Alcohol-induced liver disease is a life-threatening condition that occurs when alcohol causes damage to the liver. It is possible to develop the condition without being addicted to alcohol; regularly consuming alcohol above recommended levels can increase the risk. This condition is sometimes called alcoholic liver disease, and healthcare professionals may use the abbreviations ALD or ARLD when discussing it.
Alcohol-related liver disease has various stages, with cirrhosis being the most severe and typically taking many years to progress.
Symptoms like weight loss, yellowing of the skin and eyes (jaundice), and abdominal swelling (ascites) generally manifest only in the advanced stages of the disease.
Key points
- Alcohol-induced liver disease occurs when alcohol causes damage to the liver.
- Alcohol-related liver disease has various stages, with cirrhosis being the most severe.
- The liver is the only internal organ capable of self-repair.
The facts of alcohol-related liver disease
- Alcohol is responsible for the majority of liver disease cases in the UK, with 6 out of 10 cases being attributed to alcohol consumption. Approximately 1 in 5 individuals in the UK consume alcohol in a manner that could potentially damage their liver.
- Signs of alcohol addiction are not necessary to experience the effects of alcohol-related liver disease. Regularly consuming half a bottle of wine or a few pints each evening can harm your liver.
- Consuming alcohol heightens the risk of developing seven different types of cancer, with breast and bowel cancer being among the most prevalent types linked to alcohol consumption.
- It is estimated that 3 to 5% of people with cirrhosis will develop liver cancer annually.
What Causes Alcohol-related Liver Disease?
Typically, exceeding the recommended alcohol limits raises the likelihood of experiencing alcohol-related liver disease. It can also exacerbate other forms of liver disease.
Several other factors can elevate the risk of liver damage. Consuming excessive alcohol in addition to any of these factors increases the likelihood of developing alcohol-related liver disease. These factors include:
- Being in the overweight or obese category
- Suffering from diabetes, particularly type 2 diabetes
- Being female, women are more susceptible to the adverse impacts of alcohol than men.
- Having a pre-existing liver ailment like hepatitis C or haemochromatosis
- Genetic factors, such as alcohol-related illnesses and addiction, tend to be hereditary.
Alcohol Liver Disease Symptoms and Signs
Liver disease can develop in individuals who drink heavily, even just a few days per week, not just those who drink daily or are dependent on alcohol. Many people underestimate how easy it is to drink too much and put themselves at risk for alcohol-related liver disease.
Both men and women should adhere to the same safer drinking limits:
- Consume no more than 14 units of alcohol per week.
- Distribute drinking occasions across the week.
- Refrain from drinking 2 to 3 consecutive days weekly for the best results.
It’s crucial to have your liver examined if you’ve been consistently exceeding the recommended alcohol intake for many months.
Being completely honest about your alcohol consumption and its frequency is important, as it is essential to determine if your drinking has resulted in harm. Identifying liver damage early on enables you to make choices that will aid in the recovery of your liver. Even if you suspect your liver may have already sustained damage, confirming this will allow you to seek any necessary help or treatment.
The three stages of alcohol-related liver disease
Below are the three stages of alcohol-related liver disease. It is essential to recognise these signs as the earlier liver disease is caught, the more likely it can be treated.
Stage 1: alcohol-related fatty liver.
Consuming more than four units of alcohol daily can result in the accumulation of fat in the liver. The liver processes alcohol, but some of the resulting substances are harmful and can cause liver damage. This, among other issues, leads to fat accumulation in the liver. If you abstain from alcohol for an extended period (months or years), your liver can heal.
Stage 2: Alcohol-related hepatitis.
Alcohol-related liver disease at this stage is extremely severe, with approximately one-third of heavy drinkers with alcohol-related fatty liver progressing to this stage. Typically, it develops after prolonged excessive alcohol consumption, but it can suddenly and severely manifest even after stopping drinking.
The onset is usually preceded by weeks or months of heavy drinking but can also occur following a short period of intense alcohol consumption, known as binge drinking. This condition is referred to as acute alcohol-related hepatitis, which can lead to liver failure and ultimately death.
Stage 3: cirrhosis.
At this stage, alcohol-related liver damage becomes highly severe, resulting in significant scarring (fibrosis) of the liver. Cirrhosis develops in up to 20% of heavy drinkers.
If you have one of the more severe forms of liver damage, it is crucial to be referred to a specialist in liver conditions. These conditions are more challenging to treat and require specialised care.
What are the Early-Stage Symptoms?
Alcohol-related liver disease typically does not exhibit symptoms in its initial stages and is frequently identified while testing for other ailments. Individuals often receive a diagnosis only after their condition has progressed significantly.
However, the first symptoms of alcoholic liver disease are often subtle, such as skin and nail changes, which could be overlooked.
Terry’s Nails, Leukonychia
The beds of your nails (the part under the skin) looks whiter than normal, there may also be a brown line where your nail meets the skin.
Clubbing Fingers and Nails
The fingers and nails look wider and swollen than normal. This may be even more distinctive when combined with whitening of the nail bed which also indicates liver problems.
Other Early symptoms can include:
- Aching or discomfort in the upper right side of the abdomen, where the liver is located, may be one of the initial indicators.
- Appetite may be significantly reduced or absent
- Overwhelming fatigue may be experienced.
- Nausea may be present.
- Diarrhea can occur.
- A general feeling of being unwell may be felt.
- Difficulty in sleeping or insomnia.
What are the Latter-stage Symptoms?
As the liver struggles to function, more severe symptoms may arise. If any of these symptoms are present, it is essential to inform a doctor immediately.
- The skin and whites of the eyes may appear yellow (jaundice), which may be challenging to detect on darker skin tones.
- You may experience abdominal pain in the area of the liver.
- Itchiness
- Unexplained weight loss
- Weakness and muscle wasting
- Swelling in the legs, ankles, and feet due to fluid build-up (oedema)
- Abdominal swelling due to fluid retention (ascites)
- Increased tendency to bruise and bleed easily, such as frequent nosebleeds and bleeding gums
- Episodes of confusion, forgetfulness, mood changes, or impaired judgment (encephalopathy or brain fog)
Even if you have no symptoms, inform your doctor if you are at risk and concerned.
How is Alcohol-related Liver Disease Diagnosed?
Alcohol-related liver disease may only be detected incidentally during routine health screenings.
Special blood tests and scans will be conducted at a hospital if your doctor suspects any form of liver disease to identify the cause and assess the extent of liver damage.
If alcohol-related liver disease is suspected based on your symptoms or blood tests, additional tests may be necessary to evaluate the level of scarring on your liver.
Providing your doctor with comprehensive information is crucial. This enables them to diagnose your condition accurately and provide appropriate treatment.
Alcohol-related liver disease is often only detected when individuals present with symptoms of severe liver disease or liver failure at A&E. By this point, a complete reversal of the liver disease is unlikely, but there are still many interventions that can be employed to prevent further deterioration and potentially restore some of the damage.
Possible tests that may be conducted include blood tests, various scans such as transient elastography (e.g. FibroScan), ultrasound, MRI, CT, endoscopy, and biopsy.
If you are diagnosed with alcohol-related liver disease, your physician should recommend a consultation with a liver specialist. This specialist could be a hepatologist (a physician with expertise in liver disease) or a gastroenterologist (a physician with expertise in the digestive system).
Treating Alcohol-related Liver Disease
The liver is the only internal organ capable of self-repair. By abstaining from alcohol and adopting a healthy diet, you can decrease the likelihood of causing more harm to your liver and improve its chances of recovery.
Upon receiving a diagnosis, your treatment plan will be based on the stage of alcohol-related liver disease you are in.
If you have early to moderate-stage liver disease, the goal will be to address the condition by allowing the liver to repair itself and preventing additional damage.
How can I reduce my alcohol?
Many individuals struggle to quit drinking or reduce their alcohol intake. Suppose you have been consistently drinking large amounts of alcohol for an extended period. In that case, you may require medical support, such as a medical detox, to help your body adjust to functioning without alcohol at first.
At Detox Plus, we can help you find a medical detox in your local area, as well as counselling and support groups.
If you prefer rehab, we can help you find a program that is right for you, whether outpatient or inpatient treatment.
Getting the treatment you need.
Seeking guidance from our committed team can provide the necessary support, encouragement, and scientifically proven treatments to facilitate lasting changes and improve overall well-being.
It’s normal to feel intimidated when considering seeking assistance. However, our compassionate professionals are determined to assist you in embarking on the journey toward sustainable recovery, enabling you to embrace a life free from drug or alcohol dependence.
Contact Detox Plus today to learn more about our outpatient therapy options and commence your journey toward a more fulfilling and healthier life.
Sources
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629063/ Recognizing skin conditions in patients with cirrhosis
