Reliable Screening Test?
Screening for liver damage due to alcohol, some medicines, or other toxins may be difficult. Though acute liver failure is obvious as in mushroom poisoning or Tylenol overdose, often presenting with severe jaundice and nausea. But chronic liver damage may be more insidious. Elevations in liver enzymes tested for in routine lab work may be due to a variety of reasons such as obesity, mild viral illness, or some medicines.
But if you are worried that you drink too much alcohol and your liver enzymes are elevated, that’s a reliable sign that you are indeed causing real harm to your liver. Liver enzymes rise when they spill from dead or dying liver cells (hepatocytes). If the liver enzymes known as ALT, AST, and GGT are twice normal, it would be advisable to stop drinking for a month and avoid Tylenol completely.
Then check them again, if they normalize, it stands to reason you need to curtail your drinking habits or abstain completely. Isolated elevations of GGT are often associated with binge drinking.
A complete blood count (CBC) can reveal evidence of long-term excessive use of alcohol. Enlarged red blood cells are a symptom of vitamin B-12 and/or folate deficiency. Often the empty calories provided by alcohol combined with alcohol induced inflammation of the gut conspire to deplete nutrients.
In fact some of the most disturbing manifestations of excessive alcohol consumption, so-called “wet brain” or Wernike Korsakoff syndrome are due to nutritional deficiency of B vitamins. In “wet brains” a specific part of the brain degenerates (mamillary bodies) and the sufferer is permanently impaired. These folks can speak but they may make no sense at all.
If you find yourself having symptoms of nausea or stomach pain, an Amylase and Lipase level will rule out pancreatitis. If those levels are elevated, it would be wise to stop drinking and see your physician. Pancreatitis can be fatal and chronic pancreatitis is difficult to live with. If those are normal, an H.pylori test may point towards a treatable stomach ulcer.
Screening for chronic cirrhosis (liver fibrosis) can be difficult. Liver damage due to long-term excessive alcohol consumption (alcoholic cirrhosis) can be a fatal condition. I’ve had patients with alcoholic liver cirrhosis and let me say, it is something you want to avoid. But screening tests for cirrhosis may be misleading because if the liver is already damaged extensively, liver function tests may not be elevated.
In this case easy bruising or prolonged coagulation tests (PT, PTT) may point towards liver damage. Ultrasound examination of the liver is now performed prior to liver biopsy, which is the gold standard for diagnosis of alcoholic liver disease.
Direct access laboratory testing can help an individual concerned about his or her long-term health avoid some of the most dire manifestations of alcohol abuse. Though many lab tests are not entirely specific for alcohol use, you yourself know what your habits are and with the help of a health professional, may be encouraged to make changes in your habits and lifestyle to prevent serious consequences and maintain excellent health.
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