Alcoholic liver disease: Symptoms, treatment, and causes

Alcoholic liver disease is a result of overconsuming alcohol that damages the liver, leading to a buildup of fats, inflammation, and scarring. It can be fatal.

The condition is a primary cause of chronic liver disease in Western nations.

The liver is one of the most complex organs in the human body, with over 500 functions. These include filtering out blood toxins, storing energy, making hormones and proteins, and regulating cholesterol and blood sugar.

Liver damage can affect the whole body. Once damage begins, it can take a long time to become noticeable, as the liver is generally highly effective at regenerating and repairing itself. Often, by the time the damage is found, it is irreversible.

According to the Centers for Disease Control and Prevention (CDC), in 2014 the number of deaths from alcoholic liver disease in the United States was 19,388, while all causes of chronic liver disease and cirrhosis are estimated to lead to 12 fatalities per 100,000 people per year.

In 2015, in the United States, nearly 20 percent of all liver transplants occurred as a result of alcoholic liver disease, making it the third most common reason for transplant behind chronic hepatitis C and liver cancer.

Fast facts on alcoholic liver disease

Alcoholic liver disease is the main cause of chronic liver disease in Western nations and the third most common cause of liver transplants.

Abstaining from drinking alcohol is the only way a person has a chance of recovery.

Jaundice and tremors are symptoms of alcoholic liver disease.

Treatment options include medication, lifestyle changes, and surgery.

The recommended daily limits are no more than one drink a day for women and no more than two drinks a day for men.

Early signs

Diseased liver
A diseased liver becomes noticeable by causing a range of vague symptoms.

The early signs of alcoholic liver disease are vague and affect a range of systems in the body.

Along with a general feeling of being unwell, signs can include:

pain in the abdomen

nausea and vomiting

diarrhea

decreased appetite

It can be easy to dismiss the early symptoms as the effects of a stomach bug or general malaise. However, leaving these symptoms undiagnosed and untreated, especially while continuing to consume alcohol, can lead to a faster progression of liver disease over time.

Symptoms

Once alcoholic liver disease progresses, its symptoms become easier to recognize.

The more distinctive signs of later-stage liver disease include the following:

jaundice, or a yellow tint of the whites of the eyes and the skin

edema, or swelling of the lower limbs

a buildup of fluid in the abdomen, known as ascites

fever and shivering

extremely itchy skin

fingernails that curve excessively, known as clubbing

losing a significant amount of weight

general weakness and wasting muscles

blood in vomit and stools

bleeding and bruising more easily

more sensitive reactions to alcohol and drugs

Once symptoms are noticeable, the condition has reached an advanced stage, and visiting a doctor is a crucial next step.

Man saying no to alcohol
Abstaining from alcohol is one of the only ways to make alcoholic liver disease reversible.

This can help to reverse some early stages of liver disease. For example, stopping drinking once diagnosed with fatty liver disease may be able to reverse the condition within 2 to 6 weeks.

Once a person is diagnosed with alcoholic liver disease at any stage, it is recommended to never resume drinking. Any conditions that have reversed will typically return once drinking restarts.

As alcohol dependency can make it more difficult to quit drinking alcohol, it is necessary to gradually reduce alcohol intake.

Those who regularly drink more than the recommended daily limits of alcohol should not stop drinking without medical support. Withdrawal from alcohol can be life-threatening. Individuals should seek help from a medical professional to safely manage alcohol withdrawal.

The recommended daily limits are more than one drink a day for women and more than two drinks a day for men.

Cognitive behavioral therapy (CBT) and medications called benzodiazepines can be used to ease withdrawal symptoms in a person with alcohol dependency. People with severe alcohol dependency may stay at an inpatient rehabilitation facility for closer monitoring.

Ongoing therapy may then be required to prevent a relapse into drinking alcohol. Medications such as acamprosate, naltrexone, topiramate, baclofen, and disulfiram can also be used to help prevent relapse.

Lifestyle changes

Weight loss and quitting smoking might also be recommended since being overweight and smoking have both demonstrated a role in making alcoholic liver disease worse. Taking a daily multivitamin is usually recommended as well.

Here is a page for purchasing a range of daily multivitamins. This will take you to an external site.

Medications

Corticosteroids or pentoxifylline may be used for reducing inflammation in people with acute alcoholic hepatitis while they are being treated in a hospital.

Other medications that show potential for treatment and are currently being studied include:

probiotics and antibiotics

stem cell therapy

medicines that target the inflammation pathway

Liver transplant

In people with liver failure, the liver completely ceases to function. This can be an outcome of advanced-stage liver disease and often means that a liver transplant is the only option for prolonged survival.

Typically, only people who can show at least six months of abstinence from alcohol before the procedure and those with other organ systems that are healthy enough to undergo surgery will be considered for transplant.

Liver transplant is a complicated procedure that depends on a donor being available. Anti-rejection medications given after transplant can increase the risk of serious infections and certain cancers.

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