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Alcoholic Hepatitis - ECAB

Alcoholic Hepatitis - ECAB

Philip Abraham

(2008)

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Book Details

Abstract

Alcoholic hepatitis involves an acute or chronic inflammation of liver occurring as a consequence of alcohol abuse The pathological changes occur in 3 stages namely, fatty liver, alcoholic hepatitis and cirrhosis, with the final stage traditionally considered to be irreversible Alcoholic liver disease is responsible for a significant number of premature deaths per annum all around the globe There is an urgent need to educate the masses about the hazards of alcohol abuse An efficient system to encourage and prolong the period of alcohol abstinence is the need of the hour The importance of lifestyle modifications like weight reduction and cessation of smoking in the progression of liver disease needs to be communicated to the patients and the medical community as well Moreover, realization of the role of nutrition in the management and recovery of ALD would enhance the treatment strategies for this condition

This book has been designed to update the readers on the important aspects of ALD and is a step forward to enable the society in combating the social and economic losses that occur as a result of alcohol abuse The book has stressed upon various aspects of ALD like the role of nutrition, epidemiology and pathogenesis, and the possible therapeutic strategies involved Supportive case scenarios have also been incorporated with relevance to the topics covered under the book Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country


Table of Contents

Section Title Page Action Price
Front Cover Front Cover
Front Matter ia
ECAB Clinical Update:Gastroenterology/Hepatology ic
Copyright ie
About the Authors if
ECAB Clinical Update Information i
Contents ih
Introduction 1
Nutrition and Alcoholic Liver Disease 3
Malnutrition in Alcoholics 4
Role of Oxidants in Pathogenesis of Alcoholic Liver Disease 5
Role of Iron in Alcoholic Liver Disease 6
Mechanism of Damage by Iron 6
Interaction of Diet, Ethanol, and Immune Function 7
Nutritional Aspects 9
Implication of Nutrition in Management of Alcoholic Liver Disease 9
Alcohol's Effects on Digestion and Absorption of Essential Nutrients 10
Amino Acids and Proteins 11
Vitamins 12
Effects of Malnutrition 14
Nutritional Assessment 16
Nutritional Management of Alcoholic Liver Disease 17
Management of Nutritional Deficiencies 18
Case Study Nutrition and Alcoholic Liver Disease 26
Case Study 1 26
Alcoholic Liver Disease: Epidemiology and Pathogenesis 27
Epidemiology 28
Risk Factors 30
Hepatitis C Infection 30
Obesity 30
Cigarette Smoking 31
Pathogenesis 31
Pathogenesis of Alcoholic Liver Disease and Cirrhosis 32
Biochemistry 32
Cytokines 32
Acetaldeyde 33
Oxidative Stress 33
Hypoxia 35
Autoimmune Reactions 36
Recent Advances 36
Mitochondrial Dysfunction 36
Impaired Proteasome Function 37
Abnormal Metabolism of Methionine, S-Adenosylmethionine and Folate 37
Kupffer Cell Activation and Dysregulated Cytokine Production 38
Immune and Inflammatory Mechanisms 39
Gender 40
Diabetes 40
Mechanisms of Hepatic Fibrosis 41
Alcoholic Liver Disease in India 43
Case Studies Alcoholic Liver Disease: Epidemiology and Pathogenesis 48
Case study 1 48
History 48
Clinical Diagnosis 49
Investigations 49
Final Diagnosis 49
Treatment 50
Outcome 50
Discussion 50
Case Study 2 51
History 51
Clinical Diagnosis 51
Relevant Investigations 51
Diagnosis 52
Treatment 52
Outcome 52
Discussion 52
Management of Alcoholic Hepatitis 54
What is Alcoholic Liver Disease? 55
Mechanisms of Alcohol-Related Liver Injury 55
Treatment Modalities for Alcoholic Liver Disease 56
Abstinence 56
Acute Alcoholic Hepatitis 57
Nutritional Support 58
Corticosteroids 61
Oxpentifylline (Pentoxifylline) 64
Anti-TNF Therapy 66
Antioxidants 66
Propylthiouracil 67
Colchicine 67
Metadoxine 68
Transplantation 69
Case Study Management of Alcoholic Hepatitis 77
Case 1 77
Genetics of Alcoholic Liver Disease 79
Genetic Predisposition to Alcoholism 80
Genetic Predisposition to Alcoholic Hepatitis and Cirrhosis 83
Genetic Predisposition to Hepatocellular Carcinoma in Alcoholic Cirrhosis 83
Genetic Variation to Response to Treatment with Naltrexone 84
Local Experience 84
Future 84
Summary 88
Forthcoming Books 90