Alcoholic liver disease
Consumption of alcohol is common in adults, and modest consumption has reported health benefits; however, chronic daily alcohol consumption above recommended limits is an important cause of chronic liver disease and cirrhosis. The amount and duration of alcohol consumption affect the likelihood of progression of alcoholic liver disease (ALD). The spectrum of ALD includes simple steatosis, alcoholic steatohepatitis, fibrosis, and cirrhosis, and the risk of hepatocellular carcinoma increases in more advanced disease. Alcoholic hepatitis (AH) is a potentially devastating acute form of ALD with a heightened risk of mortality. Furthermore, alcohol consumption promotes progression of liver disease in individuals with concomitant liver diseases, such as chronic viral hepatitis. Consequently, chronic alcohol consumption is associated with significant morbidity and mortality. Despite progress in understanding the pathophysiology of disease progression in ALD, no targeted therapies are available. The management of ALD relies on early recognition and complete abstinence from alcohol. Supportive care should focus on treating alcohol withdrawal and providing nutrition while managing the complications of chronic liver disease. Liver transplantation should be considered in individuals with advanced liver disease who achieve sobriety.