Alcoholic liver diseases

Alcoholic liver disease (ALD) is a cause of significant morbidity and mortality and a leading indication for liver transplantation. Factors that contribute to ALD include total dose of alcohol, host characteristics such as sex, body mass and iron deposition, and environmental influences such as viral hepatitis. Three overlapping forms of injury are seen: steatosis, hepatitis and cirrhosis. Steatosis is reversible with abstinence but may progress to more severe forms of ALD if drinking persists. Alcoholic hepatitis and cirrhosis may be fatal. Clinical history is the cornerstone of recognizing ALD. Alcoholic hepatitis presents as new onset jaundice in someone with recent excessive alcohol consumption. Treatment of every form of ALD is predicated on abstinence from alcohol. Prednisolone assists the recovery in some patients with severe alcoholic hepatitis. Liver transplantation is an effective therapy for selected patients with life-threatening liver failure due to ALD.