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Natural history and factors influencing the course of alcohol-related liver disease

Lookup NU author(s): Dr Stuart Kendrick, Professor Chris Day


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Although alcohol-related liver disease (ALD) may be seen to have a single clear precipitant in the consumption of alcohol, its pathogenesis is very much that of a complex disease with genetic, environmental, and behavioral factors influencing its clinical course. The clearest example of this is the fact that only a minority of those consuming hazardous quantities of alcohol develop clinically overt liver dysfunction. For instance, in an Italian cohort of unselected heavy drinkers, 20% to 30% had evidence of steatohepatitis on liver biopsy and only 10% had cirrhosis, with even fewer experiencing symptoms.1 This does not mean that the majority of heavy drinkers are safe from the hazards of alcohol excess. Although liver disease has the closest association with alcohol, it accounts for a minority of the total morbidity attributable to drinking, which includes cancer, neuropsychiatric disorders, physical injury, cardiovascular disease, and stroke.2For those who do develop ALD, ongoing heavy drinking is the primary determinant of clinical progression, and abstinence from alcohol offers the best chance of slowing, halting, or even reversing that progression. This was demonstrated in a large-scale epidemiological study of cirrhosis deaths in France in the 1930s and 1940s showing that cirrhosis mortality fell almost immediately when war interrupted the supply of alcohol

Publication metadata

Author(s): Kendrick S, Day C

Publication type: Review

Publication status: Published

Journal: Clinical Liver Disease

Year: 2013

Volume: 2

Issue: 2

Pages: 61-63

Print publication date: 24/04/2013

ISSN (electronic): 2046-2484

Publisher: Wiley


DOI: 10.1002/cld.145