The American College of Gastroenterology, in their latest clinical guideline published in the American Journal of Gastroenterology, has outlined key recommendations for handling alcohol-associated liver disease (ALD).
This comes in response to the growing health care challenges posed by ALD, exacerbated by increased alcohol consumption over the past decade.
Dr. Loretta L. Jophlin, M.D., Ph.D. along with her colleagues, have crafted these guidelines to tackle ALD effectively. They highlight that alcohol-associated hepatitis (AH), a severe form of ALD, can be particularly dangerous.
AH shows up as a sudden worsening of jaundice, a yellowing of the skin, and can lead to acute-on-chronic liver failure. This condition has a high risk of death within a month, particularly in its more severe forms.
To determine the severity of AH, the most reliable method is the Model for End-Stage Disease Score. When it comes to treating severe AH, corticosteroids are currently the only effective option, improving survival rates at one month for about half to three-fifths of patients.
One of the major challenges in treating ALD is dealing with concurrent alcohol use disorder (AUD). Achieving abstinence from alcohol is often difficult for patients.
Unfortunately, those with ALD are not frequently treated for their AUD. The guidelines emphasize the need for better strategies to help patients overcome these barriers to treatment.
A multidisciplinary approach involving hepatology experts, addiction medicine providers, and social workers is recommended. This integrated care model aims to provide comprehensive treatment addressing both ALD and AUD.
Moreover, in cases where patients with AH do not respond to medical treatment and are at low risk of returning to alcohol use after surgery, liver transplantation is suggested as an option.
The guideline points out several key areas for future research, including policies to reduce alcohol use, improved care for patients with both AUD and ALD, and refining the process for liver transplantation in severe AH cases.
It’s also noted that several authors of the guideline have connections to the pharmaceutical industry.
These guidelines mark a significant step in addressing the complex challenges of treating alcohol-related liver disease, highlighting the need for a holistic, patient-centered approach in managing this growing health concern.
If you care about liver health, please read studies about simple habit that could give you a healthy liver, and common diabetes drug that may reverse liver inflammation.
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The research findings can be found in the American Journal of Gastroenterology.
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