What Is Alcoholic Fatty Liver Disease?
Alcoholic fatty liver is a liver disease caused by long-term heavy drinking and is a type of alcoholic liver disease. Patients have a long history of alcohol consumption, usually more than 5 years. The clinical symptoms are non-specific and may be asymptomatic or have right upper quadrant pain, loss of appetite, fatigue, weight loss, and so on.
- English name
- alcoholic fatty liver
- Visiting department
- Department of Gastroenterology, Liver Diseases
- Multiple groups
- Long-term drinker
- Common locations
- liver
- Common causes
- Long-term heavy drinking
- Common symptoms
- Symptoms are non-specific, liver discomfort, lack of appetite
Basic Information
Clinical manifestations of alcoholic fatty liver
- The clinical manifestations of alcoholic fatty liver are directly proportional to the degree of fatty infiltration in the liver. Symptoms can disappear after excess fat is removed from the liver. Clinically, hepatomegaly is the most common sign, followed by liver pain and tenderness. A few patients may have mild jaundice, and laboratory tests suggest that it is related to obstruction of the biliary system. Severe patients may have ascites and lower extremity edema, with occasional splenomegaly. Some patients can be accompanied by manifestations of vitamin deficiency, such as peripheral neuritis, glossitis, angular cheilitis, skin bruising and so on. In short, alcoholic fatty liver lacks specific clinical symptoms.
Alcoholic fatty liver test
- Plasma protein
- Changes in total plasma protein and inversion of albumin are the most common biochemical abnormalities. Electrophoresis of plasma proteins in some patients shows increased 1 , 2 , and globulin. After the recovery of fatty liver, plasma protein abnormalities recovered later than other indicators, and returned to normal after 3 to 6 months.
- 2. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
- The increase of the former is not obvious, AST / ALT> 2 has diagnostic significance, and the insensitivity of ALT increase is caused by the decrease of the enzyme cofactor B 6 by acetaldehyde. ALT activity in liver tissue was more significantly inhibited than AST activity.
- 3. -glutamyl transpeptidase (-GT)
- Alcohol damage to liver cell microsomes is more sensitive and is a more sensitive indicator for the diagnosis of alcoholic liver disease.
- 4. Alcohol oral stress test
- Changes in glycoprotein, prealbumin, 2 HS glycoprotein, and haptoglobin were detected in alcoholic fatty liver.
- 5.B-ultrasound
- B-mode diffuse fatty liver can be divided into three types: Mild fatty liver shows enhanced near-field echo, far-field echo attenuation is not obvious, and intrahepatic tubular structures are visible; Moderate fatty liver with enhanced front-field echo and back Echo failure, the tubular structure is blurred; The near-field echo of severe fatty liver is significantly enhanced, the far field is significantly attenuated, and the tubular structure is unclear and unrecognizable. Ultrasound changes of localized fatty liver are non-uniform distribution, and the sound image shows multiple strong echogenic nodules, but there is no clumping effect. Liver biopsy is feasible when necessary.
- 6.CT inspection
- Its accuracy is better than that of B-mode ultrasound, which mainly shows that the liver parenchymal density is general or focally reduced.
Alcoholic fatty liver diagnosis
- 1. Have a long history of heavy drinking or short-term overeating.
- 2. Clinical manifestations of alcoholic fatty liver and corresponding laboratory examination abnormalities and imaging changes.
- 3. Eliminate fatty liver caused by viruses, drugs or other reasons.
- Based on the above three points, a clinical diagnosis can be made, and if there are changes in liver histology, further diagnosis can be obtained.
Alcoholic fatty liver treatment
- Abstain from drinking
- Abstinence is the most important measure for the treatment of alcoholic fatty liver, and attention should be paid to the prevention and treatment of withdrawal syndrome during the abstinence.
- 2. Nutritional support
- Patients with alcoholic fatty liver need good nutritional support. They should provide a high-protein, low-fat diet on the basis of abstinence, and pay attention to vitamin B, vitamin C, vitamin K and folic acid.
- 3. Drug treatment
- If serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) or -glutamyl transferase (GGT) is slightly elevated, drug treatment can be considered. S-adenosylmethionine treatment can improve the clinical symptoms and biochemical indicators of patients with alcoholic fatty liver; polyene phosphatidylcholine has a tendency to prevent histological deterioration in patients with alcoholic fatty liver; glycyrrhizic acid preparations, silymarins, polyenes Drugs such as phosphatidylcholine and reduced glutathione have different degrees of anti-oxidation, anti-inflammatory, protection of liver cell membranes and organelles, and clinical applications can improve liver biochemical indicators.
Prognosis of alcoholic fatty liver
- Most patients with alcoholic fatty liver have a good prognosis. Generally, when abstaining from alcohol and treating for about one month, intrahepatic fat decreases, which disappears after a few months, and disappears in one to two years in the severe case.