Alcoholic Liver Disease

Abstract Alcoholic liver disease is a major cause of morbidity and mortality in the United States. Alcohol is implicated in more than 50% of liver-related deaths in the United States, and complications of alcoholism contribute to a quarter of a million deaths annually. Also, alcoholic liver disease is a major health care cost expenditure, accounting for nearly $3 billion annually. The clinical spectrum of alcoholic liver disease includes fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Fatty liver develops in response to short periods (days) of alcohol abuse. It is generally asymptomatic and reversible with abstinence. More advanced liver injury usually requires prolonged alcohol abuse over a period of years. Of note, the majority of people who abuse alcohol for extended periods do not develop more advanced lesions of alcoholic liver disease. However, alcoholic hepatitis or alcoholic cirrhosis (or both) develops in about 20% of these people.