Alcohol-Related Liver Disease: Symptoms and Treatment
Author: Thomas Roth
Last Updated: 3/07/2022
Alcohol-Related Liver Disease is most generally known as acute inflammation of the liver. There are three stages of Alcohol-Related Liver Disease widely accepted by doctors and scientists, ranging from the more mild fatty liver, to the extremely serious, and sometimes fatal, cirrhosis of the liver.
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What Is Alcohol-Related Liver Disease?
Alcohol-Related Liver Disease is a wider term to describe a few expressions of severe liver inflammation due to consuming copious amounts of alcohol. The three forms which Alcohol-Related Liver Disease takes, in order of severity, are fatty liver, Hepatitis C of the liver, which is acute inflammation, and cirrhosis of the liver, which is when abusive alcohol use destroys the cells of the liver leaving scar tissue rather than healthy cells. This damage cannot be reversed.
When it comes to Alcohol-Related Liver Disease, a lifestyle filled with heavy drinking is always the main cause. While it is true that some people may be more predisposed than others to Alcohol-Related Liver Diseases, the reality is that both scientists and medical professionals have not yet agreed upon a particular reason why some heavy drinkers might develop more serious liver diseases than others. While there might be a genetic component to this variance, the generally accepted major cause of Alcohol-Related Liver Disease is heavy alcohol consumption over an extended period of time.
Due to the fact that heavy drinking is the main cause of Alcohol-Related Liver Disease, the best treatment is prevention. Abstaining from alcohol use will allow the liver to heal, or at least not debilitate further, in almost all cases. The liver is the alcohol disposal system of the body, and each drink a person has places a modicum of pressure on the liver’s ability to process efficiently and effectively. Inflammation does occur with continued alcohol abuse, damaging the cells of the liver, and leading to the symptoms which arrive with Alcohol-Related Liver Disease. Like most diseases of the organs, these symptoms do not just affect the performance and health of the liver, but the entire body as well.
How Much Alcohol Will Damage Your Liver?
Alcohol is damaging to the liver no matter how much a person consumes. This is because alcohol is inherently inflammatory and inflames the cells of the liver when it is consumed. However, assuming that a person is an adult and does not have outstanding health complications pertaining to the liver or other organs that are connected to digestion, small amounts of alcohol, used moderately, are rarely known to cause any Alcohol-Related Liver Diseases.
That being said, overconsumption of alcohol, especially over a period of months or years, will lead to severe inflammation of the liver, the destruction of liver cells, and irreversible damage. Drinking several drinks every day, binge drinking nightly, incorporating drugs that damage the liver with drinking, these are all habits that, if not stopped, can cause serious damage to the liver in the form of Alcohol-Related Liver Diseases.
What Are The Types of Alcohol-Related Liver Disease?
There are three forms that Alcohol-Related Liver Diseases may take. They range in severity, as well as ease of prevention and methods of treatment.
1. Alcoholic Cirrhosis
The most life threatening and severe of the Alcohol-Related Liver Diseases is alcoholic cirrhosis. Cirrhosis is the destruction of cell tissue. In this case, the damage is caused by heavy alcohol consumption over a long period of time without any measures of prevention of treatment. When cirrhosis occurs, healthy cells are damaged to the point of becoming scar tissue, replacing the liver tissue, which is functional, with non-functional dead cells. A series of severe symptoms can occur due to alcoholic cirrhosis of the liver including liver cancer, kidney failure, intestinal bleeding, ascites (the buildup of fluid in the belly), portal hypertension, and an enlarged spleen. There is no definitive treatment for alcoholic cirrhosis apart from a liver treatment. Ceasing the consumption of alcohol is required to avoid more serious complications including death.
2. Acute Alcoholic Hepatitis
Alcoholic Hepatitis is also inflammation of the liver which is caused by excessive drinking, but differs from cirrhosis in several key aspects. Foremost, alcoholic hepatitis, while irreversible, takes place before the cells of the liver die and become scar tissue. Albeit not as dangerous as cirrhosis, hepatitis of the liver is still very debilitating. It occurs when inflammation of the liver becomes too serious to reverse, and the most common symptom is jaundice, which is the yellowing of the skin and the whites of the eyes. Malnutrition is also very common in people who suffer from alcoholic hepatitis because the consumption of alcohol generally required to damage the liver as much as a liver diseased with hepatitis C is most commonly found in a body of an individual who acquires alcohol as most of their calories, ignoring the nutrients found in a more complete diet. It is important to see a doctor as soon as symptoms of hepatitis of the liver occur, as medications such as corticosteroids and pentoxifylline have been seen to have short-term benefits as antiinflammatories. While already damaging to the liver, alcoholic hepatitis can become even more harmful if complications arise. These include kidney failure, varices (enlarged veins) and ascites (enlarged arteries) as well as slurred speech, confusion, and drowsiness, which may cause physical damage and life threatening mistakes.
3. Alcoholic Fatty Liver Disease
Alcoholic Fatty Liver Disease occurs when there is an abnormal buildup of fat in the liver due to overconsumption of alcohol over an extended period of time. While the severity of alcoholic fatty liver disease depends upon how much fat has built up, doctors do consider a fatty liver caused by drinking a sign that alcohol consumption must be ceased. Alcoholic fatty liver disease might result in an enlarged liver, which may cause pain or discomfort, and sometimes tiredness, but usually a fatty liver does not come with a host of symptoms. People who are more likely to develop Alcoholic Fatty Liver Disease tend to be those who are obese, malnourshed, and older. The treatment for Alcoholic Fatty Liver Disease is to abstain from drinking alcohol entirely, focus on healthy nutrition, get consistent exercise, and most importantly, not resume drinking. If Alcoholic Fatty Liver Disease is not too serious, then the effects of the fatty liver may reverse, leaving the individual with a healthier liver one more. However, this is only possible with total abstinence from alcohol.
What Causes Alcoholic Liver Disease?
Most crucially, Alcoholic Liver Disease is caused by abusive consumption of alcohol over a long period of time. The more time a person consumes excessive alcohol, the greater the risk of the serious complications that arise from Alcoholic Liver Disease. Generally, the most severe cases of Alcoholic Liver Disease occur in individuals who have been consistently drinking a minimum of six drinks of alcohol per day for ten years. While not a particularly precise measurement, the reality is that the causes of Alcoholic Liver Disease, albeit drinking, may differ from one case to the next. Due to the fact that medical professionals and scientists have not been able to pinpoint exactly which demographics are more susceptible than others, the people who should be most concerned about contracting an Alcoholic Liver Disease are those who have engaged in a lifestyle where heavy drinking on a daily and/or weekly basis is a regular occurrence.
What Are the Risk Factors For Alcohol Related Liver Disease?
The largest and most relevant risk factor for Alcohol Related Liver Disease is the amount of alcohol a person consumes. If the individual has a history of drinking the equivalent of 3.5 ounces of alcohol a day, then they are absolutely in the danger area for Alcohol Related Liver Disease. Additionally, while the science is not concrete, many medical professionals and scientists contend that Blacks and Hispanics may be at a greater risk than other races when it comes to developing an Alcohol Related Liver Disease, as well as women, as women are known to process alcohol in different, potentially less effective ways than men. Obesity is also a well known risk factor, as being obese already places an undue amount of pressure on the body’s organs. When an obese person regularly engages in heavy drinking over a long period of time, their chances of developing an Alcohol Related Liver Disease skyrocket.
What Are the Signs and Symptoms of Alcoholic Related Liver Disease?
The first stage of Alcoholic Related Liver Disease is a fatty liver. A person with a fatty liver may not have symptoms right away that are easy to detect. However, there are some signs that a person has a fatty liver, which include nausea, confusion, extreme drowsiness, abdominal pain or a full feeling in the region of the abdomen where the liver is (the upper right side of the belly), nausea, and jaundice. However, jaundice (yellowing of the skin and whites of the eyes), is also a determiner for the next stage of Alcoholic Related Liver Disease, Hepatitis C, or hepatitis of the liver. Hepatitis of the liver is also known to cause such symptoms as bleeding easily, bruising easily, abdominal fluid build up known as ascites, and dark-colored urine. While these signs are also indications of liver cirrhosis, the last stage of Alcohol Related Liver Disease, gastrointestinal bleeding is a late stage symptom, along with destruction of the liver cells as they turn into scar tissue.
What Are The Complications of Alcoholic Related Liver Disease?
There are a series of extremely serious complications which can develop with a person who is suffering from Alcoholic Related Liver Disease. Logically, the most severe complications arise when a person is suffering with cirrhosis of the liver due to alcohol. Most generally, a compromised liver can result in a suppressed immune system, which has the potential of leading to a whole series of health complications which may not be directly tied to the malfunction or unealth of the liver itself.
When a dangerous level of blood pressure rises in the liver, doctors diagnose individuals with portal hypertension. Portal hypertension happens when a severely scarred liver has trouble passing blood through it. Pressure builds as blood struggles to move comfortably through the liver, which places excessive pressure on the blood flow through the other organs of the body. For this reason, blood cannot pass to the heart as quickly as it does when traveling through the liver, and so the body is forced to use smaller blood vessels. These blood cells, not designed to carry so much blood, become weakened and stretched, and are called varices. This can cause long term bleeding, which is known as anaemia, as well as vomiting blood and passing dark stool that can look like tar. Ascites are also an effect of portal hypertension, when an abnormal amount of fluid builds up in the abdomen causing discomfort as well as the potential for even worse complications such as infection of this fluid (spontaneous bacterial peritonitis) which can lead to kidney failure and even death.
Hepatic encephalopathy occurs when the liver is incapable of removing toxins as per its normal function because it is an unhealthy liver due to the impact of alcohol related liver disease. Hepatic encephalopathy happens when a high level of toxins are found in the blood. Symptoms of hepatic encephalopathy are very serious, and they include such ailments as agitation, confusion, muscle tremors and/or stiffness, disorientation, difficulty speaking, and, most drastically, a coma.
How Do Doctors Diagnose Alcohol Related Liver Disease?
Alcohol-related liver diseases can sometimes be tricky to diagnose due to the fact that some symptoms may be confused as signs of other illnesses. When it comes to early stage Alcohol Related Liver Disease, abdominal pain may not be contributed to fatty liver. Jaundice, because it is exhibited externally, rather than internally, like so many of the other symptoms of Alcoholic Related Liver Disease, is one of the primary indicators that a person has developed fatty liver, hepatitis C, or even liver cirrhosis, although when it comes to liver cirrhosis, edema and easy bleeding are more clear indications of Alcohol Related Liver Disease.
Most importantly, doctors diagnose Alcohol Related Liver Disease based upon the amount that an individual drinks. When someone has a long term history of alcohol abuse, along with other symptoms of Alcohol Related Liver Disease like those outlined above, then it is far more logical to determine that the symptoms are because of drinking alcohol. Further examination is conducted via liver function tests, which can find out how well the liver is working, as well as a liver biopsy, which involves a removal of small tissue samples from the liver, usually by performing surgery. After checking with a microscope, a doctor can usually determine what stage of liver disease a person exhibiting symptoms has developed.
How To Treat Alcohol Related Liver Disease?
1. Alcoholic Rehabilitation Programs
After diagnosis of an alcohol related liver disease, the most important treatment for alcohol related liver diseases is abstinence from drinking. To achieve total sobriety, many people who have developed a dependency on alcohol place themselves in alcoholic rehabilitation programs. Working with other alcoholics and sponsors can result in tremendous benefits for a person who has a drinking problem. Hundreds of thousands of people have described positive experiences with a variety of alcoholic rehabilitation programs, and it is possible to find the right program, if the person is open to making a positive change in their life. Rehabilitation has been known to result in total abstinence for the duration of a person’s life, which can seriously aid in the prevention, and even reversal, of alcoholic related liver diseases.
2. Vitamin A Supplements
Medical professionals have studied livers that are diseased from heavy drinking of alcohol and learned that vitamin A levels in the liver are harshly reduced when a liver becomes alcoholic. Due to the fact that vitamin A is reduced by drinking heavy amounts of alcohol, incorporating vitamin A supplements into the diet, while also abstaining from drinking, can be a helpful tool in restoring the proper balance of vitamins in the liver and helping the organ overcome the damage done to it by a lifestyle of heavy drinking. Vitamin A supplements can be found over the counter, but should be taken along with a variety of other supplements, as it is important to create a balance in the system, rather than overload the body.
Similarly to vitamin A, multivitamins can be crucial in restoring homeostasis to the liver and other organs. Due to the fact that overconsumption of alcohol over a long period time causes so much inflammation to the organs and damage to the blood, upsetting the natural pH of the body, and also because alcoholics tend to derive most of their calories from drinking alcohol, which possesses very little complex nutritional value, it is essential for a person recovering from Alcoholic Related Liver Disease to restore their body’s nutrition by incorporating a multivitamin into their diet. Alongside multivitamins, a well rounded diet of lean protein, whole grains, vegetables, and fruit, as well as probiotic foods and/or supplements, can be very helpful in upgrading a person’s nutrition and aiding their organs in the healing process.
4). Liver Transplant
A liver transplant is seen as the most extreme course of action when treating an individual who is suffering from an acute alcohol related liver disease such as cirrhosis of the liver. Liver transplants are almost exclusively conducted when at least half of the patient’s liver is completely compromised by scar tissue and is incapable of working well enough to keep them alive. If a liver transplant is agreed upon by patient and physician, then surgeons must act quickly to find a suitable donor, remove the sick liver, and transplant it with a healthy liver. While a costly and invasive measure, liver transplants can be very successful. However, doctors are sometimes skeptical to harvest a healthy liver and transplant it into the body of an alcoholic for fear that, with a new liver to poison, their patient’s addiction to alcohol will bring them back to drinking without the consequences of a liver that was damaged by cirrhosis. For this reason, the best treatment for any alcohol related liver disease is rehabilitation from drinking and total abstinence for the duration of an individual’s life. If a person is able to truly overcome their reliance on alcohol, then they will see positive change.
How Long To Abstain From Alcohol To Repair The Liver?
To repair the liver, abstaining from alcohol is the most important step a person can take. The amount of time a person should abstain is dependent upon the severity of the alcohol related liver disease. For fatty liver of the less severe variety, the majority of guidelines iterated by experts dictate that thirty days should be enough time for the liver to return to normal function. That being said, this metric takes into consideration no other serious medical complications and a healthy diet. The liver does have the power to regenerate and shed inflammation, if given the proper time necessary to do so, without continued damage, but that does not mean anyone should be testing the limits of their body by binge drinking and then abstaining over and over again, creating a vicious cycle. When it comes to more severe cases of alcohol related liver disease, abstaining from alcohol for the rest of the person’s life is the only method of treatment worth attempting if positive results are to be attained. This is down mostly in part to the fact that more severe cases of alcohol related liver disease leave the liver too damaged to recover in full, meaning that continued alcohol use at any point has the potential to quickly debilitate the liver and return it to its previous damaged state.
How Long Does It Take For Your Liver To Recover From Alcohol?
If the alcohol related liver disease is not particularly severe, then a period of thirty days is considered a general timeline for the liver’s regeneration. Additionally, over years, the liver will regenerate if no more inflammatory substances like alcohol or hard drugs, or even certain medicines, are used over prolonged periods of time. The liver will only cease to recover from alcohol if it falls into a state of cirrhosis, during which the cells are no longer simply inflamed, but completely dead. At this point they become scar tissue, which does not regenerate.
What are the Other Liver Diseases similar to Alcoholic Liver Disease?
There are other liver diseases similar to alcoholic liver disease that are not caused by heavy drinking but still do impact the health and function of the liver. Hepatitis A and B are both diseases caused by the Herpes-Simplex Virus which affect the liver primarily. Liver cancer, which is not always caused by drinking, but can have a variety of causes, is very damaging to the liver, as are inherited diseases, such as Wilson’s disease, a rare illness which causes people to develop an irregular amount of copper in the liver, as well as hemochromatosis, which occurs when the liver absorbs too much iron from food a person consumes, leaving the liver susceptible to liver disease, diabetes, and heart problems.