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Alcohol Related Liver Disease
Liver cells

Alcohol Related Liver Disease

There are three different liver diseases caused by drinking too much alcohol:

  • Fatty liver disease
  • Alcoholic hepatitis (inflammation)
  • Cirrhosis (scarring or fibrosis)

Of these, cirrhosis is the most severe and life-threatening.

Symptoms

You may:

  • Feel poorly and frequently tired
  • Be experiencing some pain in the area around the lower right hand side of your ribs (ie, in your liver)
  • Have little appetite
  • Feel sick, particularly in the mornings; the sickness may be accompanied by diarrhoea

You should arrange an appointment with your doctor immediately if you have:

These symptoms might mean that your liver is already quite badly damaged.

Other medical signs include:

  • A tender, firm, or possibly enlarged liver (hepatomegaly)
  • Red, mottled palms (palpar erythema)
  • Partly white fingernails (clubbing)
  • Enlargement of the breasts (men), which may also be tender (gynaecomastia)
  • A swollen tummy (ascites)
  • Thinning hair (alopecia)
  • Muscle atrophy (weakness and wasting)

Diagnosis

The first step is usually a series of blood tests which may show abnormal liver function.

An ultrasound scan may show that you have a damaged liver.

To confirm the diagnosis, a fibroscan or a biopsy (a small sample) of the liver may be taken for signs of scarring.

Treatment

There is no specific treatment for fatty liver disease caused by alcohol. The best advice is to stop drinking.

If you stop drinking, you will stop further damage to your liver and in many cases it will start to recover after (at least) six months of abstinence. In many cases, no specific treatment will be needed and it is unlikely that you would be admitted to hospital. However, the longer heavy alcohol consumption continues, the more damage will be done to the liver which, if ignored, will progress from fatty liver disease to alcoholic hepatitis, to cirrhosis and severe structural damage.

Good nutrition is important to help your liver recover and so you may be referred to a dietitian who may advise you to take supplementary vitamins.

Alcohol related liver disease increases the risk of developing liver cancer. Treatment for liver cancer will largely depend on whether the cancer found in the liver is ‘primary’ or ‘secondary’.

Patients with advanced liver disease (such as hepatitis) caused by alcohol are at much higher risk and hospitalisation is likely whilst the liver stabilises. Specific medicines may be prescribed to encourage liver regeneration and reduce the inflammation. Surgery is unlikely to be performed on patients with on-going alcoholic hepatitis. However, if hepatitis develops into life-threatening cirrhosis a complete liver transplant may be the only treatment available.

Prognosis/outlook

If you are diagnosed with fatty liver disease, (or even mild alcoholic hepatitis) you should make a full recovery if you stop drinking.

If you are suffering from severe hepatitis you are likely to be admitted to hospital because you need intensive care treatment. Some people with severe hepatitis will die.

If you have cirrhosis, by stopping drinking you can improve your outlook - the cirrhosis is unlikely to progress. However, if you continue to drink this will not be the case. Where the scarring is extensive, and the liver is only just working, then a liver transplant may be your only option.

Liver transplants are not available for every patient who might need one. Of those that do take place more than 80 per cent of transplants are successful (ie, are still working after 12 months).

To arrange a consultation with a liver consultant please contact The Princess Grace Hospital, Liver, Bile Duct and Pancreas Unit