Alcoholic liver disease: assessment and management

Background: Alcohol is a major cause of liver disease in Australia and the incidence of end stage liver disease among young adult Australians is rising. Objective: This article explores the types of alcoholic liver disease, their pathogenesis and detection, and the investigation and management of these conditions. Discussion: Alcoholic liver disease is often silent until complications develop; therefore clinicians need a high index of suspicion to detect individuals with heavy alcohol consumption and evolving liver disease. At a population level, strategies to reduce per capita alcohol consumption can be expected to reduce mortality from alcohol related disease. At an individual level, early diagnosis, abstinence and effective treatment of complications are pivotal to reducing mortality. The cornerstone of management of chronic alcoholic liver disease is abstinence from alcohol and good nutrition. Other important aspects of management include care when prescribing medications, immunisations and early referral for complications.