Alcoholic liver disease

Abstract

Introduction. Alcoholic liver disease is one of the most common liver disorders in Europe and in the United States of America. This paper highlights the clinical-pathological concept of alcoholic liver disease with an overview of current therapeutic approaches. The spectrum of alcoholic liver disorders includes liver steatosis, alcoholic steatohepatitis, alcoholic cirrhosis with a potential to culimate in hepatocellular carcinoma. Alcoholic steatohepatitis is a rapidly-progressive disorder that may be associated with severe clinical manifestations of alcoholic hepatitis and high mortality. There are large variations in alcohol consumption and consequent morbidity and mortality around the world. In addition to the amount of alcohol intake, different individual manifestations of alcoholic liver disease are affected by genetic and other risk factors. Pathogenesis with a potential to culminate in hepatocellular carcinoma of the disease is based on the toxic effects of acetaldehyde, oxidative stress, lipid metabolism disorders and alcohol-induced inflammation. Diagnosis of alcoholic liver disease. In the diagnosis of alcoholic liver disease, apart from clinical picture and laboratory findings, ultrasonography, transient elastography, magnetic resonance imaging, serum biomarkers and liver biopsy are important. Therapy of alcoholic liver disease includes abstinence, nutritional support, corticosteroid treatment and liver transplantation. New therapeutic modalities are being investigated. Conclusion. Despite abundant knowledge of the epidemiology, pathophysiology and clinical diagnostics of alcoholic liver disease, the therapy has not changed over the past few decades. The development of novel therapeutic modalities requires a multidisciplinary approach and close cooperation of doctors and pharmacists. The emphasis must be put on the disease prevention at both individual and community level.