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| | | |  Home  Disease Index Alcoholic liver disease
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 | What is alcoholic liver disease? |
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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).These rates have increased alarmingly in recent years. Death rates in the UK rose by up to 88 per cent between 1974 and 1994 with the highest increase in young men aged 35-44 (7.6 deaths per year per 100,000 people).
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| Causes |
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There are three main stages of ALD, although the progression through these stages is variable. Examining a sample of the liver under the microscope from a biopsy gives the most accurate measure of the degree of liver damage.
Minimal change, or fatty liver:
heavy drinkers often develop fatty change in the liver. This is not linked to deterioration in liver function, but abnormalities may be seen in some of the blood tests that give an indirect measure of liver disease (also called ‘liver function tests’ or ‘LFTs’). Fatty liver is reversible with abstinence from alcohol, but it is the first stage in the progression to cirrhosis. Alcoholic hepatitis:
the effects of this condition can be mild but may also be life threatening. The LFTs will almost always be abnormal, and the patient may develop jaundice. As with fatty liver, abstinence from alcohol can reverse the effects, but those who continue to drink heavily have a high risk of developing cirrhosis. Cirrhosis:
this is the final, irreversible stage of ALD and is characterised by scarring of the liver and development of liver nodules. It severely affects liver function and reduces life expectancy. The LFT's are usually abnormal, there may be jaundice (yellow colouring of the eyes and skin) and sometimes bruising or bleeding caused by abnormalities of the blood clotting system. In an advanced stage of ALD (severe alcoholic hepatitis or cirrhosis) the remaining liver capacity is insufficient for it to carry out its normal functions, then the body’s metabolism becomes badly affected and the stage of ‘decompensated ALD’ is reached. Complications of this are discussed below.
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| What are the symptoms? |
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The symptoms of ALD are usually non-specific, and do not necessarily indicate the severity of the underlying liver damage. Many people will have vague symptoms such as fatigue, nausea and vomiting ( typically in the morning), diarrhoea or abdominal pains. Many patients, even with advanced ALD will have no symptoms and are detected by the finding of liver blood tests performed as part of routine health screening, or during the investigation of other conditions.
Only in the more advanced stages of decompensated ALD will the sufferer present with more specific liver-related symptoms such as jaundice, ascites (fluid collecting in the abdomen, causing distension), haematemesis (vomiting of blood) or encephalopathy (confusion, reduced level of awareness and altered sleep pattern, eventually progressing to coma). These are signs of severe liver damage and require urgent medical treatment.
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