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Alcohol-related liver disease

Morbus hepatis alcoholicus · Alkoholové onemocnění jater

What it is

Fatty liver, then hepatitis, then cirrhosis — the first two reverse if drinking stops.

Symptoms & signs

  • Often silent
  • right upper ache
  • jaundice and fever in alcoholic hepatitis
  • swelling and confusion once cirrhotic

🚩 Get help if…

  • call 112 / 911 now Vomiting blood or black, tarry stools
  • call 112 / 911 now Confusion, drowsiness or shaking hands after heavy drinking
  • call 112 / 911 now Seizure, seeing things or severe shaking when stopping alcohol
  • see a doctor soon Yellow skin or eyes, or a swelling belly

Where it strikes

Medical treatment

  • Abstinence is the treatment
  • Steroids for severe alcoholic hepatitis — at most a short-term survival gain (STOPAH trial) mixed evidence
  • thiamine and nutrition
  • treat withdrawal
  • transplant assessment

Natural & lifestyle

  • Complete abstinence
  • thiamine and B vitamins
  • high-protein nutrition
  • structured support (AA, SMART)
  • treat depression

Emerging & experimental

  • Faecal transplant trials
  • IL-22 agonists
  • early transplant in selected patients

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Milk thistle — trials found no survival benefit not confirmed in trials
  • Zinc — small trials mixed evidence
  • Kudzu to reduce drinking — small trials early / small studies
  • 'Liver detox' kits — no evidence anecdotal / traditional

ICD codes