Alcoholic liver disease covers a spectrum of conditions:

• alcoholic fatty liver disease
• alcoholic hepatitis
• cirrhosis

Selected investigation findings:

• gamma-GT is characteristically elevated
• the ratio of AST:ALT is normally > 2, a ratio of > 3 is strongly suggestive of acute alcoholic hepatitis

Selected management notes for alcoholic hepatitis:

• glucocorticoids (e.g. prednisolone) are often used during acute episodes of alcoholic hepatitis
  • Maddrey's discriminant function (DF) is often used during acute episodes to determine who would benefit from glucocorticoid therapy
  • it is calculated by a formula using prothrombin time and bilirubin concentration
• pentoxyphylline is also sometimes used
  • the STOPAH study (see reference) compared the two common treatments for alcoholic hepatitis, pentoxyphylline and prednisolone. It showed that prednisolone improved survival at 28 days and that pentoxyphylline did not improve outcomes