64-Year-Old Man Diagnosed With Alcohol-Related Liver Fibrosis Shares 20-Year Drinking History
Summary: A 64-year-old male with a documented 20-year history of heavy alcohol consumption recently experienced significant health deterioration, including poor appetite, diarrhea, hand tremors, and palpitations. Liver function tests revealed abnormalities, and a liver stiffness measurement of 39.7kPa, along with an abdominal ultrasound, confirmed a diagnosis of alcohol-related liver fibrosis. Following a 26-day inpatient treatment plan that included a combination of medication and alcohol cessation, the patient showed marked improvement. His liver function normalized, ascites resolved, and sleep quality improved.
Key Information:
- Age: 64
- Condition: Alcohol-Induced Liver Fibrosis
- Hospital: 988 Hospital of the PLA Joint Logistic Support Force
- Treatment Duration: 26 days inpatient care with a 3-month follow-up period
- Treatment Plan: Combination drug therapy (including magnesium isoglycyrrhizinate injection, polyene phosphatidylcholine capsules, tiopronin tablets, silybin capsules, and Anluo Huaxian Pills), loperamide for diarrhea, and complete abstinence from alcohol
- Outcome: Liver enzymes normalized, ascites resolved, and liver stiffness decreased from 39.7kPa to 18.9kPa after three months
Initial Consultation and Symptoms:
Upon first meeting the patient, it was immediately noticeable that he had a strong odor of alcohol. He had not eaten properly for over a week and relied heavily on alcohol consumption to cope. He also experienced frequent diarrhea, hand tremors, and palpitations. Laboratory tests revealed abnormal liver function, and a FibroScan showed a liver stiffness value of 39.7kPa—well above normal. An abdominal ultrasound confirmed cirrhosis, gallbladder wall thickening, and ascites. Based on his extensive alcohol use, he was diagnosed with alcohol-related liver fibrosis.
Course of Treatment:
On the day of admission, the patient was relatively stable. However, by the second day, withdrawal symptoms became apparent—tremors worsened, and he became agitated and anxious during intravenous therapy. To manage these symptoms, sedatives were administered, and his dose of magnesium isoglycyrrhizinate was increased. Additional medications, including polyene phosphatidylcholine, tiopronin, silybin, and Anluo Huaxian Pills, were introduced to support liver function. Loperamide was prescribed to manage diarrhea and protect the gastrointestinal lining. Family members were advised that in cases of severe withdrawal, a small amount of alcohol might be temporarily reintroduced to ease symptoms, although the ultimate goal remained full abstinence. With this comprehensive approach, the patient gradually stabilized, and his liver function tests improved.
Progress and Recovery:
After 26 days of hospitalization, the patient experienced a significant turnaround. He transitioned from a state of physical dependence and withdrawal to one of improved mental clarity, better appetite, weight gain, and normalized bowel movements. His ascites resolved, and his sleep improved dramatically. Liver enzyme levels, including ALT, AST, ALP, and GGT, all returned to normal ranges. At a three-month follow-up, his liver stiffness measurement dropped to 18.9kPa, indicating meaningful improvement.
Recommendations for Long-Term Recovery:
While the patient made impressive strides during treatment, long-term success depends on sustained lifestyle changes and continued medical monitoring. Key recommendations include:
- Complete abstinence from alcohol and tobacco, as both have harmful effects on multiple organ systems.
- Adherence to prescribed medications and regular follow-up tests, including liver and kidney function panels, abdominal ultrasounds, and fibrosis assessments.
- Adoption of a nutrient-rich diet high in protein, vitamins, and calories while avoiding spicy, raw, or hard-to-digest foods.
- Development of strong mental resilience and avoidance of environments that encourage drinking.
- Engagement in social and recreational activities that promote well-being and reduce emotional reliance on alcohol.
Reflection on Alcohol-Related Liver Disease:
While many are aware that excessive alcohol consumption can harm the liver, fewer understand the full scope of its impact. Chronic alcohol use not only leads to fatty liver and hepatitis but can progress to irreversible fibrosis and cirrhosis. Moreover, alcohol abuse can damage the heart, brain, kidneys, and gastrointestinal system. For those with alcohol-related liver disease, the most effective intervention remains complete abstinence, supported by medical treatment. Once liver function decompensates, recovery becomes significantly more difficult, underscoring the importance of early intervention and lifestyle change.