Alcohol and the liver. A review of pathogenetic mechanisms and newer treatment approaches.

A great deal has been learned about the hepatotoxicity of ethanol in the past two decades. Possible mechanisms of hepatic damage have been elucidated in animal and human experimental situations, and much has been learned about those factors which may hasten or facilitate the production of liver injury. All the answers to the difficult question of individual susceptibility have yet to be provided. Some progress has been made in the management of alcohol related liver injury, but again much more needs to be made. Abstinence remains the cornerstone of therapy in patients with alcoholic hepatitis and cirrhosis. The roles of colchicine, amino-acid therapy and propylthiouracil are still being determined. The most important message for the physician in 1983 remains: Prevent alcohol related liver disease.