Treatment of patients with alcoholic liver disease.
BACKGROUND
The proportion of alcoholic liver disease among all kinds of liver diseases in China is increasing. Recent research has elucidated the mechanisms of alcohol-induced liver injury and offered the prospect of advances in the management of alcoholic liver disease.


METHODS
Searching MEDLINE (1982-July 2004) for papers on alcoholic liver disease, especially those on the treatment of alcoholic liver disease.


RESULTS
Abstinence remains the cornerstone of management of all forms of alcoholic liver disease. Nutritional support therapy is also a basal treatment. Corticosteroids may be benefitial for some severe alcoholic hepatitis. None of other measures including anti-inflammatory agents, antioxidants or colchicine has been shown consistently to improve the course of alcoholic liver damage. Ultimately, liver transplantation remains an option for selected patients with liver failure due to chronic alcoholic liver disease.


CONCLUSIONS
Abstinence and nutritional support remain the base management of alcoholic liver disease. Corticosteroid is efficient for some severe alcoholic hepatitis. Anti-inflammatory agents and antioxidants may be of benefit but need further studies. The efficacy of other measures including the use of colchicine and propylthiouracil is controversial. Liver transplantation remains an option for selected patients with liver failure.
Zhang
Fu-Kui
FK
Liver Research Center, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China. frankliver@yahoo.com.cn
Zhang
Jun-Yong
JY
Jia
Ji-Dong
JD
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006519:Hepatitis, Alcoholic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008111:Liver Function Tests; D008297:Male; D018529:Nutritional Support; D010431:Pentoxifylline / Q000627:therapeutic use; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012838:Silymarin / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014810:Vitamin E / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000975:Antioxidants; D012838:Silymarin; D014409:Tumor Necrosis Factor-alpha; D014810:Vitamin E; D010431:Pentoxifylline