Alcoholic liver disease history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

• Recent history of heavy drinking
• 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 : Abstinence (DO NOT EDIT)

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) "