[Alcohol and the liver]

P Mathurin
Gastroentérologie Clinique et Biologique 2009, 33 (8-9): 840-9
The risk of developing alcohol-induced liver injury occurs above a risk threshold around 25-30g/day. A dose-dependent relationship between alcohol intake and the risk of developing alcohol-induced liver injury is observed in alcoholic subjects with a daily consumption above this threshold. Cirrhosis is the first cause of death related to alcohol. Cirrhosis occurs more frequently in heavy drinkers disclosing alcoholic hepatitis or steatosis. Excess weight is a risk factor for alcoholic liver disease. The role of alcohol in mouth, oropharynx and oesophageal cancers is clearly established. The evidence for the role of alcohol in breast cancer has become clear. Corticosteroids improved the short-term survival of patients with severe alcoholic hepatitis. The Lille model identifies patients who will not benefit from corticosteroids. The benefit of liver transplantation is restricted to alcoholic patients with severe cirrhosis. Only abstainers are considered as candidates for liver transplantation. The recent development of non invasive methods opens up new perspectives for the screening of cirrhosis in subjects with heavy drinking.

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