Alcoholic liver disease is a type of alcohol-induced liver damage caused by long-term excessive drinking, including fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. The incidence of alcoholic liver disease in major cities in China has shown an upward trend.

bubble_chart Diagnosis

Medical History and Symptoms

Alcoholic liver disease lacks specific clinical manifestations. Therefore, the purposes of diagnosis are: 1. To determine whether it is alcoholic liver disease; 2. To identify the clinical-pathological stage of the alcoholic liver disease; 3. To differentiate it from other liver diseases. A detailed medical history, especially the history of alcohol consumption, should be obtained during the diagnostic process. This includes the type, quantity, duration, and pattern of alcohol consumption, as well as dietary habits. Attention should be paid to symptoms such as anemia and peripheral neuritis.

Physical Examination Findings

Varying degrees of anemic appearance are observed, occasionally jaundice, hepatomegaly. In the decompensated stage of alcoholic cirrhosis, splenomegaly, spider angiomas, ascites, and other signs similar to other types of cirrhosis may be present.

Auxiliary Examinations

AST/ALT > 1, mostly between 2–5, elevated AKP and GGT, decreased serum albumin, increased globulin, prolonged prothrombin time that cannot be corrected by vitamin K. In the fatty liver stage, triglycerides, pre-β-lipoprotein, and cholesterol are mildly to moderately (grade II) elevated. In the alcoholic cirrhosis stage, cholesterol levels are normal, but the ratio of cholesterol esters to total cholesterol decreases.

Imaging Studies B-mode ultrasound and CT show imaging changes consistent with fatty liver or cirrhosis.

bubble_chart Treatment Measures

Quit drinking and supplement with multivitamins such as vitamin B, C, K, etc. Provide sufficient calories and protein. Adrenal corticosteroids can improve acute symptoms and cerebral symptoms in severe alcoholic hepatitis, but attention should be paid to complications such as infections. Commonly used prednisolone 30–40 μg/d, orally for 4–8 weeks; propylthiouracil may enhance clinical recovery in mild or grade II alcoholic hepatitis, 300 mg/d, orally for 4 weeks; colchicine 1 mg/d, taken orally for 5 days a week, continuously for more than 30 days, can alleviate fibrosis and improve symptoms.