Alcoholic liver disease history and symptoms: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
<ref name="pmid23799218">{{cite journal |vauthors=Stickel F, Seitz HK |title=Update on the management of alcoholic steatohepatitis |journal=J Gastrointestin Liver Dis |volume=22 |issue=2 |pages=189–97 |year=2013 |pmid=23799218 |doi= |url=}}</ref><ref name="pmid22300464">{{cite journal |vauthors=Mathurin P, Lucey MR |title=Management of alcoholic hepatitis |journal=J. Hepatol. |volume=56 Suppl 1 |issue= |pages=S39–45 |year=2012 |pmid=22300464 |doi=10.1016/S0168-8278(12)60005-1 |url=}}</ref><ref name="pmid8892498">{{cite journal |vauthors=Hamberg KJ, Carstensen B, Sørensen TI, Eghøje K |title=Accuracy of clinical diagnosis of cirrhosis among alcohol-abusing men |journal=J Clin Epidemiol |volume=49 |issue=11 |pages=1295–301 |year=1996 |pmid=8892498 |doi= |url=}}</ref><ref name="pmid8591851">{{cite journal |vauthors=Angeli P, Albino G, Carraro P, Dalla Pria M, Merkel C, Caregaro L, De Bei E, Bortoluzzi A, Plebani M, Gatta A |title=Cirrhosis and muscle cramps: evidence of a causal relationship |journal=Hepatology |volume=23 |issue=2 |pages=264–73 |year=1996 |pmid=8591851 |doi=10.1002/hep.510230211 |url=}}</ref><ref name="pmid20463637">{{cite journal |vauthors=Burra P, Germani G, Masier A, De Martin E, Gambato M, Salonia A, Bo P, Vitale A, Cillo U, Russo FP, Senzolo M |title=Sexual dysfunction in chronic liver disease: is liver transplantation an effective cure? |journal=Transplantation |volume=89 |issue=12 |pages=1425–9 |year=2010 |pmid=20463637 |doi=10.1097/TP.0b013e3181e1f1f6 |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Alcoholic steatosis | !Alcoholic steatosis | ||
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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)[8]
Abstinence : Guidelines (DO NOT EDIT)[8]
| 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.
- ↑ Stickel F, Seitz HK (2013). "Update on the management of alcoholic steatohepatitis". J Gastrointestin Liver Dis. 22 (2): 189–97. PMID 23799218.
- ↑ Mathurin P, Lucey MR (2012). "Management of alcoholic hepatitis". J. Hepatol. 56 Suppl 1: S39–45. doi:10.1016/S0168-8278(12)60005-1. PMID 22300464.
- ↑ Hamberg KJ, Carstensen B, Sørensen TI, Eghøje K (1996). "Accuracy of clinical diagnosis of cirrhosis among alcohol-abusing men". J Clin Epidemiol. 49 (11): 1295–301. PMID 8892498.
- ↑ Angeli P, Albino G, Carraro P, Dalla Pria M, Merkel C, Caregaro L, De Bei E, Bortoluzzi A, Plebani M, Gatta A (1996). "Cirrhosis and muscle cramps: evidence of a causal relationship". Hepatology. 23 (2): 264–73. doi:10.1002/hep.510230211. PMID 8591851.
- ↑ Burra P, Germani G, Masier A, De Martin E, Gambato M, Salonia A, Bo P, Vitale A, Cillo U, Russo FP, Senzolo M (2010). "Sexual dysfunction in chronic liver disease: is liver transplantation an effective cure?". Transplantation. 89 (12): 1425–9. doi:10.1097/TP.0b013e3181e1f1f6. PMID 20463637.
- ↑ 8.0 8.1 "www.aasld.org" (PDF). Retrieved 2012-10-27.