Steatotic liver disease

Any level of alcohol use may be harmful to liver health in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).[81]Jarvis H, O'Keefe H, Craig D, et al. Does moderate alcohol consumption accelerate the progression of liver disease in NAFLD? A systematic review and narrative synthesis. BMJ Open. 2022 Jan 4;12(1):e049767. https://www.doi.org/10.1136/bmjopen-2021-049767 http://www.ncbi.nlm.nih.gov/pubmed/34983755?tool=bestpractice.com Patients should be counseled to abstain or keep alcohol intake below the risk threshold.[40]European Association for the Study of the Liver; European Association for the Study of Diabetes; European Association for the Study of Obesity. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402. http://www.journal-of-hepatology.eu/article/S0168-8278(15)00734-5/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27062661?tool=bestpractice.com [66]National Institute for Health and Care Excellence. Non-alcoholic fatty liver disease (NAFLD): assessment and management. Jul 2016 [internet publication]. https://www.nice.org.uk/guidance/ng49 [81]Jarvis H, O'Keefe H, Craig D, et al. Does moderate alcohol consumption accelerate the progression of liver disease in NAFLD? A systematic review and narrative synthesis. BMJ Open. 2022 Jan 4;12(1):e049767. https://www.doi.org/10.1136/bmjopen-2021-049767 http://www.ncbi.nlm.nih.gov/pubmed/34983755?tool=bestpractice.com

Patients should also not exceed 2 g of acetaminophen in a 24-hour period. Patients should be cautious about the use of over-the-counter or herbal medications. Patients with ascites should adhere to a strict 2 g sodium diet. Patients with cirrhosis need to seek urgent medical attention with any suggestion of decompensation, which includes abdominal distension, fevers, chills, confusion, hematemesis, hematochezia, or melena. NIH: nonalcoholic fatty liver disease and NASH Opens in new window