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Treating Alcoholic Liver Disease

I recommend adding magnesium, 1 pill a day, for many months. Magnesium may decrease intestinal permeability, an important component of reducing endotoxin absorption and exposure to the liver. There are some data although of a relatively minimal nature on the use of pentoxifylline for a longer duration, but most doctors do not use the drug beyond 1 month for patients with alcoholic hepatitis.

One is granulocyte colony-stimulating factor GCSF. In several studies from India, the use of GCSF along with either prednisolone or pentoxifylline, depending on the study, improved short-term months survival. In my opinion, studies of GCSF should be performed in the United States or in the Western world to confirm its effectiveness in a Western population before the therapy can be broadly recommended. One of the potential advantages of GCSF is its reported safety.

N -acetylcysteine NAC has also been studied for the treatment of alcoholic hepatitis. In a meta-analysis, NAC by itself did not improve survival in alcoholic hepatitis. However, one study showed that treatment with prednisolone and NAC was better than treatment with prednisolone alone at 1 month, although the survival benefit was lost by 6 months. In my opinion, additional clinical trials of NAC are needed before it can be recommended for patients with alcoholic hepatitis. Alcohol use after transplantation is often minimal and does not affect organ survival; however, in a small number of patients, there is a significant return to alcohol use.

Nevertheless, abstinent patients with decompensated alcoholic cirrhosis are generally considered to be suitable candidates for liver transplantation if they have fulfilled all of the standard components of the transplant evaluation process. In contrast, transplanting patients with alcoholic hepatitis who have less than 6 months of abstinence is a difficult issue that is under study at several sites.

These patients are currently being considered for transplantation at a number of transplant centers. There have been several trials in which transplant teams evaluated patients with alcoholic hepatitis who had not been abstinent for very long and transplanted select patients, with very good survival reported at 1 and 2 years. Thus, some data do support transplanting select patients with alcoholic hepatitis with less than 6 months of alcoholic abstinence. Early liver transplantation of patients with alcoholic hepatitis is complicated because of perceived issues among the donor population that the donated liver may be given to a recipient who might end up drinking alcohol again.

Because livers are scarce commodities, some in the transplant community feel that the organs should be reserved for the people who will take care of them the best.


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The ongoing uncertainty regarding the reliability of recently abstinent patients with alcoholic hepatitis to take care of their liver likely influences the decision of transplant teams across the United States to transplant patients with alcoholic hepatitis. In studies that were performed in France and the United States, roughly 1 in 10 patients with alcoholic hepatitis was a potential transplant recipient, and perhaps half of these patients ended up receiving a liver transplant.

Overall, transplanting patients with alcoholic hepatitis has a relatively small effect on the use of donor livers. Nevertheless, the transplantation of patients with alcoholic hepatitis who have not been abstinent for very long remains a complicated issue with no clear consensus.

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These consortia are looking at new treatments for alcoholic hepatitis and are also performing basic science and translational research into the pathophysiology and mechanisms of liver injury in alcoholic hepatitis. The consortia have been active for 4 or 5 years and have published some preliminary findings thus far. Standard definitions and common data elements for clinical trials in patients with alcoholic hepatitis: recommendation from the NIAAA Alcoholic Hepatitis Consortia. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. Thursz M, Morgan TR.


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  6. Other effects on the liver include long-term inflammation , called alcoholic hepatitis. This can lead to scar tissue. Over a period ranging from several years to decades, the scarring can completely invade the liver, causing it to be hard and nodular.

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    This is known as cirrhosis. If the liver cannot perform its life-sustaining functions, multiple organ failure and death will occur. Symptoms often develop only after extensive damage has already been done. Overconsumption of alcohol can lead to pancreatitis , a painful inflammation of the pancreas that often requires hospitalization. The inflammation is likely related to premature activation of proenzymes to pancreatic enzymes and chronic exposure to acetaldehyde, and other chemical activities in the pancreas caused by alcohol injury. Around 70 percent of cases of pancreatitis affect people who regularly drink large amounts of alcohol.

    Chronic alcohol consumption can increase the risk of developing different cancers , including cancers of the mouth, esophagus, larynx, stomach, liver, colon, rectum, and breast.

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    Both acetaldehyde and the alcohol itself contribute to the heightened risk. People who smoke tobacco as well as drinking have a higher risk of cancer of the upper gastrointestinal tract and respiratory tract. Heavy drinking can cause problems with the digestive system, such as stomach ulcers, acid reflux , heartburn , and inflammation of the stomach lining, known as gastritis.

    As alcohol initially passes through the gastrointestinal tract, it begins to exert its toxic effects. Alcohol interferes with gastric acid secretion. It can delay gastric emptying, and it can impair the muscle movements in the entire bowel. Drinking too much weakens the immune system, making the body vulnerable to infectious diseases, such as pneumonia and tuberculosis. Alcohol causes changes in red blood cells, white blood cells, and platelets.

    Alcohol consumption putting vast majority of Europeans at risk of digestive cancers, report reveals

    A drop in the white blood cell count can occur due to alcoholism. This happens because the body's production of white blood cells is suppressed, and the cells become trapped in the spleen. Each episode of heavy drinking reduces the body's ability to ward off infections. Exposure to large amounts of alcohol and chronic, heavy alcohol use will adversely affect white blood cell production and function over time. Alcohol is associated with blurred vision, memory lapses, slurred speech, difficulty walking and slowed reaction time. These are all due to its effects on the brain. It alters the brain receptors and neurotransmitters, and it interferes with a person's cognitive function, moods, emotions, and reactions on multiple levels.

    Because alcohol is a central nervous system CNS depressant, it causes difficulty with processing information and poses challenges with solving simple problems. Alcohol's effect on serotonin and GABA receptors may cause neurological changes that could lead to a reduction in a person's normal fear of consequences to their own actions, contributing to risk-taking or violent behaviors.

    Long-term effects of alcohol consumption - Wikipedia

    Alcohol also disrupts fine motor coordination and balance, often leading to injuries from falls. Excessive drinking can cause "blackouts" or the inability to remember events. Long-term heavy drinking can speed up the brain's normal aging process, resulting in early and permanent dementia.

    Until the age of 24 years , the brain is still developing. As a result, young adults are especially vulnerable to the damaging effects of alcohol.

    Ten health risks of chronic heavy drinking

    Dysfunctional drinking leads to malnourishment and vitamin deficiencies. This may be due partly to a poor diet, but also because nutrients are not broken down properly. They are not adequately absorbed from the gastrointestinal tract into the blood, and they are are not used effectively by the body's cells. Also, alcohol's ability to interrupt the bone marrow's red blood cell production and to cause bleeding from gastric ulcers may lead to the development of iron deficiency anemia.

    Chronic heavy alcohol consumption, particularly during adolescence and young adulthood, can dramatically affect bone health, and it may increase the risk of developing osteoporosis , with a loss of bone mass, later on in life. Osteoporosis increases the risk of fractures , especially in the proximal femur of the hip. Alcohol interferes with the balance of calcium , vitamin D production, and cortisol levels, adding to the potential weakening of bone structure. Drinking high quantities of alcohol during adolescence increases the risk of osteoporosis later in life. Heavy can cause blood pressure to be high by triggering the release of certain hormones that cause constriction of blood vessels.

    This can adversely affect the heart. Excessive alcohol intake has long been linked to multiple cardiovascular complications, including angina , high blood pressure , and a risk of heart failure. Stroke is a potentially deadly complication of binge drinking. Fluctuations in blood pressure and increases in platelet activation are common during the body's recovery from a binge.

    This deadly combination heightens the chance of ischemic stroke. Drinking alcohol in any amount is linked to car crashes, domestic violence, falls, drowning, occupational injuries, suicide, and homicide. Driving ability may be impaired with as little as one drink, and a person who drinks heavily is likely to sustain a greater severity of injury with an accident. Chronic or heavy drinking poses an enormous health risk. Drinking too much, whether on one occasion or over an extended period, can lead to severe and irreversible body damage.

    No pattern of drinking is entirely risk-free, and there is no reliable method of predicting how or when an individual will be harmed as a result of the chronic heavy drinking of alcohol. Concussion in young women may lead to alcohol abuse. Girls who suffer concussion in childhood could be at increased risk for abusing alcohol as adults, though the risk is reversible, according to a study published in the Journal of Neurotrauma.

    Neuroscientists locate 'alcoholism neurons' in the brain. Alcohol consumption alters the structure and function of neurons in an area of the brain called the dorsomedial striatum, find scientists. Heavy drinking in midlife increases stroke risk 'more than diabetes'. It is well known that high blood pressure and diabetes can raise the risk of stroke.

    But a new twin study finds that, for people in middle-aged, heavy alcohol consumption may increase that risk even more. This MNT Knowledge Centre article explains the symptoms and causes of hangovers and also offers some potential cures. Discover more here. A large-scale, prospective study investigates the link between visible signs of aging and excessive alcohol intake, as well as smoking.


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