Alcoholic liver disease history and symptoms: Difference between revisions
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==History== | ==History== | ||
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*Patient should have a significant history of alcohol use.<ref name="pmid19621845">{{cite journal |vauthors=Willenbring ML, Massey SH, Gardner MB |title=Helping patients who drink too much: an evidence-based guide for primary care clinicians |journal=Am Fam Physician |volume=80 |issue=1 |pages=44–50 |year=2009 |pmid=19621845 |doi= |url=}}</ref> | |||
*CAGE questionnaire should be implemented.<ref name="pmid19621845">{{cite journal |vauthors=Willenbring ML, Massey SH, Gardner MB |title=Helping patients who drink too much: an evidence-based guide for primary care clinicians |journal=Am Fam Physician |volume=80 |issue=1 |pages=44–50 |year=2009 |pmid=19621845 |doi= |url=}}</ref> | |||
*AUDIT-C questions should be asked.<ref name="pmid17451397">{{cite journal |vauthors=Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR |title=AUDIT-C as a brief screen for alcohol misuse in primary care |journal=Alcohol. Clin. Exp. Res. |volume=31 |issue=7 |pages=1208–17 |year=2007 |pmid=17451397 |doi=10.1111/j.1530-0277.2007.00403.x |url=}}</ref> | |||
* Chronic alcohol intake i.e. > 80 g/d in men and 40 g/d in women with alcoholic hepatitis or cirrhosis. | * Chronic alcohol intake i.e. > 80 g/d in men and 40 g/d in women with alcoholic hepatitis or cirrhosis. | ||
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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
- Abdominal pain and tenderness
- Dry mouth
- Excessive thirst
- Fatigue
- Fever
- Fluid collection in the abdomen (ascites)
- Jaundice
- Loss of appetite
- Mental confusion
- Nausea
- Unintentional weight gain (because of fluid collection)
Other symptoms that can occur with this disease:
- Abnormally dark or light skin
- Agitation
- Bloody, dark black, or tarry bowel movements (melena)
- Breast development in males (gynocomastia)
- Changing mood
- Confusion (encephalopathy)
- Changed level of consciousness
- Hallucinations
- Impaired short- or long-term memory
- Difficulty paying attention (attention deficit)
- Impaired ability to concentrate
- Impaired judgment
- Light-headedness or fainting, especially when standing
- Paleness
- Tachycardia when rising to standing position
- Redness on feet or hands
- Slow, sluggish, lethargic movement
- Hematemesis or coffee-ground emesis
Symptoms vary based on the severity of the disease. They are usually worse after a recent period of heavy drinking.
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.