Alcoholic liver disease is defined by the development of three types of liver damage following chronic heavy alcohol consumption, namely, alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. The clinical features and laboratory
tests
often do not distinguish among these types of liver injuries. in addition, a considerable number of the patients who have clinical and laboratory features compatible with alcoholic liver disease are diagnosed on liver biopsy to have chronic viral
hepatitis or the lesions. Because of these factors, liver biopsy is frequently needed to arrive a definite diagnosis of the liver disease, its activity, and its chronicity. Fatty liver is usually a benign and reverible condition that disappears
on
abstinence from alcohol. However, alcoholic hepatitis is usually regarded as a precursor of cirrhosis.
The principle factors in the development of alcoholic hepatitis and cirrhosis are the quantity and length of ingestion of alcohol. Women are much more susceptible than men to hepatic injuries. Since only 10-20% of alcoholics develop cirrhosis,
however,
it is conceivable that other factors, either genetic, environmental, or nutritional may contribute in the genesis of liver injuries. the most important factor in the treatment o alcoholic liver disease is prolonzed abstinence from alcohol, since
abstinence by itself improves clinical status and survival. Nutritional support in patients with nutritional deficiency, and specific drug therapies such as corticosteroid or anabolic steroids for hospitaliged patients with severe alcoholic
hepatitis
also play an important role in decreasing morbidity and improving survival. Liver transplantation is a newer treatment modality in the patient with advanced cirrhosis, not responsible to medical treatment.
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