Overview
Alcoholic liver disease or alcohol-related liver disease (ARLD) is a health condition that occurs due to heavy alcohol intake over a long period. It damages the liver while causing scarring, inflammation, and fat accumulation. There are three stages of ARLD based on your symptoms and the severity of the condition.
Regardless of the stage of your ARLD, the first step towards recovery is to stop drinking, followed by lifestyle changes, therapies, medications, and a liver transplant (in case of liver failure).
Associated Anatomy
Liver
Alternate Name of Alcoholic Liver Disease
Alcohol-induced liver disease, Laennec's cirrhosis, alcoholic cirrhosis or hepatitis.
Alcoholic Liver Disease Stages
- Fatty liver: When alcohol consumption is high, fatty acids are deposited in the liver. This condition is reversible, provided you abstain from drinking alcohol. Fatty liver may not cause any symptoms.
- Alcoholic hepatitis: Alcoholic hepatitis is a severe state of alcoholic liver disease. Jaundice, high body temperature, enlarged liver, and high white blood cell count are common symptoms of the condition. Alcoholic hepatitis may cause cirrhosis if you do not stop drinking.
- Liver Fibrosis or Cirrhosis: It is an end-stage liver condition in which your liver develops scar tissue due to chronic alcoholism. It can be life-threatening, and symptoms may include fatigue, loss of appetite, itchy skin, nausea, jaundice, weight loss, drowsiness or fluid in the abdomen.
Alcoholic Liver Disease Causes
Drinking excessive alcohol is the most common cause of chronic liver disease. The more alcohol you consume, your chances of developing the condition increase. Alcohol misuse can lead to ARLD in two forms:
- Binge drinking: Consuming too much alcohol within a short period. It is a leading cause of fatty liver and, rarely, alcoholic hepatitis.
- Uncontrolled drinking: Consuming dangerous levels of alcohol over a prolonged period. It can lead to liver cirrhosis and hepatitis.
Alcoholic Liver Disease Symptoms
In most cases, the symptoms surface after the liver is considerably damaged. In case you do develop any early signs or symptoms, these may include the following:
- Abdominal pain
- Fatigue
- Not feeling well
- Loss of appetite
- Diarrhoea
Once the condition progresses, you may develop the following symptoms:
- Jaundice or yellowing of eyes or skin
- Oedema
- Fluid accumulation in the abdomen
- Hair loss
- Itchiness
- Curved nails and fingertips
- Weight loss
- Muscle weakness
- Insomnia
- Black stool or bloody vomit due to internal bleeding
- Confusion
- Increased sensitivity to various substances, including alcohol
- Frequent bleeding gums or nosebleeds
Alcoholic Liver Disease Diagnosis
Typical tests to diagnose alcoholic liver disease
Your doctor may suggest tests like complete blood count (CBC), coagulation studies, liver function tests, abdominal CT scan, ultrasound, ultrasound elastography, and liver biopsy for diagnosing alcoholic liver disease.
Alcoholic Liver Disease Treatment
The key treatment options include the following:
- Lifestyle changes like quitting alcohol consumption and a low-sodium diet can help you keep your liver disease in check.
- Smoking and being overweight may aggravate your symptoms. So, quit smoking and maintain a healthy weight.
- Your doctor may prescribe diuretics (water pills), vitamin K supplements, antibiotics, corticosteroids, probiotics, and stem cell therapy.
- Some doctors may also recommend cognitive behaviour therapy (CBT) alongside medications to ease your symptoms.
- Other treatments may include endoscopic treatments, paracentesis, and placing a transjugular intrahepatic portosystemic shunt (TIPS).
- Your doctor may suggest a liver transplant if you have an end-stage condition.
Risk Associated with Alcoholic Liver Disease
- Type of alcohol: If you drink liquor or beer, your likelihood of developing this liver disease is higher than those who drink wine.
- Age: If you are between your 40s and 50s are more likely to develop this condition.
- Gender: Men are at an increased risk of developing ARLD than women. However, some women are more vulnerable to this condition. So, despite drinking less than men, they may develop ARLD.
- Heredity: In some cases, heredity plays a crucial role. So, a percentage of people may inherit this condition.
- Overweight: If you are overweight or obese, you are more likely to have alcoholic liver disease.
Possible Complications of Alcoholic Liver Disease
The possible complications of alcoholic liver disease may include the following:
- Portal hypertension
- Varices (Bloody vomitting or blank tools)
- Ascites (Fluid in abdomen)
- Hepatic encephalopathy
- Infection
- Liver cancer
Alcoholic Liver Disease Prevention
Primary prevention for alcoholic liver disease
- Drink in moderation: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has set guidelines to prevent alcoholic liver disease. It means consuming around one and two drinks for women and men, respectively, once they are 21 years old. Here, one drink equals 12 fluid ounces of beer with 5% alcohol content, 5 ounces of wine with 12% alcohol content, and 1.5 ounces of spirits with 40% alcohol content.
- Do not mix alcohol with medications: Read the labels on the medicines carefully.
- Beware of hepatitis: It is a virus-bound infectious liver condition.
Secondary prevention for alcoholic liver disease
After you have quit drinking alcohol, you are likely to need relapse prevention plans. These include the following:
- Psychological therapy: This prevention technique lets you seek help from a therapist and share your feelings and thoughts. It is crucial for your overall well-being.
- Medication: If psychological therapy does not work alone, your doctor may prescribe medicines like disulfiram, acamprosate, and naltrexone.
Expected Prognosis of Alcoholic Liver Disease
Alcoholic liver disease can be treated if diagnosed early (before severe liver damage has occurred). However, if you continue drinking, your lifespan may become short. Liver cirrhosis may aggravate your condition even more and cause life-threatening complications.
Natural Progression of Alcoholic Liver Disease
If you leave alcoholic liver disease untreated, it can lead to scarring of the organ over time. With new scar tissues replacing healthy ones, your liver becomes more damaged with decreased functionality. Moreover, it can also lead to liver failure and cancer.