Alcoholic liver disease: pathophysiology, pathology, progression, and cirrhosis
Progression of alcoholic liver disease: stages, prognosis, and complications
Alcoholic liver disease is a progressive condition affecting the liver due to excessive alcohol consumption. It advances from fatty liver to cirrhosis, with severe complications such as hepatic encephalopathy and liver failure.
Alcoholic Liver Disease: Pathophysiology, Pathology, Progression, and Cirrhosis
Alcoholic liver disease (ALD) is a spectrum of liver conditions caused by chronic alcohol consumption. It progresses through several stages, ultimately leading to cirrhosis, which can be life-threatening.
Pathophysiology
Excessive alcohol intake leads to hepatotoxic effects, causing fatty liver, inflammation, and fibrosis. Ethanol metabolism produces toxic byproducts like acetaldehyde and reactive oxygen species, triggering oxidative stress and liver damage.
Stages of Alcoholic Liver Disease
- Steatosis (Fatty Liver) - Early stage characterized by fat accumulation in hepatocytes. Reversible with alcohol cessation.
- Alcoholic Hepatitis - Acute inflammation of the liver. Symptoms include jaundice, fever, and liver dysfunction.
- Cirrhosis - End-stage liver disease with irreversible fibrosis, leading to portal hypertension and liver failure.
Complications
- Hepatic encephalopathy
- Esophageal varices
- Ascites
- Hepatocellular carcinoma
Prognosis and Treatment
ALD prognosis depends on disease severity and alcohol abstinence. Management includes supportive care, corticosteroids for severe hepatitis, and liver transplantation in end-stage cases.
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