ALCOHOLIC LIVER DISEASE
Maria Dalamagka In the last 15 yr, UK alcohol-related deaths have doubled. In 2005, there were 8386 deaths related to alcohol. Death rates in both sexes and all age groups are increasing. Alcohol-related deaths are twice as frequent in males.This review aims to highlight the different subtypes of alcoholic liver disease (ALD) and discuss the management of the various ways in which ALD can present to the intensivist. ALD is conventionally divided up into three histological types, although features of each may coexist in the same patient. Steatosis The metabolism of ethanol causes the accumulation of lipid in liver cells. This is steatosis, or 'fatty liver', estimated to occur in 90–100% of all heavy drinkers.Largely symptom free, it resolves completely within a few months of cessation of alcohol intake. ALCOHOLIC HEPATITIS Ethanol metabolism can generate reactive oxygen species and neo-antigens,promoting inflammation. This 'alcoholic hepatitis' (AH) occurs in ...