Diagnosis of alcohol liver disease by gastroenterologist
Authors:
M. Szántová 1; L. Skladaný 2
Authors‘ workplace:
III. interná klinika LF UK a UN Bratislava 2 II. interná klinika SZU FNsP F. D. Roosevelta, Banská Bystrica
1
Published in:
Gastroent Hepatol 2024; 78(2): 147-155
Category:
Hepatology
doi:
https://doi.org/10.48095/ccgh2024147
Overview
The alarming rise in morbidity and mortality from liver diseases is the reason for searching ways to reverse this trend. The COVID-19 period was a time of increased consumption of spirits in Slovakia and associated morbidity and mortality. An effective tool for early detection of risky alcohol consumption is screening in the form of the AUDIT questionnaire followed by intervention and screening of liver disease in the form of laboratory and imaging methods, including ultrasonography and elastography using non-invasive fibrosis indices. Screening for risky alcohol consumption and advanced liver fibrosis in gastroenterologist, hepatologist and general practitioner outpatient offices will help to detect at-risk individuals early and start intervention. This paper presents a screening proposal in the context of the latest EASL and AASLD guidelines and available current reviews of screening worldwide. The goal is to reduce the adverse effects of alcohol in Slovakia.
Keywords:
risk alcohol consumption – AUDIT test – elastography – screening
Sources
1. Belovičová M. Alcoholic Liver Disease as a public health problem. Gromadske Zdorovja. Ukraine Nation’s Health, 2019; 56 (3): 33–34. doi: 10.24144/2077-6594.3.2019.191629.
2. WHO 2021, The Global Health Observatory, data 2016. 2021 [online]. Dostupné z: https: //www.who.int/data/gho/data/indicators/indicator-details/GHO/alcohol-attributable-fractions- (15-) -liver-cirrhosis-deaths.
3. Sheron N, Burra P, Cortez-Pinto H et al. EASL: Hepahealth Project Report 2018; 177 s. Do- stupné z: https: //easl.eu/wp-content/uploads/ 2018/09/EASL-HEPAHEALTH-Report.pdf.
4. Turček M, Kamendy Z, Grohol M et al. Komplexný manažment pacienta so závislosťou od alkoholu. Štandardné postupy MZd SR č. 0146, 2021.
5. Rehm J, Sulkowska U, Manczuk M et al. Alcohol accounts for a high proportion of premature mortality in central and eastern Europe. Int J Epidemiol 2007; 36 (2): 458–467. doi: 10.1093/ije/dyl294.
6. Szántová M, Belovičová M. Alkohol – manuál rizík, skríningu a intervencie. Bardejov 2021.
7. GBD 2017 Cirrhosis Collabolators: The global, regional and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 2020; 5 (3): 245–266. doi: 10.1016/S2468-1253 (19) 30349-8.
8. Hydes T, Gilmore W, Sheron N et al. Treating alcohol-related liver disease from a public health perspective. J Hepatol 2019; 70 (2): 223–236. doi: 10.1016/j.jhep.2018.10.036.
9. Ganne-Carrié N, Nahon P. Hepatocellular carcinoma in the setting of alcohol-related liver disease. J Hepatol 2019; 70 (2): 284–293. doi: 10.1016/j.jhep.2018.10.008.
10. Skladaný L, Koller T, Adamcova-Selcanova S et al. Challenging management of severe chronic disorders in acute pandemic situation: Chronic liver disease under Covid-19 pandemic as the proof-of-principle model to orchestrate the measures in 3PM context. EPMA J 2021; 12 (1): 1–14. doi: 10.1007/s13167-021-00231-8.
11. NCZI: 2018 Zdravotnícka ročenka SR, NCZI, Bratislava. 2020 [online]. Dostupné z: https: //www.nczisk.sk/Documents/rocenky/2018/Zdravotnicka_rocenka_Slovenskej_republiky_2018.pdf.
12. NCZI: 2019 Zdravotnícka ročenka SR, NCZI, Bratislava. 2021 [online]. Dostupné z: https: //www.nczisk.sk/Documents/rocenky/2019/Zdravotnicka_rocenka_Slovenskej_republiky_2019.pdf.
13. NCZI: 2020 Zdravotnícka ročenka SR, NCZI, Bratislava. 2021 [online]. Dostupné z: https: //www.nczisk.sk/aktuality/pages/Zdravotnicka-rocenka-Slovenskej-republiky-2020.aspx.
14. Baška T, Kľučková B, Komáreková L et al. Structure of deaths associated with heavy alcohol use and their contribution to general mortality in Northwest Slovakia. Int J Public Health 2016; 61 (5): 545–551. doi: 10.1007/s00038-015- 0779-3.
15. Liska D, Liptakova E, Barcalova M et al. Difference in alcohol consumption in central and eastern Slovakia during a coronavirus pandemic (COVID-19). Bratisl Lek Listy. 2023; 124 (5): 394–399. doi: 10.4149/BLL_2023_060.
16. Šulejová K, Líška D, Liptáková E et al. Relationship between alcohol consumption and adverse childhood experiences in college students – a cross-sectional study. Front Psychol 2022; 13: 1004651. doi: 10.3389/fpsyg.2022.1004651.
17. Park H, Shin SK, Joo J et al. Systematic review with meta-analysis: low level alcohol consumption and the risk of liver cancer. Gut Liver 2020; 14 (6): 792–807. doi: 10.5009/gnl19163.
18. Turati F, Galeone C, Rota M et al, Alcohol and liver cancer: a systematic review and metaanalysis of prospective studies. Ann Oncol 2014; 25 (8): 1526–1535. doi: 10.1093/annonc/mdu020.
19. World Cancer Research Fund International: CUP: Diet, nutrition, physical activity and liver cancer, 2015. Dostupné z: https: //www.wcrf.org/wp-content/uploads/2021/02/liver-cancer-report.pdf.
20. Graupera I, Thiele M, Ma AM et al. LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries. BMC Public Health 2022; 22 (1): 1385. doi: 10.1186/s12889-022-13724-6.
21. Skladaný L, Havaj DJ, Adamcova Selčanová S et al. SIRIUS project: sensing probe exploring liver fibrosis in Slovakia. J Hepatol 2023,78 (6): S871.
22. Canivet CM, Boursier J. Screening for Liver Fibrosis in the General Population: Where Do We Stand in 2022? Diagnostics (Basel) 2022; 13 (1): 91. doi: 10.3390/diagnostics13010091.
23. Caballeria L, Pera G, Arteaga I et al. High prevalence of liver fibrosis amongEuropean adults with unknown liver disease: A population-based study. Clin Gastroenterol Hepatol 2018; 16 (7): 1138.e5–1145.e5. doi: 10.1016/j.cgh.2017.12.048.
24. Hagstróm H, Thiele M, Roelstraete B et al. Mortality in biopsy proven alcohol related liver disease: A population based nationwide cohort study of 3453 patiens. Gut 2021; 70 (1): 170–179. doi: 10.1136/gutjnl-2019-320446.
25. Decraecker M, Dutartre D, Hiriart JB et al. Long term prognosis of patients with alcohol-related liver disease or non-alcoholic fatty liver disease according to metabolic syndrome or alcohol use. Liver Int 2022; 42 (2): 350–362. doi: 10.1111/liv.15081.
26. Bush K, Kivlahan DR, Mc Donell MB et al. The AUDIT Alcohol consumption Questions (AUDIT-C). Arch Intern Med 1998; 158 (16): 1789–1795. doi: 10.1001/archinte.158.16.1789.
27. National Institute on Alcohol Abuse and Alcoholism. 2023 [online]. Dostupné z: http: //www.niaaa.nih.gov.
28. Mathurin P, Hadengue A, Battaler R et al. EASL Clinical Practice Guidelines: Management of alcoholic liver disease. J Hepatol 2012; 57 (2): 399–420. doi: 10.1016/j.jhep.2012.04.004.
29. Bradley K A, Bush KR, McDonell MB et al. Screening for problem drinking: comparison of CAGE and AUDIT. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. J Gen Intern Med 1998; 13 (6): 379–388. doi: 10.1046/j.15 25-1497.1998.00118.x.
30. Gual A, Segura L, Contel M et al. Audit-3 and audit-4: effectiveness of two short forms of the alcohol use disorders identification test. Alcohol Alcohol 2002; 37 (6): 591–596. doi: 10.1093/alcalc/37.6.591.
31. Anderson P, Gual A, Colom J. Alcohol and primary health care. Clinical Guidelines on Identification and Brief Interventions. 2005 [online]. Dostupné z: www.phepa.net.
32. Thursz M and CPG panel. EASL clinical practice guidelines: Management of alcohol-related liver disease. J Hepatol 2018; 69 (1): 154–181. doi: 10.1016/j.jhep.2018.03.018.
33. WHO. Standard drink defined by country. 2018 [online]. Dostupné z: https: //apps.who.int/gho/data/view.main.56470.
34. What is a standard drink of acohol? 2023 [online]. Dostupné z: https: //responsibledrinking.eu/what-is-a-standard-drink-of-alcohol/.
35. What is a standard drink? 2023 [online]. Dostupné z: https: //adf.org.au/insights/what- is-a-standard-drink/.
36. Mueller S, Seitz HK, Rausch V. Non-invasive diagnosis of alcoholic liver disease. World J Gastroenterol 2014; 20 (40): 14626–14641. doi: 10.3748/wjg.v20.i40.14626.
37. Crabb DW, Im GY, Szabo G et al. Diagnosis and Treatment of alcohol-associated liver diseases: 2019 Practice guidance from the American Association for the study of liver diseases. Hepatology 2020; 71 (1): 306–333. doi: 10.1002/hep.30866.
38. Arab JP, Izzy M, Leggio L et al. Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation. Nat Rev Gastroenterol Hepatol 2022; 19 (1): 45–59. doi: 10.1038/s41575-021-00527-0.
39. Stewart SH, Law TL, Randall PK et al. Phosphatidyethanol and alcohol consumption in reproductive age women. Alcohol Clin Exp Res 2010; 34 (3): 488–492. doi: 10.1111/j.1530- 0277.2009.01113.x.
40. Faktorová X, Žigrai M, Vyskočil et al. Aktuálne možnosti skríningu steatózy a fibrózy pečene. Lek Obz 2023; 72 (7–8): 292–299.
41. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis – 2021 update. J Hepatol 2021; 75 (3): 659–689. doi: 10.1016/ j.jhep.2021.05.025.
42. Archer AJ, Belfield KJ, Orr JG et al. EASL Clinical Practice Guidelines: non-invasive liver tests for evaluation of liver disease severity and prognosis. Frontline Gastroenterol 2022; 13 (5): 436–439. doi: 10.1136/flgastro-2021-102064.
ORCID autorov
M. Szántová 0000-0003-4287-5481,
Ľ. Skladaný 0000-0001-5171-362.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
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