BMJ Best Practice Podcast Alcohol-associated liver disease
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Dec 4, 2023 Professor Craig McClain, expert in alcohol-associated liver disease, discusses the diagnosis, management, and complications of this condition. He emphasizes the importance of obtaining a thorough drinking history and using biochemistry tests for diagnosis. Coagulation tests are explored in relation to monitoring the disease. The podcast also addresses common misconceptions and questions about alcohol-associated liver disease, including the harmful effects of underestimating alcohol consumption and the relationship between alcohol and opioids.
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Veterans Are Often Frank About Drinking
- Veterans often give frank drinking histories, unlike some other groups.
- Craig McClain notes housewives may underreport due to social stigma.
Rare Fatality From Liver Biopsy
- McClain recounts a rare fatal liver biopsy in an otherwise healthy woman.
- He uses this to justify avoiding unnecessary biopsies.
Standard Tests Miss Key Differences
- Current standard tests poorly separate severe inflammation from decompensated cirrhosis.
- Research biomarkers like keratin 18 better indicate hepatocyte death and severe hepatitis.