Dr Nancy Reau Covers Alcohol Use Disorder Interventions to Prevent Alcoholic Hepatitis


As patients come into clinic and receive appropriate follow-up, we can hopefully find ways to mitigate the increase in alcoholic hepatitis, said Nancy Reau, MD, section chief of hepatology at Rush University Medical Center.

While it's hard to determine whether the increase in alcohol use disorder and alcoholic hepatitis (AH) will be reduced, Nancy Reau, MD, section chief of hepatology at Rush University Medical Center, hopes interventions can prevent the trend from continuing upward.


Are there any interventions to prevent a continued upward trend of AH?

When we're talking about alcohol use disorder, it's really challenging to limit something that's legal, right? No one wants to look at prohibition, no one is going to have Big Brother or some state entity come in and say “you cannot drink anymore.” So, I don't know that the increase in alcohol use disorder and [AH] is going to go down, but I do hope that it probably won't go up.

Part of that is around awareness. There are some campaigns around healthy drinking. It's hard to not see something come through Medscape or some of our patient forums where it does talk about healthy lifestyle and the importance of limiting alcohol use to something that the CDC would consider safe. There are conditions that lead to alcohol-related use disorder, so depression feeds into this, loneliness, isolation. With the pandemic being a little more controlled, I think people are now more able to feel connected to their community, and when you're connected to your community, your friends might notice that you're doing something that's unhealthy and encourage you to go and link to your physician.

A lot of our substance abuse services also got disrupted during the pandemic, and those are now being reestablished. Now, for instance, I saw a patient today who had not returned to her addiction management and had relapsed problematic alcohol [use] and knew she could go back but just still hadn't established with that service. I encouraged her, “Please call, pinky promise me. We want to get a hold of this. We don't want you to get sick. Right now, you're feeling relatively well, but it's really important to manage the alcohol use so that you don't end up ill.”

I think that as patients come into clinic, as they have appropriate follow-up arranged after they're hospitalized, we're going to hopefully find ways to mitigate the increase in [AH] and these hospitalizations.

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