Review article: current management of alcoholic liver disease

• Published in: Alimentary pharmacology & therapeutics Vol. 19; no. 7; pp. 707 - 714
• Main Authors: TOME, S, LUCEY, M. R
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01.04.2004
• Subjects: Adrenal Cortex Hormones - therapeutic use; Alcoholism - rehabilitation; Biological and medical sciences; Colchicine - therapeutic use; Free Radical Scavengers - therapeutic use; Hepatitis - therapy; Humans; Liver Diseases, Alcoholic - etiology; Liver Diseases, Alcoholic - therapy; Liver Transplantation - methods; Medical sciences; Pharmacology. Drug treatments; Phosphatidylcholines - therapeutic use; Prognosis; Temperance; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Digestive diseases; Hepatic disease; Review; Current; Bibliographic review
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2004.01881.x

Alcoholic liver disease, including acute alcoholic hepatitis and alcoholic cirrhosis, is a major cause of morbidity and mortality in the Western world. Abstinence remains the cornerstone of management of all forms of alcoholic liver disease. Recent research, which has elucidated the mechanisms of alcohol-induced liver injury, offers the prospect of advances in the management of alcoholic liver disease. We review the most recent data on the efficacy of treatment of acute alcoholic injury, including nutritional support, corticosteroids, anti-inflammatory agents and antioxidants, and agents that are directed against the progression to fibrosis, such as colchicines, propylthiouracil and antioxidants. Although these therapies offer a tantalizing glimpse into a future that may include therapies that directly alter the process of injury and repair in the liver, none has been shown consistently to improve the course of alcoholic liver damage. Consequently, liver transplantation remains an ultimate option for selected patients with liver failure due to chronic alcoholic liver damage.