Podcasts

Alcoholic Liver Disease – A Growing Epidemic

In this episode, Dr. Steven Flamm, from Rush University Medical Center, and Dr. Mack Mitchell, from UT Southwestern, explore the evolving landscape of alcohol-associated liver disease (ALD), a condition seeing rising prevalence in the United States. They discuss the intersection of alcohol use with metabolic dysfunction (MetALD), the under recognized role of alcohol in liver disease progression, and the importance of comprehensive lifestyle assessment—including alcohol intake screening with tools like the PEth test. The conversation covers treatment options for alcohol use disorder (AUD), including pharmacologic therapies like naltrexone and acamprosate, and emphasizes the urgent need for a multidisciplinary approach before and after liver transplant.

The episode also highlights new developments in managing severe alcohol-associated hepatitis, including the potential role of larsucosterol and emerging therapeutics like IL-22-based agents. Drs. Flamm and Mitchell address the growing trend and controversy of liver transplantation in patients with acute alcoholic hepatitis without a 6-month sobriety requirement, stressing the importance of long-term addiction support and integrated care models to optimize outcomes. A must-watch for hepatologists, gastroenterologists, addiction medicine providers, and transplant specialists working on the frontlines of liver disease care.