Treatment for Alcoholic Liver Disease

The treatment for Alcoholic Liver Disease depends on the stage of the disease :

Minimal change or fatty liver : Abstinence from alcohol, improved nutrition and maintenance of normal weight are the mainstay of the treatment. 

Alcoholic Hepatitis : This will depend on the severity of alcoholic Hepatitis. In mild cases only abstinence from alcohol and nutritional support are required. But in acute alcoholic Hepatitis ( characterized by jaundice, easy bruising, abnormal blood tests and sometimes the presence of extra fluid within the abdomen ( ascites ) the patient has to be hospitalized. If kidney failure occurs it leads to almost 100 per cent mortality rate. 

Cirrhosis : Uncomplicated cirrhosis can be managed with abstinence from alcohol and nutritional support. If complication like bleeding from varices ( engorged veins at the lower end of the oesophagus), ascites, jaundice and encephalopathy have developed, then the treatment depends on the type of complication. 

Bleeding varices : Bleeding varices may need treatment by endoscopic ligation ( tying the swollen veins with a thread) or sclerotherapy ( injection of a chemical in the vein which obliterates the lumen of the vein). Long-term treatment with medicines such a s beta-blockers may reduce the risks of further bleeding. 

Ascites : Ascites requires a low-salt diet, and reduction of fluid intake is often advised. Diuretics ( medicines which increase urine formation) are used to decrease the ascitic fluid. Intermittent drainage of the ascitic fluid is also sometimes required. 

Encephalopathy : This involves correcting the underlying problem, and treatment with lactulose ( a liquid laxative). Lactulose decreases the production of ammonia in the gut and its absorption into the body. Ammonia is responsible for the symptoms of encephalopathy. 

 In some patients with cirrhosis, liver function continues to deteriorate despite abstinence from alcohol and they may be severely affected by complications. Such patients require lever transplantation. 

Prevention of complications 

Nutrition : A good diet and a 'normal' body weight can significantly improve the outcome of ALD. Obesity seems to increase the risk of advanced liver disease in heavy drinkers. Many patients are severely malnourished, due to loss of appetite and nausea. 
In advanced liver disease ( alcoholic Hepatitis and cirrhosis) nutritional supplements have been shown to significantly improve liver blood tests. A diet high in antioxidants such as vitamin E and selenium is though to help prevent and treat ALD . These can be taken as supplements or by eating more fresh fruit and vegetables. 

Abstinence : Even in advanced liver disease, it is beneficial to stop drinking. Cirrhotics without any complications, who continue to drink are far more likely to develop complications. The survival rates of those who stop drinking are quite high as compared to a cirrhotic who continues to drink.

Alcoholic Liver Disease
Spectrum of Liver Disease
Treatment for Alcoholic Liver Disease