Alcoholic Liver Disease

Alcoholic liver disease is a term that encompasses the liver manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis.

It is the major cause of liver disease in Western countries. Although steatosis (fatty liver) will develop in any individual who consumes a large quantity of alcoholic beverages over a long period of time, this process is transient and reversible. Of all chronic heavy drinkers, only 15–20% develop hepatitis or cirrhosis, which can occur concomitantly or in succession.

The mechanism behind this is not completely understood. 80% of alcohol passes through the liver to be detoxified. Chronic consumption of alcohol results in the secretion of pro-inflammatory cytokines (TNF-alpha, Interleukin 6 and Interleukin 8 ), oxidative stress, lipid peroxidation, and acetaldehyde toxicity. These factors cause inflammation, apoptosis and eventually fibrosis of liver cells. Why this occurs in only a few individuals is still unclear. Additionally, the liver has tremendous capacity to regenerate and even when 75% of hepatocytes are dead, it continues to function as normal.

Symptoms

While moderate alcohol consumption can be beneficial, studies over the years have shown that excessive alcohol intake can lead to liver damage through its direct action as a hepatotoxin. High alcohol consumption over a prolonged period also increases the risk of other liver diseases like chronic viral hepatitis and non-alcoholic fatty liver disease.

• Anaemia
• Jaundice
• Portal hypertension
• Digestive complaints
• Liver & spleen enlargement
• Ascites
• Haemorrhages from body

Causes

Quantity of alcohol taken

Consumption of 60–80g per day (14g is considered one standard drink in the USA, i.e., 1.5 fl oz hard liquor, 5 fl oz wine, 12 fl oz beer; drinking a six-pack of beer daily would be in the middle of the range) for 20 years or more in men, or 20g/day for women significantly increases the risk of hepatitis and fibrosis by 7% to 47%,
Pattern of drinking: Drinking outside of meal times increases up to 3 times the risk of alcoholic liver disease.

Sex

Women are twice as susceptible to alcohol-related liver disease, and may develop alcoholic liver disease with shorter durations and doses of chronic consumption. The lesser amount of alcohol dehydrogenase secreted in the gut, higher proportion of body fat in women, and changes in fat absorption due to the menstrual cycle may explain this phenomenon.
Hepatitis C infection: A concomitant hepatitis C infection significantly accelerates the process of liver injury.

Genetic factors

Genetic factors predispose both to alcoholism and to alcoholic liver disease. Both monozygotic twins are more likely to be alcoholics and to develop liver cirrhosis than both dizygotic twins. Polymorphisms in the enzymes involved in the metabolism of alcohol, such as ADH, ALDH, CYP4502E1, mitochondrial dysfunction, and cytokine polymorphism may partly explain this genetic component. However, no specific polymorphisms have currently been firmly linked to alcoholic liver disease.
Iron overload (Hemochromatosis)

Diet

Malnutrition, particularly vitamin A and E deficiencies, can worsen alcohol-induced liver damage by preventing regeneration of hepatocytes. This is particularly a concern as alcoholics are usually malnourished because of a poor diet, anorexia, and encephalopathy.

Treatment

According to the Ayurvedic system, the disease is caused by imbalances between the three types of physical energy, or doshas. Each of the doshas – vata, pitta and kapha – is present in varying degrees in each of us, though usually one is dominant. Vata is the energy of creativity, intellect and spirituality. In the physical system, it is responsible for circulation and heartbeat. Vata types are physically thin and fine-boned with dry hair and skin. Pitta forces regulate digestion and elimination, including liver function, and pitta types are characterized by sensitive skin and hot tempers. Kapha energy controls growth, moisture and the immune system. Kapha types tend to gain weight easily, have oily skin, abundant hair and calm, loving personalities.

Diet & Lifestyle Advice

Prevention

Certain foods have the ability to boost the health of your liver and provide you with detoxifying effects. In general, you should follow a pitta-pacifying diet and increase the number of vegetables and fruits you consume. You should also introduce high-fibre plants such as whole grains and legumes to your diet.

In case you’re looking forward to creating a detailed diet plan, here are the top liver-friendly foods to consider:

• Garlic contains sulfur compounds that activate liver enzymes, making it an essential ingredient in any liver friendly diet. Both garlic and onion have been found to have a hepatoprotective effect, making them useful as a non-alcoholic fatty liver disease remedy, but researchers found that they work best when used together.
• Coffee often gets a bad rap, but several studies have shown that coffee may play a big role in preventing and treating chronic liver diseases. Although researchers are unsure as to how exactly it benefits liver health, they found that it reduces fat buildup and collagen deposition in the liver, thereby protecting against liver damage.
• Nuts are an excellent source of antioxidants and essential nutrients, including healthy fats, making them a good addition to your diet. Based on some research, it would also appear that nuts can promote healthy levels of liver enzymes.
• Omega-3 fatty acids found in fatty fish have been shown to slow down the progression of the fatty liver disease through their support of healthy enzyme and blood lipid levels. They also help restrict fat buildups and can fight liver inflammation.