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Alcoholic Liver Disease

Alternate Names

  • alcoholic fatty liver
  • alcoholic hepatitis
  • alcoholic cirrhosis
  • Cirrhosis of the liver
  • Bleeding esophageal varices (varicose veins)

Definition

Habitual drinking of alcohol can damage the liver.

What is going on in the body?

Alcoholic fatty liver is found in most heavy drinkers. It is the most common liver problem in people with alcohol dependence. The liver is enlarged, firm, and yellowish. The liver cells are swollen with fat that fat comes from the diet and the body's fat cells. Alcoholic fatty liver is reversible if a person stops drinking alcohol.
Alcoholic hepatitis is the middle step between fatty liver and alcoholic cirrhosis. The liver is still enlarged, firm, and yellowish but now inflammatory cells are present and some liver cells have died.
Alcoholic cirrhosis is the end stage of the disease. If drinking is not stopped, more liver cells die. Scarring occurs throughout the liver. With continued scarring, the liver shrinks, becomes firm, and is no longer able to function properly. Cirrhosis is permanent, even if a person stops drinking. In extreme cases, complete liver failure occurs, resulting in death.

Risks

What are the causes and risks of the disease?

The longer the drinking goes on and the larger the amounts of alcohol used, the greater the risk of developing hepatitis and cirrhosis. About 10% to 15% of alcoholics develop cirrhosis. Alcoholic women are at risk for developing liver disease from lesser amounts of alcohol than men. Additional risk factors include:
  • poor nutrition
  • past liver damage from infections
  • possibly, a genetic risk factor

Prevention

What can be done to prevent the disease?

Alcoholic liver disease can be prevented by not drinking alcohol.

Diagnosed

How is the disease diagnosed?

The history of alcohol dependence, symptoms, and physical exam may be all that is required to make the diagnosis. Blood tests, X-rays, and a liver biopsy may be needed in some cases. In a liver biopsy, a small slice of liver tissue is removed with a special needle and examined in the laboratory.

Long Term Effects

What are the long-term effects of the disease?

The only long-term effect of alcoholic fatty liver is that it may progress to hepatitis or cirrhosis if drinking continues. Alcoholic hepatitis and cirrhosis can lead to death from liver failure. Infection, kidney failure known as chronic renal failure, and bleeding are other common causes of death in cirrhosis. Liver damage also leads to malnutrition, weakness, and jaundice.

Other Risks

What are the risks to others?

Alcoholic liver disease is not contagious.

Treatments

What are the treatments for the disease?

In all forms of alcoholic liver disease, the person needs to stop drinking alcohol. Alcoholics Anonymous or other support groups are often a part of successful treatment for alcoholism. Other treatments will not work if the person keeps drinking.
Most other treatments depend on the symptoms and amount of liver damage. An appropriate diet for liver disease includes a daily multivitamin and adequate protein. Medications, blood transfusions, or surgery may be needed in cases of severe hepatitis or cirrhosis.

Side Effects

What are the side effects of the treatments?

When an alcoholic stops drinking, severe alcohol withdrawal symptoms may occur. This may require a person to be admitted to the hospital. Seizures and even death can sometimes occur.
Each medication has its own series of side effects, among which allergic reactions and stomach upset are two of the more common. Blood transfusions can cause allergic reactions and infections. Surgery can be complicated by bleeding, infection, and allergic reaction to anesthesia.

After Treatment

What happens after treatment for the disease?

If drinking stops, fatty liver and hepatitis are usually reversible. Cirrhosis is not reversible but may stabilize. With advanced alcoholic cirrhosis, people usually die from liver failure even if they do stop drinking. If cirrhosis develops, lifelong treatment is required.

Monitor

How is the disease monitored?

Alcoholic liver disease is monitored through periodic visits to the healthcare professional and by liver function tests. Any new or worsening symptoms should be reported to the healthcare professional.

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