Alcoholism: A Global Disorder
Consumption of alcohol-containing (ethanol) beverages is a worldwide cause of preventable alcoholic liver disease[1] and can add to the progression of other liver diseases, such as hepatitis C virus infection.[2] Alcohol is a significant worldwide cause of death, although more frequently in men than in women.[3]
A Danish study of patients with alcoholic hepatitis found a 5-year mortality of 47%, which rose to 69% for those with alcoholic hepatitis and cirrhosis.[4] Because of risk associations, patients suspected of having alcoholic liver disease should also be tested for hepatitis C and hepatitis B virus infection.[5,6]
Screening for excessive alcohol intake is an important preventive measure and should be standard of care during clinical evaluation of older children and adults. AUDIT (Alcohol Use Disorders Inventory Test) is a 10-question screen for increased alcohol consumption and alcohol dependence.[7] Patients with a positive screen should be referred for treatment intervention.
For those with evidence of liver injury, abstinence from further ethanol intake may be the most important treatment they receive to improve their long-term outcome, when coupled with treatment of their liver disease.[8]Baclofen has been used in selected patients to reduce recidivism.[3,8]
Elusive Pathophysiology
Multiple manifestations of liver disease can develop owing to alcohol.
