Alcohol-related liver disease

ARLD can be monitored through periodic liver function tests and visits to the healthcare provider. It is important to evaluate any worsening of signs and symptoms. Healthcare providers should monitor compliance with treatment and alcohol abstinence. Models such as the Child-Turcotte-Pugh index, which includes a combination of clinical and laboratory variables, can be useful to assess disease severity and set a baseline for future reference. [ Child Pugh classification for severity of liver disease Opens in new window ] ​ Patients with advanced liver disease should be screened for esophageal varices and treated with prophylactic nonselective beta-blockers (e.g., propranolol, nadolol, or carvedilol) if they have esophageal varices 5 mm or more in size. Prophylactic endoscopic banding can be utilized if the patient has esophageal varices 5 mm or more and is intolerant to beta-blockers or not deemed appropriate for beta-blocker therapy. If esophageal varices are not found, or if they are <5 mm, then surveillance at 1- to 2-year intervals is indicated until a therapeutic decision is reached.