title: Alcoholic liver disease - the extent of the problem and what you can do about it.
abstract: It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis. At this late stage, management consists of expert supportive care, with prompt identification and treatment of bleeding, sepsis and renal problems, as well as support to change behaviour and stop harmful alcohol consumption. There are opportunities to improve care by bringing liver care everywhere up to the standards of the best liver units, as detailed in the Lancet Commission report. We also need a fundamental rethink of the technologies and approaches used in primary care to detect and intervene in liver disease at a much earlier stage. However, the most effective and cost-effective measure would be a proper evidence-based alcohol strategy.
authors.affiliation: Fiona Stanley Hospital, Murdoch, Australia;
authors.forename: Simon
authors.initials: S
authors.lastname: Hazeldine
authors.affiliation: Faculty of Medicine, University of Southampton, Southampton, UK;
authors.forename: Theresa
authors.initials: T
authors.lastname: Hydes
authors.affiliation: University of Southampton, Southampton, UK, and scientific advisor to the European Public Health Alliance, Brussels, Belgium, and RCP representative to the European Health and Alcohol Forum, Brussels, Belgium nick.sheron@soton.ac.uk.
authors.forename: Nick
authors.initials: N
authors.lastname: Sheron
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000628:therapy*; D006113:United Kingdom
keywords: Lancet Commission; Liver; alcohol; alcohol policy; cirrhosis; early detection; minimum unit price
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