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Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
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Chronic Pancreatitis I: Introduction01:24

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Acute Pancreatitis I: Introduction01:27

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
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Aldehydes and Ketones with Alcohols: Hemiacetal Formation01:19

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Similar to water, alcohols can add to the carbonyl carbon of the aldehydes and ketones. The addition of one molecule of alcohol to the carbonyl compound forms the hemiacetal or half acetal. As depicted below, in a hemiacetal, the carbon is directly linked to an OH and OR group.
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Hepatic Drug Excretion: Influencing Factors01:16

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The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
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Histological Analyses of Acute Alcoholic Liver Injury in Zebrafish
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Alcoholic Hepatitis: The Rising Epidemic.

Pranav Penninti1, Ayooluwatomiwa D Adekunle2, Ashwani K Singal3

  • 1Division of Gastroenterology and Hepatology, University of Texas Health San Antonio, TX, USA.

The Medical Clinics of North America
|March 31, 2023
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Summary

Alcoholic hepatitis (AH) is a severe liver condition with high mortality. Current treatments like corticosteroids offer limited benefit, and liver transplantation access is restricted, highlighting the urgent need for better therapies.

Keywords:
AHALDAUDAlcohol use disorderAlcohol-associated liver diseaseAlcoholic hepatitis

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Alcoholic hepatitis (AH) is a distinct clinical syndrome within alcohol-associated liver disease (ALD).
  • AH represents a growing epidemic with significant public health consequences.
  • Severe AH is associated with a 30-day mortality rate nearing 30%.

Purpose of the Study:

  • To review the current landscape of alcoholic hepatitis.
  • To highlight the limitations in existing therapeutic options.
  • To emphasize the need for improved management strategies for AH.

Main Methods:

  • Literature review of current research on alcoholic hepatitis.
  • Analysis of treatment efficacy and limitations.
  • Examination of prognostic factors and management challenges.

Main Results:

  • Corticosteroids, the primary medical treatment, provide only short-term survival benefits.
  • Liver transplantation for non-responders to corticosteroids is inconsistently applied and faces significant barriers.
  • Alcohol abstinence is crucial for long-term prognosis, yet alcohol use disorder is frequently undertreated.

Conclusions:

  • Existing therapeutic options for alcoholic hepatitis are limited, with corticosteroids offering transient benefits.
  • Access to and criteria for liver transplantation in AH patients require standardization.
  • Addressing undertreated alcohol use disorder is critical for improving long-term outcomes in AH patients.