Page 8 - Seniorstoday October 2022 Issue

necessary.
Drug Induced Liver Injury
The prevalence of drug-induced liver
injury (DILI) in India is not well known.
A recent study found that DILI was
the third most common cause of liver
injury in a tertiary care hospital in North
India. One of the most common causes
of DILI in this study were paracetamol
(acetaminophen). As recently as 2019,
Giloy has been promoted to the public in
India as an immune booster to prevent
novel coronavirus. Recently, although in
small number, it has been reported that
Giloy use can manifest in the development
of herb-induced liver injury (HILI) with
autoimmune features in some patients.
DILI can be caused by a wide variety of
drugs, both prescription and over-the-
counter. The most common symptoms of
DILI are fatigue, nausea, and abdominal
pain. DILI can often be difficult to diagnose,
as it may mimic other liver disorders.
If you suspect that you or a loved one has
DILI, it is important to see a hepatologist
(liver specialist) for proper diagnosis and
treatment. There is no specific treatment
for DILI. The best way to prevent DILI is to
be aware of the signs and symptoms and to
avoid taking multiple medications. If you
must take multiple medications, be sure to
tell your doctor or pharmacist about all of
the medications you are taking.
Alcohol and Liver Disease
Alcohol consumption is one of the
commonest causes of cirrhosis after fatty
liver disease. Almost 20% of all liver
disease patients (irrespective of etiology)
are current alcohol consumers. Thus,
alcohol amounts for a significant part of
the liver disease burden across the world.
Further, a significant proportion of liver-
8
related mortality of unknown etiology may
well be attributable to alcohol as patients
may withhold their history of alcohol
use because of various socio-cultural and
insurance-related issues.
Concomitant significant alcohol intake may
be present in well over 50% of patients with
other liver diseases including Hepatitis
C and NAFLD. It is speculated that the
burden of Alcohol Liver Disease (ALD)-
related mortality is under-estimated by
almost two-fold because of these various
factors. One also needs highlight the fact
that while there are partially evidence-
based limits for “unsafe” daily or weekly
alcohol consumption, there is little evidence
behind any proscribed “safe” limit.
The apparent health benefits of small
quantities of alcohol has been much touted
in the medical and non-medical literature.
But strong evidence to the contrary has
emerged from the Global Burden of
Diseases, Injuries, and Risk Factors Study
(GBD). There are no safe limits for alcohol
as the estimated beneficial effects on cardiac
disease strongly off-set other health hazards
particularly cancer. This notion of “no safe
limit of alcohol consumption” has been