Alcoholic Liver Disease
The term alcoholic liver disease is a blanket term that refers to one of three categories of liver diseases that are caused by alcohol consumption. The three categories are: fatty liver, cirrhosis and alcoholic hepatitis.
- Fatty liver develops as a result of acute alcohol consumption and in most instances can be reversed if further alcohol consumption is avoided.
- Cirrhosis is more severe than fatty liver, and occurs as a result of excess alcohol consumption, and can lead to liver failure.
- Alcoholic hepatitis is caused by excess alcohol consumption over a prolonged period of time. It causes damage to the liver that can range from moderate to life threatening. This severe form of alcoholic liver disease can lead to liver failure and can be fatal.
The symptoms of alcoholic liver disease depend upon the category of liver disease. General symptoms of alcoholic liver disease may include:
- Abdominal tenderness
- Pain in the abdomen
- Dry mouth
- Increased thirst
- Decreased appetite
- Weight loss
- Changes in skin color
- Redness of the hands or feet
- Spider-like blood vessels on the skin
- Vomiting blood
- Mood swings
- Memory loss
- Numbness or tingling in arms and legs
Specific symptoms of alcoholic liver disease depend on which of the three categories of liver disease are present. Possible symptoms based on the type of liver disease present include:
- Fatty liver is usually asymptomatic. When symptoms are present, they are generally mild or non-specific. Upon a physical examination, doctors may find that the liver is enlarged and smooth, but it is not usually painful to the touch.
- Individuals can develop symptoms of cirrhosis even in the absence of fatty liver. Cirrhosis can be diagnosed in conjunction with alcoholic hepatitis. Possible symptoms include jaundice, abnormal blood tests that indicate thrombocytopenia or hypoalbuminemia, variceal bleeding or hepatic encephalopathy.
- Alcoholic hepatitis symptoms can range from mild to severe. Non-specific symptoms such as anorexia, weight loss, nausea, vomiting and abdominal pain may be present. More severe symptoms that are specific to the condition may also be present, such as encephalopathy, jaundice, fever, spider angioma and hepatic failure.
Alcohol is metabolized in the liver. When alcohol is not consumed in moderation, liver damage can occur. There is a somewhat genetic component to alcoholic liver disease in terms of a predilection to alcohol abuse. For more information, read What Alcohol Does To Your Liver.
The risk of alcoholic liver disease is higher for individuals who consume excess amounts of alcohol on a regular basis. The risk increases as the quantity and duration of excess alcohol intake rises. Not all individuals who consume excessive amounts of alcohol will develop alcoholic liver disease. Moderate drinking also increases the risk for fatty liver, which has been identified in up to 40 percent of moderate drinkers. Daily consumption of more than 60 grams of alcohol for men and 20 grams of alcohol for women leads to a significant rise in alcoholic liver disease risk. Sporadic binge drinking appears to be less harmful and less of a risk than steady daily alcohol consumption, but should still be considered a health risk, nonetheless.
The specific tests that are needed to diagnose alcoholic liver disease depend on the category of the disease. Possible diagnostic tests include:
- Fatty liver is usually diagnosed after patient history, physical examination and laboratory tests that reveal abnormal liver function. An ultrasound may be able to detect a hyperechoic liver. There is no other diagnostic test for identifying fatty liver.
- Alcoholic hepatitis is diagnosed after a complete patient history, physical examination and abnormal laboratory tests such as anemia, leukocytosis and abnormal liver function. A liver biopsy may be necessary to confirm the diagnosis.
- Cirrhosis is diagnosed after identifying the classic signs and symptoms of end-stage liver disease in an individual who identifies as consuming excessive amounts of alcohol. A liver biopsy may be required to rule out other conditions and confirm the diagnosis.
Treatment options for alcoholic liver disease also depend on the specific type. Fatty liver will generally improve if alcohol consumption ends. For cirrhosis, treatment includes prevention and management of possible complications, such as variceal bleeding, encephalopathy and malnutrition. In severe cases, a liver transplant may be needed. Alcoholic hepatitis is treated the same as cirrhosis, however, most transplant centers require all patients to abstain from alcohol consumption for a minimum of 6 months in order to qualify for a liver transplant.
The number one treatment option for any type of alcoholic liver disease is refraining from consuming alcohol in order to promote healing of the liver. Corticosteroids are also receiving a lot of attention as an effective form of treatment for alcoholic hepatitis. Vitamins may be needed to treat malnutrition and an alcohol rehabilitation program or therapy sessions may be necessary to help break an addiction to alcohol.
The most important at-home remedy for alcoholic liver disease is to stop drinking alcohol. Other measures include improving the diet to ensure adequate nutrition and prevent or treat malnutrition. A nutritionist can help develop a nutritional program that includes proper foods and supplements if necessary to help balance the diet.
Refraining from consuming excessive amounts of alcohol is the number one way to reduce the risk of developing alcoholic liver disease. Because the condition can occur with only moderate alcohol intake, abstinence or occasional drinking is recommended as an effective prevention method.
Complications from alcoholic liver disease can include:
- Bleeding in the esophagus
- Non-alcoholic cirrhosis
- Hepatic encephalopathy
- Increased pressure in liver blood vessels
Continuing to consume alcoholic drinks after being diagnosed with alcoholic liver disease can lead to a worsening of the condition, additional complications, liver failure and even death. Support groups can be an effective way of managing stress related to alcoholic liver disease and seeking encouragement with cutting out alcohol consumption. Keep in mind, the liver is capable of repairing itself. However, this is only possible up to a certain extent of damage (see: Can Liver Damage From Alcohol Be Reversed?).