Alcoholic liver disease Treatment

What is Alcoholic Liver Disease Treatment?

The alcoholic liver disease treatment consists of abstinence of alcohol, supportive treatment, medicines, and if required liver transplant.

Quitting of alcohol:

• Quitting alcohol at any stage of the disease can reduce the risk of progression of the disease and the development of complications.

• Simple fatty liver can be reversed with complete abstinence

• The initial stage of complications in advanced liver disease/cirrhosis (fluid in the abdomen, encephalopathy, etc) can be controlled by the quitting of alcohol.

• A person who is diagnosed with alcoholic hepatitis must not drink alcohol again in his life.

• People with alcohol dependence often need medical help to achieve complete and durable abstinence. This can be done by the following means:

– Counseling from doctor or alcohol addiction specialist

– Medicines such as baclofen are considered safe and effective.

– Support groups such as alcoholics anonymous.

Nutritional support:

• Consists of providing required calories, vitamins, and micronutrients.

• The doctor might suggest a special diet and refer you to a dietician.

• Some patients may need to be fed through a tube passed into the stomach or through an IV line.

• Typical standard feeds for people with ALD consists of 1.2 to 1.5 g/kg of protein and 35 to 40 kcal/kg of body weight per day.

• Vitamin B supplementation may also be needed which is preferred through IV line than orally.

Medicines For Alcoholic liver disease Treatment:

• Corticosteroids: these medicines have anti-inflammatory properties and are found to have short-term benefits in increasing the survival of about half of the people (46%) with severe alcoholic hepatitis.

– However, these medicines tend to have significant side effects especially if taken for long and generally avoided in people with kidney failure, gastrointestinal bleeding, or an infection.

– Prednisolone oral solution is generally given in a dose of 40 mg/day in single or divided doses for 28 days followed by a 2-week taper.5

• Pentoxifylline: It is an anti-inflammatory medicine that is given to some people with severe alcoholic hepatitis. The overall benefit of pentoxifylline isn’t not established and is preferred in people who can’t take corticosteroids.

• Antibiotics: Antibiotics are given to manage infections in patients of ALD. Broad-spectrum antibiotics are given if a person is severely ill and suspected to have sepsis. Piperacillin-tazobactam is generally given an antibiotic.

Endoscopy and sclerotherapy: If a person with ALD develops bloody vomiting, there is a high possibility of bleeding of dilated vessels present along the food pipe. These people must get themselves checked for esophageal varices which might be followed by sclerotherapy to stop the bleeding.

Alcoholic liver disease Treatment With Liver transplant

• Liver transplant is the most effective treatment for end-stage liver disease.

• Alcoholic cirrhosis is one of the commonest cause of transplant.

• A person with advanced cirrhosis with complications such as ascites, peritonitis, hepatic encephalopathy, variceal bleeding should seek consultation from a transplant center.

• Studies have shown that severe hepatitis patients who underwent early liver transplant showed a better survival rate even after 2 years period than people who didn’t undergo transplant.

• Most of the transplant centers ask for 6 months of abstinence from alcohol before opting for transplant. However, the decision for liver transplant should not be based solely on the 6-month sobriety.