Alcohol Abuse and Liver Disease

For people with alcohol excess and liver disease, successful management must be two-fold with management of both their psychological/physical addiction to alcohol and their liver disease.  Alcohol Abuse and liver disease, with its joint focus on hepatology and psychiatry, provides both hepatologists and psychiatrists of all levels with a practical, concise and didactic guide to the investigation and clinical management of those with alcohol-related problems.

Edited by a practicing hepatologist in the UK and a practising specialist in psychiatry/substance abuse in the US, it covers areas such as:

•     Risk factors for alcoholic liver disease

•     Interaction of alcohol with other co-morbidities

•     Clinical assessment of alcohol intake

•     Detoxification and management of withdrawal

•     Psychotherapeutic and pharmaceutical interventions

•     Treatment of liver disease

Key points, management diagrams and high-quality images are all be supported by the very latest in clinical guidelines from the major hepatology and psychiatry societies such as the APA, EPA, AASLD and EASL.

With increasing emphasis on multi-disciplinary speciality care in this area, this is the ideal tool to consult in order to provide the best care possible care for what are very challenging patients to manage.

James Neuberger MD, is a Consultant Hepatologist and Professor of Hepatology, Queen Elizabeth Hospital, Birmingham and Associate Medical Director at NHS Blood and Transplant. He is Editor-in-Chief of LWW's Transplantation, the journal of the Transplantation Society, and on the board of several liver and transplant journals. He has 295 articles listed on PubMed.

Andrea DiMartini is Associate Professor of Psychiatry and Surgery in the Department of Psychiatry in the University of Pittsburgh. She has over 20 years' clinical and research experience of working with transplant surgeons and physicians in the Starzl Transplantation Institute. She was awarded the 2011 Research Award by the Academy of Psychosomatic Medicine and has focused on the natural history and management of patients with alcohol and substance abuse.

List of Contributors vii

Preface xi

1 Epidemiology of alcohol use 1
Ian Gilmore and William Gilmore

2 Epidemiology of alcohol�]related liver disease 11
Ed Britton and Martin Lombard

3 Alcoholism: diagnosis and natural history in the context of medical disease 23
Thomas P. Beresford Narin Wongngamnit and Benjamin A. Temple

4 Alcohol and other substance misuse 35
John B. Saunders

5 Risk factors for alcohol�]related liver disease 47
Stuart Kendrick and Chris Day

6 Mechanisms of alcohol toxicity 55
Guruprasad P. Aithal and Jane I. Grove

7 Extrahepatic manifestations of alcohol excess 65
Karl�]Heinz Schulz Sandra van Eckert and Jens Reimer

8 Patterns of alcohol�]associated liver damage 79
Peter Hayes and Michael Williams

9 Cofactors and alcohol�]related liver disease 87
John G. O’Grady

10 Impact of alcohol and liver disease on prescribing 91
Richard Parker and Amanda Smith

11 Psychiatric examination of liver transplant patients with alcohol use disorders 99
Robert M. Weinrieb and Omair Abbasi

12 Abnormal liver tests in the context of alcohol excess 109
James Ferguson

13 Biochemical determination of alcohol consumption 113
Friedrich Martin Wurst Natasha Thon Wolfgang Weinmann Michel Yegles Jessica Wong and Ulrich W. Preuss

14 The role of histology 123
Desley A.H. Neil

15 General assessment and management 135
Patrizia Burra and Giacomo Germani

16 Brief alcohol interventions 147
Stephanie Scott and Eileen Kaner

17 Alcohol withdrawal syndrome: diagnosis and treatment 155
Julie Taub and Thomas P. Beresford

18 Psychosocial treatments of alcohol use disorders 165
Terry D. Schneekloth

19 Pharmacologic interventions 175
Renata Yang and Marian Fireman

20 Treatment of extrahepatic manifestations of alcohol abuse 187
Joaquim Fernandez�]Sola

21 Treatment of liver disease 197
James Neuberger

22 Treatment of alcoholic hepatitis 203
Mark Thursz and Stephen Atkinson

23 Liver transplantation in people with alcohol�]related liver disease 215
Santiago Tome and Michael R. Lucey

24 Future directions: the need for early identification and intervention for patients with excessive alcohol use 223
Andrea DiMartini Shari Rogal and Stephen Potts

Index 235

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