People who drink heavily for more than five years need to undergo counseling, according to recommendations from the American College of Gastroenterology. That level of sustained alcohol consumption can put people at increased risk for alcoholic liver disease (ALD) and cirrhosis-related death. The recommendations were published in 2018 in the American Journal of Gastroenterology.
Cirrhosis is the 12th leading cause of death in the United States, with about half of those deaths attributed to alcohol abuse. Left unchecked, ALD can progress to liver diseases such as alcoholic steatohepatitis and alcoholic hepatitis, cirrhosis, hepatic encephalopathy, and hepatocellular carcinoma. There may be no symptoms or abnormal physical findings present before cirrhosis is diagnosed. Blood tests and imaging exams can detect and monitor liver injury.
The risk for ALD increases with the number of drinks per day (heavy drinking is three or more drinks a day for men and two or more for women), obesity, coexisting hepatitis C or B, and cigarette smoking.
Since abstinence from alcohol is the cornerstone of managing ALD, the American College of Gastroenterology recommends pharmacologic and behavioral therapy.
If you have a drinking problem, or think you do, talk with your doctor openly and honestly. You’re likely to be referred to an alcohol addiction specialist. You can also find support through Alcoholics Anonymous at aa.org or by calling its General Service Office at 212-870-3400.