Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2015; 21(28): 8516-8526
Published online Jul 28, 2015. doi: 10.3748/wjg.v21.i28.8516
Alcohol liver disease: A review of current therapeutic approaches to achieve long-term abstinence
María Luisa Gutiérrez García, Sara Blasco-Algora, Conrado M Fernández-Rodríguez
María Luisa Gutiérrez García, Sara Blasco-Algora, Conrado M Fernández-Rodríguez, Service of Gastroenterology, Hospital Universitario Fundación, Alcorcón, Av Budapest-1, 28922 Alcorcón, Madrid, Spain
Author contributions: Gutiérrez García ML contributed to the study idea, study design, literature search, manuscript writing and final revision of the article; Blasco-Algora S contributed to the study idea, study design, literature search, manuscript writing and final revision of the article; and Fernández-Rodríguez CM contributed to the study idea, study design, literature search, manuscript writing and final revision of the article.
Conflict-of-interest statement: The authors disclose no conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Conrado M Fernández-Rodríguez, MD, Service of Gastroenterology, Hospital Universitario Fundación, Alcorcón, Av Budapest-1, 28922 Alcorcón, Madrid, Spain. cfernandez@fhalcorcon.es
Telephone: +34-91-6219513 Fax: +34-91-6219975
Received: January 29, 2015
Peer-review started: January 29, 2015
First decision: April 13, 2015
Revised: May 7, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: July 28, 2015
Processing time: 182 Days and 6.7 Hours
Abstract

Harmful alcohol drinking may lead to significant damage on any organ or system of the body. Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. In ALD, only alcohol abstinence was associated with a better long-term survival. Therefore, current effective therapeutic strategy should be oriented towards achieving alcohol abstinence or a significant reduction in alcohol consumption. Screening all primary care patients to detect those cases with alcohol abuse has been proposed as population-wide preventive intervention in primary care. It has been suggested that in patients with mild alcohol use disorder the best approach is brief intervention in the primary care setting with the ultimate goal being abstinence, whereas patients with moderate-to-severe alcohol use disorder must be referred to specialized care where detoxification and medical treatment of alcohol dependence must be undertaken.

Keywords: Alcohol use disorders; Alcoholic liver disease; Alcohol abstinence; Alcohol withdrawal syndrome; Alcohol dependence

Core tip: Current pharmacological treatment to improve long-term survival in patients with alcohol liver disease has failed to achieve this goal. In addition, no major drug development is expected on this field for the next few years. We have described a potential itinerary from management of acute complications from alcohol abuse such as Delirium Tremens or Wernicke´s encephalopathy to prevention and long-term clinical support and monitoring of patients with harmful alcohol consumption. We think our review will provide useful practical guidelines to clinicians dealing with these patients.