Alcohol and Your Liver Video Transcript

Participants

Carol Semrad MD, Howard J. Worman MD

Summary

Most people know that alcohol abuse can cause liver damage. But what exactly does alcohol do to your liver? And how much alcohol puts you at risk? Join our panel of experts as they discuss the ins and outs of alcoholic liver disease.

Webcast Transcript

DAVID MARKS, MD:  Hi, and welcome to our webcast.  I'm Dr. David Marks.  If you're sitting in front of your computer screen with a glass of wine or a beer, you're not alone.  Almost two thirds of us over 14 years of age drink alcoholic beverages.  Now, a little bit is okay, but a lot can get you into trouble.  What you're seeing on your computer screen is called fatty liver.  That's one of the problems that can be associated with drinking alcohol.

Joining me to talk about alcohol and liver disease, we have two experts.  The first is Dr. Carol Semrad.  She is the director of clinical nutrition at Columbia University.  Welcome.  Next to her is Dr. Howard Worman.  He is director of the Division of Digestive and Liver Diseases, also at Columbia University.  Welcome.

So, Dr. Worman, we just saw a picture of fatty liver.  What exactly is that?

HOWARD WORMAN, MD:  Fatty liver is essentially what the name says.  It's the accumulation of fat in the liver cells.  As fat accumulates, the liver can look like it looked in that picture, just a yellowish accumulation of fat.

DAVID MARKS, MD:  What's the problem with that?

HOWARD WORMAN, MD:  Fatty liver itself may not be that much of a problem, or isn't that much of a problem.  The problem is that, with fatty liver, fatty liver can progress to other problems, especially if you continue to drink.

DAVID MARKS, MD:  Now, somebody who goes out and drinks a few beers at night, they build up that fat in their liver, but it does go away, doesn't it?

HOWARD WORMAN, MD:  Right.  Probably not a few beers, but let's say many beers for several nights, they can accumulate fat in the liver, and then the fat will go away after they stop drinking.

DAVID MARKS, MD:  How is it diagnosed?

HOWARD WORMAN, MD:  Fatty liver really can only be diagnosed by liver biopsy.  It's a histological diagnosis you make by looking at a piece of liver under the microscope.  But we can suspect it based on clinical grounds and laboratory tests.

DAVID MARKS, MD:  Dr. Semrad, when would you suspect fatty liver in a patient?

CAROL SEMRAD, MD:  I would expect probably fatty liver in a patient who said they were drinking and perhaps came in complaining of some pain in their right upper quadrant, or in a patient who I drew routine tests on and found an elevation in one of their liver tests.  That would tip me off that there may be a fat accumulation.

DAVID MARKS, MD:  Would you automatically send them for a biopsy?

CAROL SEMRAD, MD:  No, I would not automatically send them for a biopsy.  I would recommend, if they gave a history of drinking, to stop and see if the chemical abnormality went away.

DAVID MARKS, MD:  So the treatment really is to stop, and then you wait and see to make sure everything gets better.

CAROL SEMRAD, MD:  Yes.

DAVID MARKS, MD:  Anything else on fatty liver that people should know about?

HOWARD WORMAN, MD:  What's important to realize, alcohol is not the only cause of fatty liver.  Obesity or some people with diabetes can also accumulate fat in the liver.  So alcohol is probably the major cause, but not the only cause.

DAVID MARKS, MD:  Let's move on to something else.  Hepatitis.