Alcoholic Liver Disease: Signs, Diagnosis & Treatment
Last Updated Dec 2, 2021
Alcoholic liver disease is a spectrum of conditions a person can develop as a result of alcohol abuse.
As a person drinks alcohol, it can damage the liver. After years of abuse, this damage can accumulate enough that a person begins to develop serious or even life-threatening health complications.
What Is Alcoholic Liver Disease?
Alcoholic liver disease refers to a spectrum of diseases that occur due to liver damage as a result of long-term alcohol abuse. This condition is very serious and represents one of the biggest long-term dangers of abusing alcohol.
It is relatively common in people between 40 and 50 years old, with more men developing it than women.
Cause of Alcoholic Liver Disease
As the name implies, alcoholic liver disease is caused by the damage alcohol can do to the liver over time. Eventually, this damage can be significant enough to cause serious and even life-threatening harm to a person’s liver.
The more a person drinks and the longer they have been abusing alcohol, the more likely they are to develop alcoholic liver disease. Because of biological differences, cisgender women may develop alcoholic liver disease with less drinking compared to cisgender men.
Notably, alcoholic liver disease can occur even if a person doesn’t get noticeably drunk on a regular basis. Alcohol can still tax the liver if a person drinks often, even if they avoid binge drinking and similar practices. It also appears that some people may inherit an increased risk of developing alcoholic liver disease.
How Alcohol Damages the Liver
The liver is a key part of how the body processes alcohol. Normally, it can process occasional, moderate amounts of alcohol without significant issue.
However, excessive alcohol consumption can force the cells in a person’s liver to work harder than normal. Over time, this can damage a person’s liver cells, which can cause them to develop health issues.
Consistent alcohol abuse can eventually cause major damage to the liver, which may cause what is called cirrhosis. This is serious liver damage that may eventually require a person to get a liver transplant.
Symptoms of Alcoholic Liver Disease
The early stages of alcohol liver disease don’t always cause significant symptoms, although symptoms often become more pronounced after a period of heavy drinking.
Common early signs of alcohol liver disease include the following:
- Belly pain
- Poor appetite
- Weight loss
- Fatigue or lethargy
- Blood vessels appearing on the skin in a spider-web-like pattern
More advanced liver disease can cause symptoms such as these:
- Edema (fluid buildup in the legs)
- Ascites (fluid buildup in the abdomen)
- Jaundice (yellowing of the eyes, skin, and mucous membranes)
- Redness on the palms
- Shrinking of the testicles
- Breast swelling
- Pale or clay-colored stools
The final stages of alcohol liver disease can cause liver cirrhosis and what is called end-stage liver disease (ESLD). ESLD is characterized by a liver that is so damaged by alcohol that the only option for a patient to survive is generally a liver transplant.
The diagnostic process to detect alcohol liver disease can involve checking for a number of different signs. Generally, a doctor will begin with a physical exam. They will look for some of the more obvious visual signs of alcohol liver disease, such as swelling, jaundice, shrunken testicles, and other visual indicators that a person may have alcohol liver disease.
A doctor can also conduct a number of tests, including a complete blood count (CBC), liver function test, and potentially a liver biopsy. They may also conduct tests that can rule out other potential causes of a person’s symptoms, including performing ultrasounds and an abdominal CT scan.
Treatment of Alcoholic Liver Disease
One of the more important steps in treating alcohol liver disease is changing one’s habits. For the best prognosis, a person will generally need to radically change the amount of alcohol they drink.
If a person needs a liver transplant, they can often only get approved for one after a period of sobriety lasting at least six months. Even if they don’t need a transplant, drinking alcohol at the rate that led them to develop alcohol liver disease will cause their condition to worsen and is likely to eventually become life-threatening.
A doctor may prescribe a number of treatments as appropriate to combat a person’s symptoms, including prescribing diuretics to reduce fluid buildup, vitamin K or blood products for excessive bleeding, medications to help reduce mental confusion, and antibiotics for infections.
If a person develops end-stage liver disease, they may need a liver transplant.
Alcoholic liver disease can result in a broad spectrum of conditions, including these:
- Fatty liver disease
- Alcoholic hepatitis
Patients can also suffer from bleeding complications, infection, mental health complications, fluid buildup, and more, all of which can impact their quality of life and their prognosis.
While a number of serious complications are possible, alcoholic hepatitis and cirrhosis mean a person has caused extensive damage to their liver as a result of alcohol consumption. This can mean the liver will be unable to fully heal and return to its normal function.
Alcoholic liver disease exists on a spectrum, and so does a person’s prognosis if they suffer from it. Caught early and with the right interventions, a person can have a relatively good prognosis.
However, prognosis worsens significantly in people who develop cirrhosis, especially in those who cannot stop drinking. Cirrhosis is most life-threatening to women and the elderly.
Survival rates used to be significantly lower for late-stage alcoholic liver disease before liver transplants were viable. However, the demand for liver transplants exceeds the current supply. It is important that a person stops drinking if they’re to be considered for a transplant.
Regardless of a person’s current condition, changing the way you drink alcohol is critical to a good prognosis. If someone has difficulty stopping drinking on their own, they should seek out evidence-based treatment programs that can help them reduce their dependence on alcohol and overcome their struggles with alcohol abuse.
You can prevent alcoholic liver disease by making sure not to drink in excess and seeking help early if you find you frequently cannot stop drinking even when you know it might be negatively impacting your life. Here are some tips to avoid excessive alcohol consumption:
- Try low-alcohol drinks.
- Avoid binge drinking.
- Set alcohol-free days for yourself.
- Follow alcoholic beverages with multiple non-alcoholic ones.
- Wait after an alcoholic drink before drinking another.
For many people, it helps to avoid situations in which you may be pressured (intentionally or not) to abuse alcohol. Common situations that cause a person to drink more than they should include the following:
- Drinking with others who frequently abuse alcohol
- Drinking in rounds, where people buy a group of friends drinks all at once
- Drinking when feeling negative emotions, such as stress or anxiety
- Going to places where drinking is socially expected, such as bars
Even if you have not yet developed alcoholic liver disease, excessive alcohol consumption can have a negative impact on your health and social relationships. Seek help if you cannot stop abusing alcohol.
Even if you cannot see yourself ever stopping your drinking, evidence-based treatment programs can help you resist alcohol abuse and can greatly improve your chances of overcoming any addiction or other issues with alcohol you may have.
Acute Alcoholic Hepatitis, End Stage Alcoholic Liver Disease and Liver Transplantation: An Italian Position Statement. (October 2014). World Journal of Gastroenterology.
Alcohol and Liver Health. (January 2018). Hepatitis NSW.
Alcoholic Hepatitis. (March 2022). StatPearls.
Alcoholic Liver Disease. (July 2021). MedlinePlus.
The Prognosis and Outcome of Alcoholic Liver Disease. (1994). Alcohol and Alcoholism.
Alcohol Consumption and Risk of Liver Cirrhosis: A Systematic Review and Meta-Analysis. (October 2019). The American Journal of Gastroenterology.
Alcoholic Liver Disease: Pathogenesis and Current Management. (2017). Alcohol Research Current Reviews
Cirrhosis and Its Complications: Evidence Based Treatment. (May 2014). World Journal of Gastroenterology.
Diagnosis of Alcoholic Liver Disease. (September 2014). World Journal of Gastroenterology.
Liver Transplantation and Alcoholic Liver Disease: History, Controversies, and Considerations. (July 2018). World Journal of Gastroenterology.
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