guidelines (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>=== | ===Abstinence : Guidelines (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>=== | ||
{|class="wikitable" | {| class="wikitable" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LightGreen"|[[AASLD guidelines classification scheme#Class of recommendation|Class I]] | | colspan="1" style="text-align:center; background:LightGreen" |[[AASLD guidelines classification scheme#Class of recommendation|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"| '''1.''' <nowiki>"</nowiki> Clinicians should discuss alcohol use with patients, and any suspicion of possible abuse or excess should prompt use of a structured questionnaire and further evaluation. ([[AASLD guidelines classification scheme#Level of evidence|Level of evidence: C)]] <nowiki>"</nowiki> | | bgcolor="LightGreen" | '''1.''' <nowiki>"</nowiki> Clinicians should discuss alcohol use with patients, and any suspicion of possible abuse or excess should prompt use of a structured questionnaire and further evaluation. ([[AASLD guidelines classification scheme#Level of evidence|Level of evidence: C)]] <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"| '''2.''' <nowiki>"</nowiki> Patients with alcoholic liver disease (ALD) and suggestive symptoms should be screened for evidence of other end-organ damage, as appropriate. ([[AASLD guidelines classification scheme#Level of evidence|Level of evidence: C)]] <nowiki>"</nowiki> | | bgcolor="LightGreen" | '''2.''' <nowiki>"</nowiki> Patients with alcoholic liver disease (ALD) and suggestive symptoms should be screened for evidence of other end-organ damage, as appropriate. ([[AASLD guidelines classification scheme#Level of evidence|Level of evidence: C)]] <nowiki>"</nowiki> | ||
|} | |} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
History should focus on the history of alcohol use by the patient, and the history of symptoms that may have developed. Pertinent symptoms that may be reported are; an increase in abdominal girth (due to ascites, loss of appetite, gynocomastia, skin changes, excessive thirst, fatigue, nausea, hematemesis, mental confusion, and jaundice.
History
- Patient should have a significant history of alcohol use.[1]
- CAGE questionnaire should be implemented.[1]
- AUDIT-C questions should be asked.[2]
- Chronic alcohol intake i.e. > 80 g/d in men and 40 g/d in women with alcoholic hepatitis or cirrhosis.
Symptoms
Alcoholic steatosis | Alcoholic hepatitis | Compensated cirrhosis | Decompensated cirrhosis |
---|---|---|---|
Asymptomatic | Yellow discoloration of skin | Asymptomatic | Yellow discoloration of skin |
Loss of appetite | Loss of appetite | Itchy skin | |
Fever | Loss of weight | Blood in vomitus / stool | |
Abdominal pain | Weakness / fatigue | Abdominal distention / Weight gain | |
Abdominal distention | Muscle cramps | Sleep disturbances / Confusion | |
Proximal muscle weakness | Irregular menstruation | Leg swelling | |
Confusion (hepatic encephalopathy) | Impotence / infertility/ loss of sexual drive | Easy bruisability |
2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)[3]
Abstinence : Guidelines (DO NOT EDIT)[3]
Class I |
1. " Clinicians should discuss alcohol use with patients, and any suspicion of possible abuse or excess should prompt use of a structured questionnaire and further evaluation. (Level of evidence: C) " |
2. " Patients with alcoholic liver disease (ALD) and suggestive symptoms should be screened for evidence of other end-organ damage, as appropriate. (Level of evidence: C) " |
References
- ↑ 1.0 1.1 Willenbring ML, Massey SH, Gardner MB (2009). "Helping patients who drink too much: an evidence-based guide for primary care clinicians". Am Fam Physician. 80 (1): 44–50. PMID 19621845.
- ↑ Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR (2007). "AUDIT-C as a brief screen for alcohol misuse in primary care". Alcohol. Clin. Exp. Res. 31 (7): 1208–17. doi:10.1111/j.1530-0277.2007.00403.x. PMID 17451397.
- ↑ 3.0 3.1 "www.aasld.org" (PDF). Retrieved 2012-10-27.