ILOs

• Understand that the majority of alcohol-specific deaths are due to Alcohol-related liver disease (ArLD)
• Recognise ArLD is a major cause of ill-health and hospital admission
• Describe how Public Health measures can impact ArLD
• Explain how Alcohol is oxidatively metabolised by three mechanisms (ADH, MEOS and catalase)
• Understand that Alcohol liver injury is mediated by the products (acetaldehyde and acetate) and by-products of this metabolism (reactive oxygen species and NADH)
• Understand that increased intestinal permeability leads to Kupffer cell activation and production of TNF which triggers apoptosis/pyroptosis, necrosis and fibrosis
• Explain how chronic injury leads to steatosis, steatohepatitis and cirrhosis
• Recognise that screening for ArLD in high-risk patients is feasible
• Understand that ArLD may present with features of liver decompensation: ascites, encephalopathy, variceal bleeding
• Recognise that Alcoholic hepatitis is a specific manifestation of ArLD with a high short-term mortality.

Part 1 - The Scale of the Problem

• What is an alcohol specific death?
• What are alcohol attributable deaths?
• How much alcohol affects health?
• A graph showing estimated years of life lost if you drink >12.5 units/week
• But wait, what’s a unit of alcohol?
• Look at the problem here...!
• Data showing the burden of alcoholic disease in Glasgow