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I am a drinker. Having variations in liver enzymes. What is the risk I am facing?

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General & Family Physician
Practicing since : 2007
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My liver enzymes have gone up and Down over the years. I am quite a heavy drinker and at the moment they are six times normal. Are you able to help me quantify the risk I am facing and the long term diagnosis please
Posted Mon, 6 Aug 2012 in Smoking and Alcohol Addiction
Answered by Dr. Neelam Ashish Vanjari 1 hour later

Thanks for writing in.
To answer your question, the diagnosis is alcoholic liver disease. If you do not have any symptoms (like nausea, fever, jaundice, confusion, altered sleep pattern or any bleeding) at present, we may be looking at the earlier stages of alcoholic hepatitis. On the long term, we do expect it to proceed to severe alcoholic hepatitis and alcoholic cirrhosis finally.
The early stages of alcoholic hepatitis is not something very serious and the short term mortality is negligible. But over the long term, as the disease progresses, we could be looking at a 30 day mortality of 15-50%.
To exactly quantify the risk, we would need your prothrombin time and your bilirubin levels. With these results in hand, we can calculate a value called the discriminant function (DF). It is calculated as follows:
DF = (4.6 × PT prolongation) + total serum bilirubin in mg/dL
Values greater than 32 indicate severe disease and predict a 30-day mortality rate of approximately 50%, assuming only supportive treatment is given.
At this stage, the important thing to understand is that the disease is reversible. This however requires you to completely stop alcohol. With time still in our hands, we can give the liver enough time to take care of itself. But with continued use of alcohol, we can reasonably expect only a downhill course.
Do take the first step forward and try and reduce the alcohol you’re consuming.
I hope I have addressed your concerns.
Let me know if you need any more information.
Best regards,
Dr. Neelam.
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