Health Encyclopedia

Alcoholic liver disease

Definition

Alcoholic liver disease is damage to the liver and its function due to alcohol abuse.

Alternative Names

Liver disease due to alcohol; Cirrhosis or hepatitis - alcoholic; Laennec's cirrhosis

Causes, incidence, and risk factors

Alcoholic liver disease usually occurs after years of excessive drinking. The longer the alcohol use and the more alcohol that was consumed, the greater the likelihood of developing liver disease.

Acute alcoholic hepatitis can result from binge drinking. It may be life-threatening if severe.

People who drink excessively can become malnourished because of the empty calories from alcohol, reduced appetite, and poor absorption (malabsorption) of nutrients in the intestines. Malnutrition contributes to liver disease.

Other factors that contribute to the development of alcoholic liver disease:

Genetic factors
Personal susceptibility to alcohol-induced liver disease
Toxicity of alcohol (ethanol) to the liver

Alcoholic liver disease does not affect all heavy drinkers. Women may be more susceptible than men. It is not necessary to get drunk for the disease to develop.

Symptoms

Changes start in the liver as inflammation (hepatitis) and lead to fatty liver and cirrhosis. Cirrhosis is the final phase of alcoholic liver disease.

Symptoms may not be present until the disease is advanced, and may include:

Abdominal pain and tenderness
Dry mouth
Excessive thirst
Fatigue
Fever
Fluid collection in the abdomen (ascites)
Jaundice
Loss of appetite
Mental confusion
Nausea
Unintentional weight gain (because of fluid collection)

Other symptoms that can occur with this disease:

Abnormally dark or light skin
Agitation
Bloody, dark black, or tarry bowel movements (melena)
Breast development in males
Changing mood
Confusion (encephalopathy)
- Changed level of consciousness
- Hallucinations
- Impaired short- or long-term memory
Difficulty paying attention (attention deficit)
Impaired ability to concentrate
Impaired judgment
Light-headedness or fainting, especially when standing
Paleness
Rapid heart rate (tachycardia) when rising to standing position
Redness on feet or hands
Slow, sluggish, lethargic movement
Vomiting blood or material that looks like coffee grounds

Symptoms vary based on the severity of the disease. They are usually worse after a recent period of heavy drinking.

Signs and tests

Tests to rule out other diseases include:

Abdominal CT scan
Blood tests for other causes of liver disease
Ultrasound of the abdomen

Treatment

The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol.

An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially B-complex and folic acid, can help reverse malnutrition.

If cirrhosis develops, you will need to manage the complications of cirrhosis. You may need a liver transplant.

Support Groups

You can often ease the stress of illness by joining a support group whose members share common experiences and problems.

See:

Expectations (prognosis)

Continued excessive drinking can shorten your lifespan. The outcome will likely be poor if you keep drinking.

Complications

Bleeding esophageal varices
Cirrhosis
Hepatic encephalopathy
Increased pressure in blood vessels of the liver (portal hypertension)

Calling your health care provider

Call your health care provider if:

You develop symptoms of alcoholic liver disease
You develop symptoms after prolonged or heavy drinking
You are concerned that drinking may be damaging your health

Prevention

Discuss your alcohol intake with your doctor. The doctor can counsel you about how much alcohol is safe to drink for your situation.

References

Carithers RL, McClain C. Alcoholic liver disease. In: Feldman M, Friedman LS, Brandt LJ. Feldman: Sleisinger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 81.

Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.

Review Date:12/12/2008
Reviewed By:A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Previously reviewed by Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network (5/20/2008).

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