Anne E Duggan
John M Duggan
Alcohol is a major cause of liver disease in Australia and the incidence of end stage liver disease among young adult Australians is rising.
This article explores the types of alcoholic liver disease, their pathogenesis and detection, and the investigation and management of these conditions.
Alcoholic liver disease is often silent until complications develop; therefore clinicians need a high index of suspicion to detect individuals with heavy alcohol consumption and evolving liver disease. At a population level, strategies to reduce per capita alcohol consumption can be expected to reduce mortality from alcohol related disease. At an individual level, early diagnosis, abstinence and effective treatment of complications are pivotal to reducing mortality. The cornerstone of management of chronic alcoholic liver disease is abstinence from alcohol and good nutrition. Other important aspects of management include care when prescribing medications, immunisations and early referral for complications.
The fermentation of grapes, grain and similar carbohydrates to form alcohol was recognised in biblical times; the association of these with liver disease was known in Classical Greece. Today, alcohol is a major cause of liver disease worldwide. In Australia, between 1992 and 2001, an estimated 31 132 people died from alcohol caused disease and injury, with 6825 dying from alcoholic liver cirrhosis.1 The rising incidence of end stage liver disease among young adult Australians is of particular concern.2
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