ALCOHOLIC LIVER DISEASE

ALCOHOLIC LIVER DISEASE Dr. Rakesh Kumar . Adi (D.M.) Gastroenterology Osmania General Hospital

PARADOX ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

India : alcohol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BEVERAGES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Standard drink ( 12 gms abs.alcohol ) 4 4 One beer wine hard liqour 1 ounce = 30 ml

Simple conversion ,[object Object],[object Object],[object Object],[object Object]

Risk for the development of ALD. ,[object Object],[object Object],[object Object],[object Object],[object Object]

Risk of liver disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Alcohol Abuse vs. Alcohol Dependence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

DETECTION OF ALCOHOL ABUSE ,[object Object],[object Object]

Laboratory markers ,[object Object],[object Object],[object Object],[object Object],[object Object]

Spectrum of disease ,[object Object],[object Object],[object Object],[object Object]

ALCOHOLIC HEPATITIS ,[object Object],[object Object],[object Object]

Ethanol Metabolism ,[object Object],[object Object],[object Object],[object Object]

Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ALCOHOL ENDOTOXEMIA ACETALDEHYDE OXIDATIVE STRESS MALNUTRITION KUFFER CELL ACTIVATION INFLAMMATION HEPATOCYTE INJURY STELLATE CELL ACTIVATION FIBROSIS IMPAIRED REGENERATION ALCOHOLIC HEPATITIS Gut permeability ADH CYP2E1 TNF ADDUCTS TGF

PATHOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object]

HPE ,[object Object],[object Object],[object Object],[object Object]

HPE Ballooning Degeneration of hepatocyte Mallory bodies

Presentations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clincal Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lab ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Others….. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prognosis of AH: Why Score it? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Prognostic Scores for AH ,[object Object],[object Object],[object Object],[object Object]

Maddrey Discriminant Function ,[object Object],[object Object],[object Object],[object Object],[object Object]

Glasgow Alcoholic Hepatitis Score (GAHS ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

A prognostic model (the ‘‘Lille’’ model ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MANAGEMENT ,[object Object],[object Object],[object Object]

Life style Modification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nutrition Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Corticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Carithers, Ann Int Med, 1989 Mendenhall, NEJM, 1984

Pentoxifylline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Akriviadis, Gastroenterology, 2000

Specific Anti–TNF Therapy ,[object Object],[object Object],[object Object]

Antioxidants ,[object Object],[object Object],[object Object],[object Object],[object Object]

Newer Approaches ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Women : alcohol ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Women’s Risk of ALD

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