Sunday, January 7, 2018

Considering A Dry January? If Not - Let's Talk About Liver Disease

Considering A Dry January? If Not - Let's Talk About Liver Disease
Greetings, will you be changing any bad habits this year? If you consume too much alcohol why not take part in the "Dry January" campaign. Could one month of giving up alcohol improve your heath? Today over at NPR, Dr. Rajiv Jalan, talks about the science behind just that, listen to program, here.

The Effects Of Alcohol On The Body
The benefits of participating in a Dry January may be an effective stepping stone to giving up alcohol completely in the future. If you abuse alcohol consider this, the effect of alcohol on your body begins early on, but long-term use of alcohol can take a serious toll on your liver causing fibrosis, cirrhosis and liver cancer. Rather you drink a little or a lot, alcohol use increases your risk of developing not just liver cancer, but other cancers such as head and neck cancers, colorectal cancer, esophagus and female breast cancers. In addition, people with alcoholic liver disease and cirrhosis die more frequently from decompensation of cirrhosis than patients with cirrhosis related to chronic HCV infection or fatty liver disease, and alcohol-related liver disease has now surpassed HCV as the most common indication for liver transplant in the United States.

HCV & Alcohol 
Numerous studies have demonstrated the progression of liver disease for people with both alcohol abuse and HCV is worse when compared to people with only one disease. Those who have HCV and abuse alcohol show an increased rate of fibrosis and liver cancer, and have a higher rate of early death, compared to people with HCV who do not abuse alcohol. According to a 2016 prospective study published in the Journal of Hepatology drinking even low levels of alcohol is connected with increase risk for liver cancer in people with HCV related cirrhosis;
Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. In this prospective study, light-to-moderate alcohol intake was associated with the risk of hepatocellular carcinoma in multivariate analysis. No patients who did not use alcohol and who reached viral eradication developed hepatocellular carcinoma during follow-up. The risk of hepatocellular carcinoma increased with alcohol intake or in patients without viral eradication and was highest when alcohol intake was present in the absence of viral eradication. Patients with HCV-related cirrhosis should be strongly advised against any alcohol intake. Patient care should include measures to ensure abstinence.
Read a nice summary of the article over at Healio.

In a more recent 2017 review, which explores risk of alcohol use in people with liver diseases other than alcoholic liver disease, that is people with hepatitis C, hepatitis B, fatty liver disease, and autoimmune hepatitis reported; alcohol consumption of more than 30 g per day in men and 20 g per day in women is associated with fibrosis progression, development of cirrhosis and hepatocellular carcinoma, and mortality in most liver diseases, view the article here.

How Do I Know If I Have Liver Disease Related To Alcohol?
In many cases, people who have developed liver disease associated with alcohol abuse just don't have any noticeable symptoms until their liver is badly damaged. 

What Is ALD? 
Alcohol-related liver disease or ALD, is caused by excessive consumption of alcohol overtime, the earliest stage of ALD is fatty liver disease, also called steatosis, and is the most common alcohol-related liver disorder. The next stage is alcoholic hepatitis, in which the liver cells become inflamed, finally alcoholic cirrhosis, develops when normal liver tissue is replaced by nonliving scar tissue.

Whilst many people who consume more than 60 g of alcohol a day (equivalent to half a bottle of wine or more than a litre of beer) will develop steatosis (accumulation of fat in the liver), only a minority will go on to develop the more serious condition of alcoholic liver inflammation (alcoholic hepatitis) and between 10 to 20% will develop cirrhosis (irreversible scarring of the liver). Alcohol consumption is responsible for nearly 5.9% of all deaths globally and 139 million disability-adjusted life-years lost due to premature death from alcohol.
How much Alcohol - Is Too Much?
Watch - All About Alcohol: Dr. Joe Galati
In 2017, Dr. Joe Galati discussed cutting down on alcohol and the importance of knowing the amount of alcohol in various types of alcohol and serving sizes.

The Bottom Line
Remember the best treatment for alcoholic liver disease is to not drink, hopefully your liver isn't too far damaged and can repair itself, prolonged alcohol misuse (drinking too much) over many years can reduce its ability to regenerate. As for people with HCV, not drinking is the on the list of the most important thing you can do for your liver. But you already know that. 


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