Man in His 50s Diagnosed with Alcoholic Liver Disease After Developing Jaundice and Dark Urine

A 57-year-old male patient with no prior history of hepatitis or medication use was diagnosed with alcoholic liver disease after presenting symptoms of jaundice, dark urine, abdominal distension, and poor appetite. Laboratory tests showed elevated bilirubin and gamma-glutamyl transferase (GGT) levels, indicating liver damage. After receiving targeted treatment and committing to complete abstinence from alcohol, the patient's condition significantly improved.

Initial Consultation and Diagnosis

The patient first visited the clinic complaining of sudden onset jaundice, dark urine, and abdominal discomfort over the past five days. He also reported a significant decrease in appetite. Blood tests revealed a total bilirubin level of 231.3 µmol/L, direct bilirubin of 146.1 µmol/L, albumin at 27.2 g/L, globulin at 37 g/L, and a markedly elevated GGT level of 446 U/L. Viral hepatitis screening was negative for both hepatitis B surface antigen and hepatitis C antibodies. Upon reviewing his medical history, it was revealed that the patient had no chronic liver disease but was a long-term heavy alcohol user. Based on the clinical presentation and lab results, including reversed albumin-globulin ratio, a diagnosis of alcoholic liver disease was made.

Medical Intervention and Recovery Plan

Given the patient's history of chronic alcohol consumption and recent deterioration in liver function, treatment focused on liver protection and inflammation control. He was administered intravenous magnesium isoglycyrrhizinate to reduce liver inflammation, polyene phosphatidylcholine to stabilize liver cell membranes, and ademetionine to address cholestasis. Crucially, he was advised to stop alcohol consumption immediately, as abstinence is the most critical step in managing alcoholic liver disease.

Positive Outcomes Following Treatment

After three weeks of hospitalization and continued outpatient follow-up, the patient's jaundice and dark urine resolved, and his appetite returned to normal. Follow-up liver function tests showed a significant decrease in bilirubin levels and normalization of albumin. His overall physical and mental health improved, and he was advised to return for a follow-up visit one month after discharge.

Post-Treatment Care and Lifestyle Adjustments

Despite the positive response to treatment, ongoing outpatient monitoring was recommended for one month. The patient was strongly advised to maintain complete alcohol abstinence and adopt a diet rich in calories, protein, and low in fat, along with vitamin supplementation. If cirrhosis develops, further antifibrotic therapy may be required. Regular monitoring of liver function and abdominal ultrasound every three months was also recommended to detect any progression of liver disease.

Insights on Alcoholic Liver Disease

Alcoholic liver disease often begins with fatty liver changes and can progress to alcoholic hepatitis or cirrhosis if alcohol consumption continues. However, early diagnosis and strict abstinence from alcohol can halt or even reverse liver damage. Along with quitting alcohol, nutritional support and appropriate use of hepatoprotective drugs are essential components of effective management. It is crucial for individuals with a history of heavy drinking to understand the risks associated with alcohol consumption and take proactive steps to protect their liver health.