Habitual drinking of alcohol can damage the liver.
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.
Alcoholic fatty liver often causes no symptoms. The disease may not be found until the person sees a healthcare professional for another medical condition. Symptoms can include an enlarged liver and sometimes tenderness when the liver is touched.
Symptoms from alcoholic hepatitis can range from mild to critical and may include: feverloss of appetiteabdominal distressnausea and vomitingweight lossdiarrheajaundice, or yellowing of the eyes and skin
Alcoholic cirrhosis usually takes at least 10 years or more of excessive drinking to develop. The symptoms develop slowly. The liver shrinks and is scarred, firm, and nodular.
Scarring around the veins in the liver causes blood to find other routes of flow, leading to big, swollen veins in the throat, rectum, abdomen, and chest. These veins can rupture and bleed easily.
Alcoholic cirrhosis usually takes at least 10 years or more of excessive drinking to develop. The symptoms develop slowly. The liver shrinks and is scarred, firm, and nodular. Scarring around the veins in the liver causes blood to find other routes of flow. This leads to big, swollen veins in the throat, rectum, abdomen, and chest. Common symptoms of alcoholic cirrhosis include: weakness and fatigueloss of appetiteweight lossloss of muscle mass and muscle crampsjaundice, or yellowing of the eyes and skinswelling of the legsascites, or swelling of the abdomen from fluid accumulationnausea and vomitingloss of body hair, lowered sex drive, and shrinkage of the testes in menincreased facial hair, a deep voice, and menstrual problems in women
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 nutritionpast liver damage from infectionspossibly, a genetic risk factor
Alcoholic liver disease can be prevented by not drinking alcohol.
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.
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.
Alcoholic liver disease is not contagious.
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.
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.
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.
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.
