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Alcoholic Liver Disease

Alcoholic liver disease (ALD) refers to liver disease cause by consuming large quantities of alcohol regularly for a long time.
Excessive consumption of alcohol can cause liver disease, as well as harming many other body organs.

The prevalence of alcoholic liver disease (ALD) in a population is usually determined by measuring death rates from alcoholic cirrhosis (in which healthy liver tissue becomes increasingly replaced by scar tissue).

What is alcoholic liver disease?

There are three stages of Alcoholic liver disease:
• Fatty liver: Fatty liver is reversible with abstinence from alcohol, but it is the first stage in the progression to cirrhosis. Abnormalities may be seen in liver function tests (LFTs).
• Alcoholic hepatitis: Abstinence from alcohol can reverse the effects, but those who continue to drink heavily have a high risk of developing cirrhosis. This condition can in itself be life threatening. The LFTs will be abnormal, and there may be jaundice.
• Cirrhosis: Final, irreversible stage of Alcoholic liver disease.
The liver becomes scarred and develops nodules. Life expectancy is reduced. The LFTs will be abnormal, and there may be jaundice plus more serious complications as the liver can no longer function properly.
What are the symptoms of alcoholic liver disease?

The symptoms of alcoholic liver disease are usually non-specific, and do not indicate the severity of the underlying liver damage. Symptoms are often vague and include fatigue, nausea and vomiting (usually in the morning), diarrhoea or abdominal pains.

In the more advanced stages of alcoholic liver disease there may be symptoms such as jaundice, ascites (distension of the abdomen), haematemesis (vomiting of blood) or encephalopathy (confusion). These are signs of severe liver damage requiring urgent medical treatment.

How is alcoholic liver disease diagnosed?

Many patients, even with advanced alcoholic liver disease, have no symptoms and are alcoholic liver disease is detected from liver blood tests performed for other reasons.

Further tests, Liver Function Tests (LFTs) and ultrasound scans can help assess the severity of alcoholic liver disease, but the most accurate diagnosis requires a liver biopsy. Liver biopsy is the most accurate test to determine the stage of alcoholic liver disease present and to ensure alcohol is the cause of the liver disease.

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