Heavy drinkers should get early screening for liver disease, says Nice

Heavy drinkers should be screened for early signs of liver disease, health officials have said.

Harmful drinkers – women who drink more than 35 units a week and men who drink more than 50 – should also be sent for scans to detect liver scarring, the National Institute for Health and Care Excellence (Nice) said.

A bottle of wine is estimated to contain 10 units of alcohol and a pint of beer is estimated to contain 2.3 units. Across England there are estimated to be 1.9 million “harmful drinkers”.

In a bid to identify early liver problems among these people, Nice said GPs should refer them for scans to detect liver cirrhosis, or scarring.

In its new draft quality standard, the health regulator said diagnosing cirrhosis would ensure patients received the treatment and support needed to manage their condition.

The document, which is out for consultation until February, also says people with cirrhosis should be sent for ultrasounds twice a year to check for liver cancer.

Dr Andrew Fowell, consultant hepatologist at Portsmouth hospitals NHS trust who helped draft the document, said: “Identifying people who are at risk of liver disease and offering them non-invasive testing to diagnose cirrhosis is key to ensuring they are given the treatment and support they need early enough to prevent serious complications.

“Ten years ago diagnosis of cirrhosis would often require a liver biopsy, but now with advances in non-invasive testing, it is much easier for patients and health professionals to make a diagnosis.”

Prof Gillian Leng, deputy chief executive of Nice, said: “Many people with liver disease do not show symptoms until it is too late. If it is tackled at an early stage, simple lifestyle changes or treatments can be enough for the liver to recover.

“Early diagnosis is vital, as is action to both prevent and halt the damage that drinking too much alcohol can do.”

Liver disease is the fifth largest cause of death in England and Wales.

Heavy drinkers should get early screening for liver disease, says Nice

Light drinkers could nonetheless be raising threat of heart condition

The research authors, who reviewed more than 50 studies into the consuming habits and cardiovascular health of more than 260,000 people, say this suggests that lowering alcohol intake even for people who do not drink much, could even now have wellness positive aspects.

This challenges the outcomes of earlier research which suggested light to moderate consuming, of 6 to 12 glass of wine a week, could have a protective effect on cardiovascular wellbeing.

Juan Casas, review writer and professor of epidemiology at the London College of Hygiene &amp Tropical Medication, said: “While the damaging effects of hefty alcohol consumption on the heart are nicely-established, for the final few decades we’ve typically heard reports of the possible well being positive aspects of light-to-moderate consuming.

“However, we now have evidence that some of these studies endure from limitations that may possibly impact the validity of their findings.

“In our research, we noticed a website link amongst a decreased consumption of alcohol and improved cardiovascular overall health, regardless of whether the personal was a light, reasonable or heavy drinker.

“Assuming the association is causal, it seems that even if you’re a light drinker, lowering your alcohol consumption could be helpful for your heart.”

The researchers employed a gene that serves as an indicator of alcohol consumption.

People that carry a genetic variant of the ‘alcohol dehydrogenase 1B’ gene are identified to breakdown alcohol at a diverse pace.

This triggers unpleasant signs and symptoms such as nausea and facial flushing, and has been located to lead to lower levels of alcohol consumption in the prolonged phrase.

Making use of the genetic variant as an indicator of decrease alcohol consumption, they were in a position to discover backlinks amongst these folks and improved cardiovascular well being.

Scientific studies into the prolonged-phrase well being effects of alcohol can be demanding, due to the difficulty of setting up trials involving several people who will sustain the very same alcohol consumption ranges in excess of an extended time period of time.

The researchers say that their study’s genetic approach makes it much less prone to some of the limitations of prior observational research.

Dr Shannon Amoils, senior research advisor at the British Heart Basis, stated: “Scientific studies into alcohol consumption are fraught with problems in component because they depend on people providing precise accounts of their drinking routines.

“Here the researchers employed a clever review design to get round this difficulty by which includes individuals who had a gene that predisposes them to drink significantly less.

“The outcomes reinforce the see that small to reasonable quantities of alcohol may not be wholesome for the heart despite the fact that the research would require to be repeated in a more substantial group of people for definitive benefits.

“Whilst the heart health effects of light to reasonable alcohol consumption are still unclear, what is clear is that drinking more than the recommended limits of alcohol can have a damaging effect on the heart.”

Light drinkers could nonetheless be raising threat of heart condition

Supermarket personnel abused for refusing to promote to underage drinkers report

Supermarket employees ‘face physical and verbal abuse from customers refused an alcohol sale’, the report says. Photograph: Frank Augstein/AP

Supermarket checkout workers who refuse to promote alcohol to underage buyers are becoming subjected to verbal abuse and violent physical assault, whilst “proxy getting” by close friends and even dad and mom is on the enhance, a new report on underage drinking has warned.

The information comes from a main analysis of the 1st eight years of the so-known as Challenge 25 scheme – a retail-led approach to inspire men and women among 18 and 25 who want to acquire alcohol to carry ID.

The research also suggests that consuming amid young individuals is falling overall. It identified that the amount of youthful people drinking in the preceding week – a essential measure – had fallen by 18% because Challenge 25 was introduced, even though total alcohol consumption between 16-24 yr olds slumped by 24%.

Despite the fall in underage drinking, it identified worrying new trends” past retailers’ manage, which may possibly be contributing in direction of “pre-loading”: youngsters drinking heavily at residence prior to hitting nightclubs in towns and City centres, fuelling anti-social behaviour.

Challenge 25, which is administered by the Retail of Alcohol Standards Group, was launched in 2006 and requires anybody above the age of 18, who seems to be underneath 25, to produce an acceptable type of ID when acquiring wine, beer and spirits from a supermarket or participating retailer. The voluntary scheme was launched to tackle the alarmingly high fee of illegal underage purchases and has now been adopted by all main Uk supermarkets, they have also invested heavily in advertising it.

Around 11 million folks have been challenged to supply proof of their age as a result of Challenge 25, like 75% of 18–24 year olds. But the report also highlights some of the continuing issues that merchants face in relation to underage income, including “frontline workers facing verbal and bodily abuse from consumers refused an alcohol sale, and the expanding dilemma with proxy getting”.

To deal with these problems, the report suggests that participants function a lot more closely with the police and other stakeholders to tackle “the significant issue of assaults on frontline staff and get in touch with on the government to create a new aggregated offence of assaulting shop employees”. It says more function is essential to curb proxy buying, including far better alcohol education and regional partnership working.

Miles Beale, chief executive of the Wine and Spirit Trade Association, stated: “Tackling underage income of alcohol is a essential priority for the industry and this report demonstrates great progress is currently being manufactured thanks to Challenge 25. Nevertheless, as alcohol has become increasingly hard for youthful men and women to buy immediately, there has been a worrying boost in proxy purchasing. More requirements to be done in partnership with government, schools and other individuals to tackle this developing dilemma as it is an problem that retailers are unable to tackle on their own.”

Overall health groups expressed their concern. Emily Robinson, deputy chief executive of Alcohol Concern, mentioned: “It really is encouraging to see the amount of young people drinking has fallen, but worrying trends nevertheless continue to be and they need to be tackled. Mothers and fathers frequently think that by purchasing their kids alcohol to drink at property, they are introducing them to wise drinking, or preventing them from drinking outdoors the house. In reality, the evidence demonstrates that the ideal issue parents can do is to give kids an alcohol-totally free childhood.”

Supermarket personnel abused for refusing to promote to underage drinkers report

Binge drinkers should pay for hospital beds

Last autumn, a poll of one,000 men and women located that a lot more than 7 out of ten people think that individuals who check out A&ampE while drunk or beneath the influence of recreational drugs need to pay out for the remedy they obtain.

Mrs Manning explained Britain’s ageing population and elevated pressures on hospital providers and GPs, meant that it was not possible to keep meeting growing demand without obtaining added financial sources.

The think tank chief executive also stated ministers need to also think about introducing nationwide insurance for pensioners in purchase to raise NHS funding.

For the duration of the debate at the NHS Confederation yearly conference in Liverpool, Nick Timmins, senior fellow at the King’s Fund, disagreed, saying that the sums which could be brought in from costs linked to alcohol difficulties have been “trivial sums of money” which would make small distinction.

Fellow speakers also criticised the notion of forcing expenses on NHS patients who may possibly effectively be alcoholics.

Final night, the charity Alcohol Concern stated it was opposed to the notion. Emily Robinson, deputy chief executive, stated: “To deal with the genuine situation right here, we need to get to the source of the issue, this kind of as the sale of cheap alcohol. In order to tackle the escalating value alcohol misuse is leading to the NHS, we need to have the Government to introduce proof-primarily based policies, this kind of as minimum unit pricing, which we know will perform.

“Each A&ampE ought to also have an alcohol liaison professional offered to provide assistance and tips to individuals attending hospital since of alcohol-relevant problems.

“We do not feel that alcohol need to be singled out as an issue when our NHS is totally free at the level of use for everybody.”

Binge drinkers should pay for hospital beds

Heavy drinkers to be deemed for NHS liver transplants

About a fifth of liver transplants already involve sufferers whose condition is linked to their drinking, which includes the late footballer George Very best. Photograph: Kieran Doherty/Reuters

People with a extreme drink-associated liver disease are to be considered for transplant for the 1st time, reopening the debate in excess of regardless of whether individuals who are considered to deliver ill well being on themselves deserve pricey therapy.

The determination by the NHS’s blood and transplant service (NHSBT) comes at a time when there is a national shortage of suitable organs, and amid concerns that donors would be reluctant to assistance schemes of this nature.

Well being officials concede they are acutely mindful of the sensitivities surrounding their selection, but argue that a pilot scheme is worthwhile. “We transplant humans, not angels,” NHSBT’s associate health care director James Neuberger advised the Guardian.

The new scheme concerns people with significant alcohol linked hepatitis (SAAH) who have been excluded from consideration due to the fact the prognosis was so poor. There is occasionally not enough time to judge the prospects of them giving up alcohol and they frequently suffer infection and bleeding as properly as getting deep jaundice and psychological confusion.

The sufferers the doctors are hunting to deal with in the pilot scheme have to be fairly young – between 18 and forty – seeing a physician for the first time with liver disease, and getting diagnosed with a drink dilemma for the 1st time.

There has been some concern amongst transplant specialists above the number of candidates they could have to assess, which includes for publish-transplant abstinence, and the influence on other individuals awaiting transplants.

Study suggesting that this kind of individuals may escape a speedy death via this kind of intervention persuaded the NHS to set up a trial involve 20 sufferers who may get up to two many years to recruit – a modest proportion of people with the disease.

Alcohol use was a “very complex and emotive region”, stated Neuberger. “We need to retain public self-assurance that organs donated are utilized properly. That trust has to be earned it can be misplaced very speedily. We have to operate difficult to ensure we are honest and that organs are utilised in the correct way.”

The move comes amid mounting concern above rises in deaths from alcohol-relevant liver disease. The Workplace for National Statistics unveiled in February that in England and Wales these had gone up from three,269 in 2002 to 4,265 in 2012, a rise of 18%. The most significant enhance – a third – was seen in men and women more than 60. Liver condition of all varieties is going up steadily, the only major ailment class in which premature mortality is growing in Britain whilst falling elsewhere in Europe, a trend that will mean steeply enhanced demand for replacement organs.

Already about a fifth of liver transplants involve patients whose liver situation has been linked to their consuming, such as the late footballer George Ideal.

The most current rethink was prompted by a study by a French and Belgian staff published in the New England Journal of Medication in November 2011 which reported encouraging outcomes amid SAAH individuals. It discovered early transplantation worked in some targeted sufferers, with 6-month survival prices of 77% amid 26 who had transplantation in contrast with 23% amongst patients who did not.

The transplant support normally lists people for transplant if they are expected to have a much more-than-50% opportunity of getting alive with a excellent high quality of lifestyle right after five many years. Its recommendations for those with drink-linked condition say prospective recipients must abstain from alcohol prior to transplant, and be required to continue to be abstinent for the rest of their lives.

Andrew Langford, chief executive of the British Liver Trust, said some people explained they would not donate organs because of the George Ideal situation or desired to be certain the organ would go to an individual who would seem following it.

Instead of seeking at the cause of a potential recipient’s condition, “we should be hunting at what their healthcare demands are and not be judgmental”, Langford said. Most liver condition was caused “a single way or one more” by personal selections.

“The vast vast majority of folks who have transplanted organs do search soon after them and lead a far healthier life,” he said.

Heavy drinkers to be deemed for NHS liver transplants

The best ten drinkers in art

In this ironic masterpiece, the Spanish painter whose career took him from portraying the street life of 17th-century Seville to painting the king in Madrid and the pope in Rome edgily juxtaposes myth and reality, high art and low life. Like a modern conceptual photographic artwork (except done in magnificent oil paints), it imagines that the ancient god Bacchus has come to earth in early-modern Spain. Instead of the satyrs and maenads who follow him in the old stories, Bacchus is surrounded by scruffy boozers. The myth of wine as cultural aspiration meets the reality of drink as an escape from poverty.

In this strangely hypnotic video, Gilbert and George sit and drink from a bottle of gin to the strains of romantic classical music. Elgar woozes as they booze. They get progressively drunker, their movements visibly clumsier. A brilliant early use of video to record action in real-time, this is a haunting work of art that shows two men in search of ecstasy and oblivion.

Degas’s In a Cafe (or Absinthe) (1873). Photograph: AP

The green fairy, absinthe, is truly a demon drink in this acidic portrait of life in bohemian Paris almost 150 years ago. Degas homes in on the misery of a woman contemplating her pale green poison as she sits isolated at a cafe table. It’s an acute observation of a changing world: alone in the city and cut off from the rural, communal bonds that had until so recently shaped European life, she pauses for thought before plunging into a drunken numbness.

In his deliberately shocking photographs of Russians living on the edge of society, Mikhailov chronicles the underside of one of the world’s most famously drink-friendly cultures. Robbed – in the artist’s eyes – of the predictability and protection of communist life, these people who were adults when the USSR ended have descended into a real-life hell awash with vodka.

In ancient myth, Silenus is the fat, drunken old friend of the wine god Bacchus. In this majestic baroque painting, he is so drunk he can’t stand up straight. As satyrs gladly support his weight, his massive body slumps in a rollicking landscape of sweat, wrinkles and abandon. He is utterly happy in his humiliation, at one with nature itself as he partakes of the grape, lost in visions of the divine that come to him in his drunken state.

Michelangelo’s Bacchus, 1496-1497. Photograph: Arte & Immagini srl/Arte & Immagini srl/CORBIS

In ancient mythology (and most Renaissance art) Bacchus is a mighty god, uncannily in control as he gets mortals drunk. Young Michelangelo Buonarroti saw it differently. He saw everything seriously, saw life as infinitely grave. The Bacchus he carved in his early 20s in Rome is an image of terrifying madness. He is a drunk, and a scary one. His eyes are shockingly vacant, his head awkardly angled as he starts to lose control. This is the most profound and far-reaching image of intoxication ever created by an artist.

Jan Steen portrays himself as one of the crass male boozers bullying a waitress in this scene from 17th-century drinking life. Where Velázquez used mythology to reveal reality, Dutch painters in Steen’s time were happy to dwell in an everyday world unredeemed by classical allusions. So this is probably the kind of thing that really went on in pubs in the 1600s. Jan Steen, by the way, is the idiot lifting the woman’s skirt.

Red-figure Cup, attributed to the Brygos Painter (c490-480BC). Photograph: The Trustees of the British Museum

Drinking parties were central to male upper-class society in classical Athens. The social life of this pioneering democracy – where philosophy, drama and art reached the heights – was lubricated by strong wine. This painted cup shows a symposium (a drinking party) where a wealthy young man reclines, huge drinking cup at his side, to watch a dancer. It may look like pure indulgence, but according to Plato the conversation at such a drinking party could get serious: his dialogue The Symposium records a deep debate at a drunken get-together.

The British artist who collaborates with her subjects to create dramas of real life photographed Theresa and Seamus as part of a project on London street drinkers. She was interested, she said, in people freed from their inhibitions: “Alcohol is an obvious tool in freeing inhibition. It takes away a lot of rational thought, leaving us much more physical and emotional …” It’s the same boozed-up freedom from reason that baroque painters once found in the myth of Silenus. Are Theresa and Seamus modern Silenuses, showing the wisdom of the drinker?

Titian’s Bacchanal of the Andrians (1523-1526). Photograph: Alamy

Drunkenness has never looked as beautiful as it does in Titian’s painting of a wine-fuelled party in the open air. These drinkers conduct their antics with a magical grace. The dancers do not fall over. The wine jug balanced on a man’s hand does not go flying. Wine has freed everyone from inhibition and made them amorous. In vino veritas. These drinkers do not yell at each other, vomit or pass out. Instead they all seem to be falling in love. One woman lies in a naked ecstasy as wine unleashes her passion.

The best ten drinkers in art

Sweet and sour information for Britain"s drinkers

If all the recent scare stories about sugar in foods drove you to drink, it turns out that it wasn’t always the very best location to go. Research performed for The Sunday Telegraph reveals that a single pint of cider contains as a lot sugar as the Globe Health Organisation recommends ought to be an individual’s day-to-day restrict. Scrumpy, it appears, is very best averted if you are on a diet program. Worryingly substantial quantities of the sweet stuff have been also discovered in Baileys Irish Cream and sherry, although, admittedly, those are drinks that have a tendency to be constrained to a single glass: rarely does anybody commit a evening in the cells for public disruption triggered by binge-consuming sherry.

And there is some good news. Our examine discovered substantially lower quantities of sugar in beer, wine and – very best of all – champagne. In fact, Aseem Malhotra, a cardiologist and science director of the campaign group Action on Sugar, tells us that “a moderate volume of red wine, which is comparatively low in sugar, might in fact protect towards cardiovascular disease”. He adds: “And this is my drink of selection.” So if you are concerned about your weight and nevertheless fancy a tipple, red wine is a very good selection. Rumour has it, the Prime Minister is a large fan, as well, and is considered to “chillax” on a Sunday afternoon with three or four glasses. Bottoms up, Mr Cameron!

Sweet and sour information for Britain"s drinkers

Wellness charities inspire drinkers to abstain from alcohol in January

Drinkers are currently being encouraged to have a sponsored alcohol-free January soon after the festive season. Photograph: Terry Waller/ Terry Waller/Demotix/Corbis

As get together-goers prepare to nurse their new year hangovers, health charities are urging people to consider staying off alcohol for the rest of the month.

Alcohol Concern and Cancer Research Uk are operating fundraising campaigns in which participants are sponsored for abstaining from drink all through January.

Alcohol Concern’s Dry January 2014 encourages people to avoid alcohol for 31 days and aims to “get folks talking and pondering about their drinking”.

Folks who consider component could “drop bodyweight, really feel far better, save income and make a big difference”, the charity stated.

A spokeswoman said thousands have previously signed up to the challenge.

She explained the campaign is aimed at social drinkers whose alcohol consumption could have “crept up on them”.

Emily Robinson, director of campaigns at Alcohol Concern, mentioned: “A lot of of us believe the way we drink isn’t a difficulty, but even obtaining just a few beers after work or a number of glasses of wine at residence also frequently can take you in excess of secure limits and shop up difficulties for the potential.

“We’re challenging individuals to consider component in Dry January and consider providing up booze for 31 days, and if it sounds like a large request you’re precisely the person we want to join us and have a go.

“It really is not about in no way drinking once again, it’s just the perfect opportunity for all of us to consider a breather and get pondering about our drinking.”

She additional: “We feel individuals will feel greater, sleep greater, conserve cash and they might also lose excess weight.

Cancer Investigation UK’s campaign, Dryathlon, is encouraging participants to turn out to be “dryathletes” by staying off booze for 31 days although obtaining sponsorship from close friends and family members members.

The 2013 Dryathlon campaign saw 35,000 dryathletes increase much more than £4m for the charity.

Anthony Newman, director of marketing and advertising at Cancer Investigation Uk, explained: “We know offering up alcohol and taking element in Dryathlon will genuinely test some people’s willpower, but we also know it’s something lots of people already do effectively.

“So, regardless of whether you are presently planning to give up alcohol for January or hunting to consider on an further challenge in the new year, why not signal up to Dryathlon and swap your lager for a latte, protected in the expertise that the income you raise will be helping us to beat cancer sooner.”

Wellness charities inspire drinkers to abstain from alcohol in January