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Alcoholic liver disease

Definition

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

See also:

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 drinking too much. The longer the alcohol use has occurred, and the more alcohol that was consumed, the greater the likelihood of developing liver disease.

Alcohol may cause swelling and inflammation (hepatitis) in the liver. Over time, this can lead to scarring and then cirrhosis of the liver. Cirrhosis is the final phase of alcoholic liver disease.

Other important factors include:

  • Alcoholic liver disease may be more common in some families
  • This disease does not occur in all heavy drinkers
  • You do not have to get drunk for the disease to develop
  • Women may be more susceptible than men

People who drink too much, too often do not get enough healthy foods and nutrients. Poor nutrition may make liver disease worse.

Acute alcoholic hepatitis may be caused by binge drinking (five drinks for men, four drinks for women). It may be life-threatening.

Symptoms

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

Symptoms may not be present until the disease is advanced.

General symptoms include:

Skin changes include:

  • Abnormally dark or light skin
  • Redness on feet or hands
  • Small, red spider-like blood vessels on the skin
  • Yellow color in the skin, mucus membranes, or eyes (jaundice)

Abnormal bleeding:

  • Bloody, dark black, or tarry bowel movements (melena)
  • Nosebleeds or bleeding gums
  • Vomiting blood or material that looks like coffee grounds

Brain and nervous system symptoms:

  • Agitation (being stirred up, excited, or irritable)
  • Changing mood
  • Confusion (encephalopathy)
    • Periods of decreased alertness or awareness
    • Hallucinations
    • Impaired short- or long-term memory
  • Pain, numbness, or tingling in the arms or legs
  • Problems paying attention or concentrating
  • Poor judgment
  • Slow, sluggish movements

Other symptoms that can occur with this disease:

Signs and tests

Tests to rule out other diseases include:

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.

See also: Alcoholic neuropathy

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

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. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 84.

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


Review Date: 12/13/2010
Reviewed By: George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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