Alcohol-related liver disease in medical practice

Czech version

Authors: Jiří Hlušička; Radan Brůha
Authors‘ workplace: 4. interní klinika – klinika gastroenterologie a hepatologie 1. LF UK a VFN v Praze
Published in: Čas. Lék. čes. 2022; 161: 84-89
Category: Review Article

Overview

The Czech Republic is still one of the European countries with above-average alcohol consumption. Excessive consumption has a dual effect – it affects the soul and body, leads to the development of alcohol dependence, withdrawal symptoms, psychosocial problems, significantly contributes to the damage of multiple organs. The "tolerable" dose is up to 20 g of pure alcohol per day for women and 30 g of alcohol per day for men. Regular use of higher doses leads to liver damage of varying severity. The first stage of damage is clinically insignificant steatosis, which progresses to steatohepatitis and liver fibrosis as abuse continues. The end stage is irreversible liver cirrhosis. Alcoholic hepatitis is also a serious condition. The basic therapeutic measure is absolute abstinence. The treatment of these patients is long, complicated and a multidisciplinary approach seems to be the most effective. The only treatment modality in patients with liver cirrhosis and long-term abstinence is liver transplantation.

Keywords:

alcohol – abuse – Cirrhosis – Steatosis – fibrosis – alcoholic hepatitis

Sources

Hunt S, Climer J. Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery. Sage, Thous and Oaks, 2009.
World Health Organization. Global status report on alcohol and health 2018. WHO Library Cataloguing in Publication Data, Ženeva, 2019.
Gao B, Bataller R. Alcoholic liver disease: pathogenesis and new therapeutic targets. Gastroenterology 2011; 141(5): 1572–1585.
World Health Organization. Global status report on noncommunicable diseases 2014. WHO Library Cataloguing in Publication Data, Ženeva, 2014.
Mravčík V, Chomyová P, Černíková T a kol. Zpráva o alkoholu v České republice 2021. Úřad vlády ČR, Praha, 2021.
Shield KD, Rylett M, Rehm J. Public health successes and missed opportunities. Trends in alcohol consumption and attributable mortality in the WHO European Region 2014. Centre for Addiction and Mental Health, Ontario, 2016, 1990: 20–22.
Sheron N. Alcohol and liver disease in Europe–Simple measures have the potential to prevent tens of thousands of premature deaths. J Hepatol 2016; 64(4): 957–967.
Klatsky AL. Alcohol and cardiovascular diseases: where do we stand today? J intern Med 2015; 287(3): 238–250.
Bagnardi V, Rota M, Botteri E et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis. Brit J Cancer 2015; 112(3): 580–593.
Waszkiewicz N, Zalewska A, Szulc A et al. The influence of alcohol on the oral cavity, salivary glands and saliva. Pol Merkur Lekarski 2011; 2011: 69–74.
Racek J, Rajdl D. Klinická biochemie. Základy toxikologie. Galén, Praha, 2021.
Brůha R, Dvořák K, Petrtýl J a kol. Alkoholové poškození jater. Medicína pro praxi 2009; 6(3): 144–146.
Bellentani S, Saccoccio G, Costa G et al. Drinking habits as cofactors of risk for alcohol induced liver damage. Gut 1997; 41(6): 845–850.
Dietary Guidelines for Americans. US Department of Health and Human Services and US Department of Agriculture, Des Moines, 2015; 7.
World Health Organization. Food-based dietary guidelines in the WHO European Region. No. EUR/03/5045414. WHO Regional Office for Europe, Ženeva, 2003.
Askgaard G, Grønbæk M, Kjær MS et al. Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study. J Hepatol 2015; 62(5): 1061–1067.
Åberg F, Helenius-Hietala J, Puukka P et al. Binge drinking and the risk of liver events: a population-based cohort study. Liver Int 2017; 37(9): 1373–1381.
Askgaard G, Leon DA, Kjaer MS et al. Risk for alcoholic liver cirrhosis after an initial hospital contact with alcohol problems: a nationwide prospective cohort study. Hepatology 2017; 65(3): 929–937.
Torruellas C, French SW, Medici V et al. Diagnosis of alcoholic liver disease. World J Gastroenterol 2014; 20(33): 11684.
Babor TF, de la Fuente JR, Saunders J. Test pro identifikaci poruch působených užíváním alkoholu, WHO, Ženeva, 1989. Dostupné na: www.adiktologie.cz/test-pro-identfikaci-poruch-pusobenych-uzivanim-alkoholu-audit
Seitz HK. Additive effects of moderate drinking and obesity on serum g-glutamyl transferase. Am J Clin Nutr 2006; 83(6): 1252–1253.
Helander A, Wielders J, Anton R et al. Standardisation and use of the alcohol biomarker carbohydrate-deficient transferrin (CDT). Clin Chim Acta 2016; 459: 19–24.
Wurst FM, Wiesbeck GA, Metzger JW et al. On sensitivity, specificity, and the influence of various parameters on ethyl glucuronide levels in urine – results from the WHO/ISBRA study. Alcohol Clin Exp Res 2004; 28(8): 1220–1228.
Ehrmann J, Aiglová K, Urban O a kol. Onemocnění jater související s alkoholem (ALD). Vnitřní lékařství 2020; 66(5): e3–e15.
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018; 69(1): 154–181.
Naveau S, Giraud V, Borotto E et al. Excess weight risk factor for alcoholic liver disease. Hepatology 1997; 25(1): 108–111.
Phillips M, Curtis H, Portmann B et al. Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis – a randomised clinical trial. J Hepatol 2006; 44(4): 784–790.
Plauth M, Cabre E, Riggio O et al. ESPEN guidelines on enteral nutrition: liver disease. Clin Nutr 2006; 25(2): 285–294.
Michelena J, Altamanirano J, Abraldes JG et al. Systemic inflammatory response and serum lipopolysaccharide levels predict multiple organ failure and death in alcoholic hepatitis. Hepatology 2015; 62(3): 762–772.
Kjaergard LL, Liu J, Als-Nielsen B et al. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure: a systematic review. JAMA 2003; 289(2): 217–222.
Mancebo A, Gonzalez-Dieguez ML, Cadahia V et al. Annual incidence of hepatocellular carcinoma among patients with alcoholic cirrhosis and identification of risk groups. Clin Gastroenterol Hepatol 2013; 11(1): 95–101.
Kim WR, Lake JR, Smith JM et al. OPTN/SRTR 2016 annual data report: liver. Am J Transplant 2018; 18(Suppl. 1): 172–253.
Routhu M, Hosák L. Alkoholismus a abúzus alkoholu. In: Hůlek P, Urbánek P (eds.). Hepatologie (3. vyd.). Grada, Praha, 2018.

Labels

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

ÚVODEM

EDITORIAL

Liver tests

Diagnostic methods of fatty liver diseases

Liver elastography

Metabolic dysfunction-associated fatty liver disease (MAFLD) as a more accurate name for NAFLD – common aspects of pathogenesis

Diagnosis of non-alcoholic fatty liver disease and its active screening in risk groups

An overview of current therapy options of non-alcoholic fatty liver disease

Statins and liver

Current hepatitis C therapy

Klinická obezitologie – nejen Základy

Dietary habits in students from the medical faculties