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Research has revealed a huge increase in liver disease in recent years. Meanwhile, there is increasing evidence of health loss from alcohol, including drinking at levels that were previously considered “moderate”.
These developments make a motivational case to see alcohol consumption from public health point of view.
As an internal medical physician and alcohol an epidemicist, I am interested in overlap between patients and the use of liver disease and alcohol in the general population. As it has been revealed, these topics are closely related, but perhaps in a surprising way.
The liver is necessary: humans need to live it. Liver contributes to metabolism and food storage, produces proteins that help in blood clots and play an important role in the immune system.
At the cellular level, alcohol is a toxin that mainly contains metabolides (broken) in the liver. When the alcohol supplements are very high, liver cells are inflamed and damaged (liver inflammation is called hepatitis).
Over time, inflammation or damaged cells are replaced by fibrosis, which is a replacement of normal liver tissue with scar tissue, resulting in cirrhosis, or severe scars and laxity of the liver. Cirrhosis can be fatal in itself and may also be liver cancer.
How does alcohol contribute to liver disease?
Liver disease due to alcohol is known as alcohol related liver disease or ALD, which is first called intoxicating liver disease. The heaviest drinkers, often who have alcohol use disorders (AUD), can develop cirrhosis and liver failure.
But alcohol related liver disease not only affects people who drink AUD/heavy. The growing body of evidence suggests that the use of chronic liquor at low levels can also affect liver function and lead the disease, especially with other risk factors for liver disease.
Alcohol consumption patterns are also important, including people who cannot consume high amounts of alcohol on average. For example, a pattern of consumption is a pattern of consumption that is very harmful to the liver because it results in high blood liquor concentrations.
Drinking diabetes can be harmful to the liver, even among people who do not drink too much on average or do not use alcohol.
Why are the deaths due to liver disease increasing?
In the last two decades, deaths due to liver disease in Canada and the United States have been dramatically increasing. A major factor has increased alcohol consumption during the same period, but it has been trending over the years. Between 2016 and 2022, Canadian death increased by 22 percent due to liver disease due to alcohol.
But alcohol is not the only significant contribution to an increase in deaths due to alcohol disease. Another one is the rise of a position that is called a steetotic liver disease, or masld associated with metabolic dysfunction.
Despite the complex name, Masld is a type of liver disease caused by the same metabolic disturbances that are accompanied by overweight and rise of obesity with insufficient physical activity. This is the only set of risk factors due to which diabetes has increased. So anyone can imagine Masld, which is equal to diabetes.
Hepatis C, which is a blood-borne viral infection that can be acquired through the use of injection drug and needle sharing, is another significant contribution to liver disease and cirrhosis.
Even though medical vocabulary has historically distinguished between liver diseases related to alcohol and non-alcohol, but alcohol allegedly contributes to the progression of non-alcoholic liver disease, including masald and hepatitis C.
My colleagues and I studied Masld patients from the US -based Framingham Heart Study. We found that even among non-informer drinkers, there was a dose dependent on the amount of alcohol use and the severity of both the liver inflammation and the severity of the fibrosis.
Similarly, even low levels of alcohol use can accelerate the growth of liver cirrhosis in people with hepatitis C. For example, research has shown that in patients with hepatitis C, the risk of cirrhosis increases by 11 percent with each one-east increase in average drink per day.
Lowering and reducing the damage caused by alcohol
Beyond providing medical care for individual patients with known liver disease, there is a need to take steps within the health system. These include screening around the use of alcohol in primary care, consultation for people with risky drinking habits and treatment for people with alcohol use disorders. To do this effectively, more resources are required to be available for all these intervention.
However, treating individuals does not address large public health issues: measures are required to reduce alcohol consumption at population level.
It is the cornerstone of preventing and reducing liver disease and resulting in disability, hospitalization and death. And the most effective way to reduce alcohol consumption is through alcohol control policies:
1) Make alcohol more expensive (for example, alcohol tax and minimum prices);
2) less available (eg restrictions on sales, or number of liquor selling places), or
3) Less desirable socially (such as advertising and marketing or sports sponsors).
In the previous research, we found that 10 percent strong or more restrictive liquor policies had low mortality rates. In addition, states increased the restrictions up to five percent, cutting the ALD later.
Loss of liver is a public health problem due to alcohol. Collectively, we need to take better care of our rivers by taking steps to reduce the consumption of alcohol in the population.
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