Aging Begins at 30

French Livers Tend To Be Hard

We were discussing French health and wine. "One glass leads to two, then three and then the 'liver of no return'," he said, World-wide alcohol consumption is increasing but decreasing in France and the U.S., from education. About a third of heavy drinkers have no liver involvement. Others develop scarring called cirrhosis Greek for the orange-yellow appearance of the magenta colored liver. About 90% of cirrhosis deaths are from alcohol abuse. One other long term effect is liver cancer. We are physicians and came from countries with high alcohol consumption but only drink a rare glass of wine. Patients with cirrhosis turn you off alcohol.

A "unit" of alcohol is one 1 _ oz whiskey shot, a 5 oz glass of wine or a can of beer. The type of alcohol doesn't matter. Sixteen units of alcohol daily for 5 years or 4 units daily over 25 years will usually damage your liver. Yes, you can get cirrhosis from social drinking. A third of doctors forget to take a drinking history. Women are more susceptible than men but more men die. Patterns of alcohol drinking are inherited. There is no single genetic marker. Lower protein intake or coexistent viral hepatitis hasten damage to the liver. Certain types of hepatitis alone can cause cirrhosis. There are a few other rare causes.

The liver the size of a football weighs 3 pounds. Nearly all the blood from the stomach and intestines passes through the liver. It produces clotting factors, bile, energy-glycogen, blood sugar, and several hormones. It detoxifies poisons including alcohol but it can be overwhelmed. Cirrhosis requires lessening many medicines, affects the treatment of diabetes, alters responses to infection and surgery. Blood tests help make the diagnosis. Sometimes a needle biopsy is needed. Alcohol damaged liver cells are replaced by scars which distort the liver and blood flow.

Cirrhosis is often silent. Patients with symptoms have loss of appetite, nausea, weight loss, enlargement of the liver and later jaundice. If severe, fluid, accumulates in the belly. Vomiting of blood occurs due to enlarged veins (varices) in the lower end of the esophagus as blood bypasses the liver under back pressure of trying to make it through the scarred liver. In late disease, patients lapse into confusion and coma.

Cirrhosis kills 27,000 Americans yearly. It is the third leading cause of death in ages 25 - 59 and the ninth in all age groups. Over one year cirrhosis was the first listed diagnosis in 72,000 hospital admissions and mentioned in another 220,000 admissions.

Cirrhotics should abstain completely from alcohol. Interventional counseling should involve feedback to the patient about risks, patient responsibility for change, a menu of options for change, empathetic advice, and self-motivation should imbue self. Good monitoring is important. At least 25% will continue to imbibe.

Deaths from cirrhosis have decreased 25% in the past 10 years. No more than 2 drinks a day. None is even better and will prevent you getting alcoholic cirrhosis. In 90% prevention is possible. Alcohol damage is no myth. We can calculate when you will probably get cirrhosis if you are a steady drinker.

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See related Patient Topics Cirrhosis, Digestive System or Liver Diseases--General.

See related Provider Topics Digestive System or Liver Diseases--General.

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