Most with liver disease ‘are not alcoholics’

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“Habitual” drinkers, not alcoholics, account for most people with alcohol-related liver disease.

From the Irish Examiner

Wednesday, April 24, 2013

Experts are particularly concerned at the rise in the number of young people ”” up almost three-fold ”” and women with the potentially fatal disease.

One of the leading authorities said mortality rates were “probably a serious under-estimate” because of a culture of denial among families affected.

The Royal College of Physicians in Ireland (RCPI) yesterday issued a paper detailing the extent of the problem.

It is urging the Government to introduce minimum pricing for alcohol, restrictions on availability, and an end to sports sponsorship.

“We have all seen it in our practice, an increased number patients admitted to hospital, young people in particular and increasingly women, with complications, illness and death due to alcohol,” said Prof Frank Murray, the college chairman.

He said a lot of patients were not dependent, but were “habitual” drinkers, whose level and frequency of consumption was higher than recommended.

Prof Aiden McCormack of the specialist liver unit in St James’s Hospital, said he had seen “dramatic inc-reases” in the past decade.

“A lot of people think that’s for alcoholics, the binge drinkers ”” it doesn’t affect me or my family. In fact, it affects everybody.”

He said he recently had a case of a widow who increased her wine drinking after she lost her husband and developed liver disease.

“She would be appalled to be labelled an alcoholic. It’s very easy for consumption levels to come up and become normalised. It’s ordinary people that are doing it.”

He said relatives often ring him asking can he remove alcohol from the death certificate, an issue he has raised with the coroner.

“Alcohol is denied in a major way in this country and I think official figures are probably a serious under-estimate,” he said.

Prof McCormack said liver disease was “relatively silent” until a person developed a major problem, like vomiting “two litres of blood” on the street or waking up looking yellow.

Dr Steven Stewart of the centre for liver disease at the Mater Hospital said he was seeing patients in their 30s and 40s dying.

He raised concern at the widespread availability of cheap alcohol and highstrength cider.

He said most patients were not dependent: “The classic [comment] in out-patients is ’I couldn’t have alcoholic liver disease because I have never missed a day at work’ or ’everybody in the pub drinks twice as much as I do’.”

Prof Joe Barry of Trinity College Dublin joined the others in expressing concern at wine consumption levels among many ordinary drinkers, particularly women.

He said the recommended average for men was 17 standard drinks a week and 11 for women.

One bottle of wine contains between eight and 11 standard drinks.

*See the full paper at

Liver legacy

*Alcoholic liver disease mortality rate trebled from 2.6 per 100,000 in 1995 to 7.5 in 2009 (up 188%).

*There were 27,816 discharges with alcohol liver disease diagnosis from 1995 to 2009.

*Rate of alcohol liver disease rose 200% in that period.

*Biggest rise was in 15-34 year-olds (up 275%); then 15-49 year-olds (up 227%).

*Source: Health Research Board