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[Therapy of alcoholic hepatitis]
1Klinik und Poliklinik für Innere Medizin, Martin-Luther-Universität, Halle.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|June 9, 1992
Summary
The primary treatment for alcoholic liver disease is alcohol cessation. Supportive therapies include nutrition, symptomatic care, and potentially specific medications like silymarin or glucocorticoids for severe cases.
Area of Science:
- Hepatology
- Internal Medicine
- Critical Care Medicine
Context:
- Alcoholic liver disease (ALD) encompasses a spectrum of conditions, including alcoholic hepatitis.
- Effective management requires a multidisciplinary approach integrating hepatology and intensive care.
- Identifying optimal therapeutic strategies beyond alcohol cessation is crucial.
Purpose:
- To outline the fundamental and advanced therapeutic principles for managing alcoholic liver diseases, with a focus on alcoholic hepatitis.
- To review current and emerging treatment options, including nutritional support, pharmacotherapy, and surgical interventions.
Summary:
- The cornerstone of ALD management is complete alcohol abstinence.
- Supportive care involves balanced nutrition and symptomatic treatment guided by hepatology and intensive care principles.
- Additional therapies like glucose-glucagon-insulin infusions, silymarin, and glucocorticoids may be considered. S-adenosyl-L-methionine shows promise pending further clinical validation.
- Liver transplantation is a consideration for patients with poor prognoses.
Impact:
- Provides a comprehensive overview of ALD treatment strategies for clinicians.
- Highlights the importance of alcohol cessation as the primary intervention.
- Informs clinical decision-making regarding adjunctive therapies and liver transplantation in advanced ALD.