Diagnosis, follow-up and treatment of alcoholic and autoimmune liver diseases and biliary diseases

Alcohol is one of the main causes of chronic liver disease. Sometimes the consumption of alcohol is underestimated and the effect of this is underestimated by patients.  For this reason, sometimes only after taking a careful medical history does alcohol emerge as a possible ‘toxin' capable of justifying the liver damage observed in a particular patient.

Patients with alcoholic liver diseaseare mainly monitored on an outpatient basis, on the one hand evaluating the need for referral at an alcological centre dedicated to the cessation pathway, and on the other by characterising the pathology on the clinical level to identify and distinguish cases of non-evolved disease (alcoholic hepatitis or alcoholic hepatic steatosis) from those of alcoholic cirrhosis. In this way, patients can be directed towards individualised follow-up programmes.

Within the Clinical Medicine and Hepatology Unit, we also monitor patients affected by autoimmune diseases of the liver and biliary tract: autoimmune hepatitisprimary biliary cholangitis, primitive sclerosing cholangitis. The correct diagnostic classification of the patient suffering from autoimmune hepatitis or cholangiopathy is the result of the simultaneous use of different diagnostic tools by expert personnel and is fundamental for the purposes of a correct therapeutic management.

Patients suffering from autoimmune disease are studied in outpatient settings with complete blood tests (in particular, autoantibodies with a complete panel of all antigenic subclasses), possibly  subjected to liver biopsy  on a day-hospital basis to define the aetiology and stage of the disease, and finally sent for treatment, where the cornerstone is represented by  immunosuppressive therapy  and the use of  ursodeoxycholic acid (UDCA) or more innovative drugs.