Alcoholic liver disease
Classification and external resources
Microscopy of liver showing fatty change, cell necrosis, Mallory bodies
ICD-10	K70.
ICD-9	571.1
MedlinePlus	000281
MeSH	D008108

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Alcoholic liver disease is the major cause of liver disease in Western countries, (in Asian countries, viral hepatitis is the major cause). It arises from the excessive ingestion of alcohol.

[edit] Pathophysiology

Pathogenesis of alcohol induced liver injury

[edit] Fatty change

Fatty change, or steatosis is the accumulation of fat in liver cells which can be seen as fatty globules under the microscope. Alcoholism causes large fatty globules (macrovesicular steatosis). Small fatty globules have different causes. Other causes of macrovesicular steatosis include diabetes, obesity and starvation. Alcoholic fatty change is probably dose-related.^{[citation needed]} The mechanism of alcohol induced fatty liver involves an above average NADH:NAD ratio caused by alcohol metabolism by alcohol dehydrogenase and aldehyde dehydrogenase. A higher NADH concentration induces fatty acid synthesis while decreased NAD level causes decreased fatty acid oxidation. Consequently, the higher levels of fatty acid signals the hepatocytes to compound it to glycerol to form triglycerides.

[edit] Alcoholic hepatitis

Some people get an acute hepatitis or inflammatory reaction to the cells affected by fatty change. This is not directly related to the dose of alcohol. Some people seem more prone to this reaction than others. This is called alcoholic steatonecrosis and the inflammation probably predisposes to liver fibrosis.

[edit] Cirrhosis

Cirrhosis is a late stage of liver disease marked by fibrosis and altered liver architecture. It is often progressive and may eventually lead to liver failure. Late complications of cirrhosis or liver failure include portal hypertension, coagulation disorders, ascites and other complications, including hepatic encephalopathy and the hepatorenal syndrome.

Cirrhosis also has number of causes besides alcohol abuse, such as viral hepatitis and non-alcoholic toxins. The late stages of cirrhosis may look similar regardless of cause. This phenomenon is termed a "final common pathway" for the disease.

Fatty change and alcoholic hepatitis are probably reversible. The later stages of fibrosis and cirrhosis tend to be irreversible but can usually be quite well managed for long periods of time.

[edit] References

[edit] External links

• "Alcoholic liver disease (per capita) (most recent) by country". NationMaster. http://www.nationmaster.com/graph/mor_alc_liv_dis_percap-alcoholic-liver-disease-per-capita. Retrieved 29 July 2009.