alcoholic liver cirrhosis

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  • 2. Aswini Chand Paruchuri Reg no: 611171602018 IV/VI Pharm-d
  • 4. LIVERLiver is one of the largest organ in our body.,weighs upto 1500 grams in adults. With the exception of the brain, the liver is the most complex organ in the body And it has morethan 500 different vital functions in our body. Some of the more well-known functions include the following: Production of bile, which helps carry away waste and break down fats in the small intestine during digestion
  • 5. Production of certain proteins for blood plasma Production of cholesterol and special proteins to help carry fats through the body Conversion of excess glucose into glycogen for storage (glycogen can later be converted back to glucose for energy) Regulation of blood levels of amino acids, which form the building blocks of proteins Processing of haemoglobin for use of its iron content (the liver stores iron) Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine) Regulating blood clotting Resisting infections by producing immune factors and removing bacteria from the bloodstream
  • 6. And yet, when your liver is damaged, you generally wont know about it until things get serious. Liver disease is defined as acute or chronic liver on the basis of whether the history of disease is lessthan/greater than 6months, respectively. The hepatocyte is the functioning unit of the liver. Liver is the only organ which is readily regenerate. Viral infections and paracetamol overdose are the leading causes of acute liver disease, but a significant number of patients have no defined aetiology. Alcohol abuse and chronic viral hepatitis(B and C) are the major causes of chronic liver disease.
  • 7. ALCOHOLIC LIVER CIRRHOSIS Alcoholic liver disease is a term that encompasses the hepatic manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with hepatic fibrosis or cirrhosis. It is the major cause of liver disease in Western countries. Term was 1st coined by Laennec in 1826 Primary histologic features: 1. Marked fibrosis 2. Destruction of vascular & biliary elements 3. Regeneration 4. Nodule formation
  • 8. About Alcohol : Alcohol beverage is a drink that contains ethanol In the bloodstream, from the stomach, alcohol is absorbed between 5-10 minutes Fact : females absorb alcohol faster than males because their bodies contain less water Problem With Alcohol Beverages: Alcohol beverages are being consumed everyday, but consuming too much can bring problems An example would be alcoholic liver disease(cirrhosis),heart disease, cancer and strokes Cause addiction
  • 9. Stages Of ALD : There are three main stages of alcoholic liver disease, although there is often an overlap between each stage. The three stages are explained below. Alcoholic fatty liver disease Alcoholic fatty liver disease is the first stage of alcoholic liver disease. Drinking a large amount of alcohol, even for only a few days, can lead to a build-up of fatty acids in the liver. Fatty liver disease rarely causes any symptoms but it is an important warning sign that you are drinking at a level that is harmful to your health. Fatty liver disease is reversible. If you stop drinking alcohol for two weeks, your liver should return to normal. Alcoholic hepatitis Alcoholic hepatitis (not related to infectious hepatitis) is the second, more serious stage of alcoholic liver disease.
  • 10. Prolonged alcohol misuse over many years can cause the tissues of the liver to become inflamed. This is known as alcoholic hepatitis. Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time (binge drinking). Alcoholic hepatitis is usually reversible, although you may need to stop drinking alcohol for several months or years. Cirrhosis Cirrhosis is the final stage of alcoholic liver disease. Cirrhosis happens when prolonged inflammation causes scarring of the liver and loss of function. Loss of liver function can be life threatening. The damage caused by cirrhosis is not reversible. In mild to moderate cases, stopping drinking alcohol immediately should prevent further damage and lead to the gradual recovery of liver function. In more severe cases, a liver transplant may be required.
  • 11. Epidemiology : In india, liver cirrhosis is one of the leading cause of death . 12th leading cause of death in the united states On average about 27,000 deaths per year 40% cases asymptomatic Additional 10,000 deaths due to liver cancer secondary to cirrhosis Overall, alcoholic liver disease accounts for well over a third (37%) of liver disease deaths. And figures show victims of liver disease are getting younger more than 1 in 10 of deaths of people in their 40s are from liver disease, most of them from alcoholic liver disease
  • 12. Aetiology of liver cirrhosis Hepatitis C, fatty liver, and alcohol abuse are the most common causes of cirrhosis of the liver., but anything that damages the liver can cause cirrhosis, including: Fatty liver associated with obesity and diabetes Chronic viral infections of the liver (hepatitis types B, C, and D; Hepatitis D is extremely rare) Blockage of the bile duct, which carries bile formed in the liver to the intestines, where it helps in the digestion of fats; in babies, this can be caused by biliary atresia in which bile ducts are absent or damaged, causing bile to back up in the liver. In adults, bile ducts may become inflamed, blocked, or scarred, due to another liver disease called primary biliary cirrhosis. Repeated bouts of heart failure with fluid backing up into the liver
  • 13. Certain inherited diseases such as: Cystic fibrosis Glycogen storage diseases, in which the body is unable to process glycogen, a form of sugar that is converted to glucose and serves as a source of energy for the body Alpha 1 antitrypsin deficiency, an absence of a specific enzyme in the liver Diseases caused by abnormal liver function, such as hemochromatosis, a condition in which excessive iron is absorbed and deposited into the liver and other organs, and Wilson's disease, caused by the abnormal storage of copper in the liver Although less likely, other causes of cirrhosis include reactions to prescription drugs, prolonged exposure to environmental toxins, or parasitic infections.
  • 14. Risk Factors : The risk factors presently known are: Quantity of alcohol taken: consumption of 75100 ml/day for 20 years or more in men, or 25 ml/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 2.7 times the risk of alcoholic liver disease. Gender: females 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 Genetic factors: genetic factors predispose both to alcoholism and to alcoholic liver disease. Monozygotic twins are more likely to be alcoholics and to develop liver cirrhosis than dizygotic twins. Due to polymorphisms in the enzymes involved in the metabolism of alcohol.
  • 15. 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.
  • 16. Signs Bleeding tendencies : deficiency of clotting factors Hyperpigmentation Hyperdynamic circulatory state Edema Hernia Testicular atrophy Delirium Constructional apraxia Flapping tremors Inversion of sleep rhythm
  • 17. Symptoms Symptoms vary based on how bad the disease is. You may not have symptoms in the early stages. Symptoms tend to be worse after a period of heavy drinking. Digestive symptoms include: Pain and swelling in the abdomen Decreased appetite and weight loss Nausea and vomiting Fatigue Dry mouth and increased thirst
  • 18. Skin problems such as: Yellow color in the skin, mucus membranes, or eyes (jaundice) Small, red spider-like veins on the s


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