Diagnosis

• n/a

Investigation

• Physical Examination: signs of liver disease
• Exclude other sources of liver disease: LFTs
• Quantify: FBC for MCV (macrocytic); GGT
• Liver Biopsy to confirm hepatitis
• Imagining: CT pancreas

Management

Acute

• Withdrawal: Benzo (Chlordiazepoxide)
• Delerium Tremens: Lorazepam (quick acting)
• Wernicke’s: Thiamine B1 (Pabrinex IV)

Conservative

• Councilling (alcoholics Anonymous), but social grouping may lead to drinking
• Cognitive Behavioural Therapy relapse prevent
• Motivational interviewing

Medical

• Disulfiram (Antabuse), blocks acetaldehyde
• Naltrexone: remove reinforcing action
• Acamprocate: reduce desire

Surgical

• Liver tx: if decomp CLD

NICE Source: CG115 Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. Summary compiled by Dr D P Sheppard MBBS.