Alcoholic liver diseases
Alcohol-related liver disease (ARLD) refers to liver damage caused by excess
alcohol intake. There are several stages of severity and a range of associated
symptoms.
ARLD doesn't usually cause any symptoms until the liver has been severely
damaged. When this happens,
Symptoms can include:
feeling sick
weight loss
loss of appetite
yellowing of the eyes and skin (jaundice)
swelling in the ankles and tummy
confusion or drowsiness
vomiting blood or passing blood in your stools
Stages of ALD:
There are three main stages of ARLD, although there's often an overlap between
each stage. These stages are explained below.
Alcoholic fatty liver disease:
Drinking a large amount of alcohol, even for just a few days, can lead to a
build-up of fats in the liver. This is called alcoholic fatty liver disease, and is the
first stage of ARLD.
Fatty liver disease rarely causes any symptoms, but it's an important warning
sign that you're drinking at a harmful level.
Fatty liver disease is reversible. If you stop drinking alcohol for two weeks,
your liver should return to normal.
Alcoholic hepatitis:
Alcoholic hepatitis – which is unrelated to infectious hepatitis – is a potentially
serious condition that can be caused by alcohol misuse over a longer period.
When this develops, it may be the first time a person is aware they're damaging
their liver through alcohol.
Less commonly, alcoholic hepatitis can occur if you drink a large amount of
alcohol in a short period of time (binge drinking).
The liver damage associated with mild alcoholic hepatitis is usually reversible if
you stop drinking permanently.
Severe alcoholic hepatitis, however, is a serious and life-threatening illness.
Many people die from the condition each year in the UK, and some people only
find out they have liver damage when their condition reaches this stage.
Cirrhosis:
Cirrhosis is a stage of ARLD where the liver has become significantly
scarred. Even at this stage, there may not be any obvious symptoms.
It's generally not reversible, but stopping drinking alcohol immediately can
prevent further damage and significantly increase your life expectancy.
A person who has alcohol-related cirrhosis and doesn't stop drinking has a less
than 50% chance of living for at least five more years.
How ARLD is treated:
There's currently no specific medical treatment for ARLD. The main treatment
is to stop drinking, preferably for the rest of your life. This reduces the risk
of further damage to your liver and gives it the best chance of recovering.
If a person is dependent on alcohol, stopping drinking can be very difficult.
However, support, advice and medical treatment may be available through local
alcohol support services.
A liver transplant may be required in severe cases where the liver has stopped
functioning and doesn't improve when you stop drinking alcohol.
You'll only be considered for a liver transplant if you've developed
complications of cirrhosis, despite having stopped drinking. All liver transplant
units require a person to not drink alcohol while awaiting the transplant, and for
the rest of their life.
Complications:
Death rates linked to ARLD have risen considerably over the last few decades.
Alcohol is now one of the most common causes of death in the UK, along
with smoking and high blood pressure.
Life-threatening complications of ARLD include:
internal (variceal) bleeding
build-up of toxins in the brain (encephalopathy)
fluid accumulation in the abdomen (ascites) with associated kidney
failure
liver cancer
Read more about the complications of ARLD.
Preventing ARLD
The most effective way to prevent ARLD is to stop drinking alcohol or stick to
the recommended limits:
men and women are advised not to regularly drink more than 14 units a
week
spread your drinking over three days or more if you drink as much as 14
units a week
Quantity of alcohol taken: Consumption of 60–80g per day (about 75–100 mL/day) for 20 years or
more in men, or 20g/day (about 25 mL/day) for women significantly increases the risk of hepatitis
and fibrosis by 7% to 47%,[1][4]
