Friday 25 May 2012

Excessive alcohol consumption can lead to hepatitis

Heavy alcohol use can lead to liver disease, and the risk increases with the length of time and amount of alcohol taken, and this can worsen the damage caused to the liver by other types of hepatitis.

THE liver helps to purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications and alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that are then eliminated from the body in the urine or stool.

The liver produces many important substances, especially proteins that are necessary for good health, For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.

The liver also  stores many sugars, fats and vitamins until they are needed elsewhere in the body. It also builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body, an example of this type of function is the manufacture of cholesterol.

Hepatitis a clinical condition relating to inflammation of the liver, can be caused by alcohol, viral infections and some other toxins introduced into the body, as well as from the body’s autoimmune process (the body attacks itself), and a lot of damages on the liver are caused by hepatitis, according to Dr Adewale Adefemi, a resident doctor at the University College Hospital, Ibadan.

Not all forms of hepatitis are infectious. Alcohol and some other types of chemicals may be bad for the liver and can cause inflammation. When the liver is inflamed, it does not perform its functions well, which brings about many of the symptoms, signs, and problems associated with hepatitis.

There are many causes of inflammation of the liver including medication side effects, excessive alcohol intake, some toxic chemicals, disorders of the gall bladder or pancreas, and infections.

Alcoholic hepatitis is the inflammation of the liver caused by alcohol, this is usually diagnosed through a liver biopsy after common clinical signs including swollen liver, nausea, vomiting, fever, jaundice and abdominal pain, among others.

Dr Adeleke Dankuwo, medical officer, IpeAkoko General Hospital, Ondo State said the toxic end product of the excessive alcohol taken are what damages the liver, adding that it is likely that factors other than alcohol play a role. These may include: malnutrition.

Many people who drink heavily are malnourished, either because they eat poorly — often substituting alcohol for food — or because alcohol and its toxic by-products prevent the body from properly absorbing and metabolising nutrients, especially protein, certain vitamins and fats.

In both cases, lack of nutrients contribute to liver cell damage. Genetic factors, which involves having mutations in certain genes that affects alcohol metabolism may increase the risk of alcoholic liver disease as well as of alcohol-associated cancers and other complications of heavy drinking. Long-term alcohol intake and abuse worsens the liver damage caused by other types of hepatitis, especially hepatitis C. For a person with hepatitis C that also takes alcohol, even moderately, they are more likely to develop cirrhosis than when the person does not drink.

Heavy alcohol use can lead to liver disease, and the risk increases with the length of time and amount of alcohol taken. Research shows that only a small percentage of heavy drinkers develop alcoholic hepatitis, yet the disease can occur in people who drink only moderately or binge just once.

Although damage from alcoholic hepatitis often can be reversed in people who stop drinking, the disease is likely to progress to cirrhosis and liver failure in people who continue to drink.

According to Dr.Adefemi, before a person begins to show signs and symptoms of liver disease from alcohol, then the liver must have been 75 to 80 per cent damaged, It is estimated that in severe cases, the mortality rate is 50 per cent.  If heavy drinking continues, 40 percent of those with alcoholic hepatitis will further develop into cirrhosis. When damage is severe enough that the liver no longer functions, a transplant may be an option.

Cirrhosis of the liver is a cause of many deaths and serious illnesses.  Cirrhosis occur when the cells of the liver are damaged and can’t repair themselves. As live cells die, scar tissue forms. When this scar tissue builds up, blood can’t flow through the liver properly. The primary job of the liver is to filter and clean the blood supply and when this tissue is scarred, it keeps blood from flowing normally causing a build-up of poisons and wastes in the body.

Prolonged periods of this poisoning and malnutrition lead to a condition known as hepatic encephalopathy, a condition in the brain with a bevy of problems.

Research has shown that women are at a greater risk than men in developing alcohol cirrhosis. Analyst say between 10 per cent and 15 per cent of people with alcoholism develop cirrhosis, but many survive it. The 5-year survival rate for people with cirrhosis who stop drinking is about 90 per cent, compared with 70 per cent in those who do not stop drinking.

Once liver cells have been damaged, nothing can be done to repair the liver or cure cirrhosis (chronic stage of the disease), but treatment is aimed at avoiding further damage to the liver, and prevention and treatment of  complication such as bleeding from broken blood vessels.

Also putting an end to offending medications and alcohol is vital to the management of cirrhosis. Alcohol can be a factor in several other forms of liver disease not specifically attributed to it, and may interact with risk factors for other forms of liver disease. An example of this is people with alcohol-related cirrhosis they are at a higher risk of developing liver cancer.

Those with Hepatitis B or C accompanied with heavy drinking are at a much higher risk of cirrhosis than those with heavy drinking alone. Interestingly enough, mortality rates from cirrhosis have declined in the United States as well as some other countries since the 1970’s.

Some of the factors that have contributed to this decline are increased participation in treatment for alcohol problems, less consumption of alcohol and changes in the types of alcoholic beverages consumed, according to a journal,  Alcohol Answers, Evidence – based Treatment and Support.

Experts say the initial phase of hepatitis, which is called the acute phase, shows symptoms which are like mild flu. Other symptoms may include  diarrhoea, fatigue, loss of appetite, mild fever, muscle or joint aches, nausea, abdominal pain, vomiting and weight loss.

The acute phase is not usually dangerous, unless it develops into the fulminant or rapidly progressing form, which can lead to death, as the patient gets worse, these symptoms may follow: circulation problems (only toxic/drug-induced hepatitis), dark urine, dizziness (only toxic/drug-induced hepatitis), drowsiness (only toxic/drug-induced hepatitis), enlarged spleen (only alcoholic hepatitis), headache (only toxic/drug-induced hepatitis), hives, itchy skin, light-colour faeces, the faeces may contain pus, yellow skin, whites of eyes, ascites (abdominal fluid build-up), confusion, thirst and fatigue. 

Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis; chronic hepatitis often leads to nonspecific symptoms such as tiredness and weakness, and often leads to no symptoms at all, It is commonly identified on blood tests performed either for screening or to evaluate nonspecific symptoms.

Dr Dankuwo said hepatitis can be curbed and prevented by going easy on alcohol consumption.


Source:tribune

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