Alcoholic liver disease medical therapy: Difference between revisions
No edit summary |
No edit summary |
||
| Line 3: | Line 3: | ||
{{CMG}} | {{CMG}} | ||
==Overview== | ==Overview== | ||
The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol. | |||
An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially [[B-complex]] and [[folic acid]], can help reverse [[malnutrition]]. | |||
If [[cirrhosis]] develops, you will need to manage the complications of [[cirrhosis]]. You may need a [[liver transplant]]. | |||
==Medical therapy== | ==Medical therapy== | ||
===General=== | ===General=== | ||
Revision as of 18:33, 28 August 2012
|
Alcoholic liver disease Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Alcoholic liver disease medical therapy On the Web |
|
American Roentgen Ray Society Images of Alcoholic liver disease medical therapy |
|
Risk calculators and risk factors for Alcoholic liver disease medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol.
An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially B-complex and folic acid, can help reverse malnutrition.
If cirrhosis develops, you will need to manage the complications of cirrhosis. You may need a liver transplant.
Medical therapy
General
- Abstinence from alcohol
- Counseling and family support during alcohol abstinence
- Naltrexone or acamprosate to reduce relapse
- Nutritional support - Adequate amounts of carbohydrates and calories as alcoholics are commonly malnourished. This prevents endogenous protein catabolism, and hypoglycemia. Administration of thiamine is important with glucose supplements. This is so because glucose administration increases B1 consumption and B1 deficiency may lead to Wernicke–Korsakoff syndrome.
- Folic acid, thiamine, and zinc supplements are recommended.
Drug therapy
Alcoholic hepatitis
- Methylprednisolone
- Decreases short term mortality
- Usually given for 1 month
- Serum bilirubin is used as a predictor for treatment success. Failure of the serum bilirubin level to decline after 7 days of treatment predicts poor prognosis
- Another predictor of treatment is Lille model comprising, age, serum creatinine, serum albumin, prothrombin time (or INR), serum bilirubin on admission, and serum bilirubin on day 7
- Pentoxifylline
- It is a tumor necrosis factor inhibitor
- Used in patients with contraindications to steroids
- Usually given for 1 months
- Decreases mortality
- Decreases risk of hepatorenal syndrome
Other less commonly used drugs