If you regularly drink alcohol, you might want to know how it impacts your liver. Heads up: it’s not good news. Alcohol can cause severe damage to your liver, leading to a condition called alcohol-related liver disease (ARLD).

ARLD is a term that covers a range of liver problems caused by excessive alcohol consumption. ARLD can lead to complications, such as bleeding, infection, and liver failure.

doctor showing stomach pain

Types and Symptoms of Alcohol-Related Liver Disease

Alcohol-related liver disease is a term that covers several types of liver damage caused by alcohol abuse or addiction, depending on how much and how long you have been drinking. These are alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis.

  • Fatty Liver Disease – This is when fat builds up in the cells of your liver, leading to an enlarged liver. The fatty liver disease rarely causes any visible symptoms, but it can lead to inflammation and scarring of the liver if you continue drinking. Alcoholic fatty liver disease can be reversed if you quit drinking alcohol.
  • Alcoholic Hepatitis – Alcoholic hepatitis is an acute inflammation of the liver caused by alcohol abuse. It can cause symptoms such as jaundice (yellowing of the skin and eyes), nausea, vomiting, fever, abdominal pain, and loss of appetite. Alcoholic hepatitis can be mild or severe and sometimes life-threatening. It can also lead to cirrhosis if you continue drinking alcohol.
  • Alcoholic Cirrhosis – Alcohol-related cirrhosis is the most advanced and irreversible type of alcohol-related liver disease. It occurs when scar tissue replaces healthy liver tissue, affecting the liver’s ability to function properly. Liver cirrhosis can cause symptoms such as fluid buildup in the abdomen (ascites), bleeding in the digestive tract (varices), confusion, memory loss (hepatic encephalopathy), and liver failure. Alcoholic cirrhosis is irreversible and can be life-threatening. It can also increase the risk of liver cancer and liver failure. However, stopping drinking alcohol immediately can prevent further liver cell damage.

Early Symptoms of Alcoholic Liver Disease

The early symptoms of alcohol-related liver disease may not be obvious or specific, but they can include:

  • Loss of appetite
  • Weight loss
  • Fatigue
  • Weakness
  • Nausea
  • Abdominal discomfort or pain
  • Dark urine
  • Pale stools
  • Itchy skin
  • Bruising or bleeding easily

Late Stage Signs of Alcoholic Liver Disease

Once alcoholic liver disease progresses, its symptoms become easier to recognize and observe. However, having these signs usually indicates that the liver is severely damaged and may not be able to perform its vital functions.

  • Bleeding or bruising easily
  • Swelling of the legs, ankles, or abdomen
  • Ascites (fluid accumulation in the abdomen)
  • Portal hypertension (high blood pressure in the vein that carries blood to the liver)
  • Varices (enlarged veins in the esophagus or stomach that can bleed)
  • Hepatic encephalopathy (brain dysfunction due to toxins in the blood)
  • Liver cancer

Keep in mind that alcoholic liver disease is a preventable condition and can be avoided by limiting or abstaining from alcohol consumption. If you have any signs or symptoms of ARLD, you should see your doctor as soon as possible for diagnosis and treatment.

Late Stage Signs of Alcoholic Liver Disease

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Diagnosing Alcohol-Related Liver Disease

How do you know if you have alcohol-related liver disease? The first step is to see your doctor.

Your primary care provider will ask you about your drinking habits, your medical history, and your symptoms to determine a diagnosis. They will also do a physical exam and order some blood tests. Complete blood count (CBC) tests are important because they can help rule out other causes of liver disease, such as viral hepatitis, infections, autoimmune diseases, or genetic disorders.

One of the blood tests that your doctor will look at is the liver function test (LFT). Liver function tests measure the levels of certain enzymes and proteins in your blood that are related to your liver health. Your doctor may also order other tests, such as imaging tests (ultrasound, CT scan, MRI) or liver biopsy (taking a small sample of liver tissue for analysis).

Treating Alcohol-Related Liver Disease

If you have been diagnosed with alcohol-related liver disease (ARLD), you may wonder about your treatment options. The most important step is to quit drinking alcohol completely. If your alcohol intake continues, your chances of developing severe liver damage increase.

Abstinence can reverse some of the effects of ARLD, especially in the early stages. For example, if you have fatty liver disease, where fat accumulates in your liver cells, quitting alcohol can restore your liver to normal within a few months or years.

However, if you have more advanced forms of ARLD, such as severe alcoholic hepatitis or cirrhosis, where your liver is inflamed or scarred, you will need to abstain from alcohol for life. This is because drinking any amount of alcohol can worsen your condition and lead to liver and associated kidney failure or death.

Of course, not everyone finds it easy to quit drinking, especially if they are alcohol-dependent or have an alcohol use disorder.

Heavy drinkers who have been drinking for a long time may experience alcohol withdrawal symptoms, such as anxiety, insomnia, nausea, tremors, or seizures. You may also have cravings for alcohol or feel depressed or anxious without it.

In this case, you probably need medical help and support to quit drinking safely and effectively.

Your doctor can prescribe medications to help you cope with withdrawal symptoms and prevent relapses. You may also benefit from psychological therapy, such as cognitive behavioral therapy (CBT), to help you change your thoughts and behaviors related to alcohol.

Treating Alcohol Related Liver Disease

Besides abstinence, other aspects of treatment can help you manage ARLD. These depend on the severity of the disease and may include:

Diet and nutrition

Many people with alcoholic liver disease are malnourished because alcohol interferes with the absorption and metabolism of nutrients. Malnutrition contributes to liver cell damage and increases your risk of complications.

This is why it is important to eat a balanced diet that provides enough calories, protein, vitamins, and minerals for your body.

Medications

Depending on the severity of your liver disease, your doctor may prescribe medications to treat specific symptoms or complications. Medical treatment and prescription will depend on your specific condition and must be prescribed by your doctor.

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Liver transplantation

In some cases, such as end-stage liver disease, when your liver is severely damaged and cannot function properly, you may need a liver transplant. This is a surgery that involves replacing your diseased liver with a healthy one from a donor.

Liver Transplantation

Complications of Alcohol-Related Liver Disease

Chronic liver disease can cause serious complications that affect your liver and other organs and systems in your body. Some of the life-threatening complications of ARLD are:

Cirrhosis is a condition where scar tissue replaces healthy liver tissue, making it hard for the liver to function. This is the most advanced and irreversible form of liver injury related to alcohol. It can cause portal hypertension, varices, ascites, hepatic encephalopathy, and liver cancer.

Portal hypertension is a condition that causes increased pressure in the blood vessels of the liver or the portal vein (the vein that carries blood aiding digestion to the liver) due to cirrhosis. It can cause blood to back up in other veins, such as those in the esophagus, stomach, or intestines, leading to varices.

Esophageal Varices are enlarged veins that can rupture and bleed, causing potentially deadly hemorrhage. Bleeding varices can occur in the esophagus, stomach, or intestines. This can cause vomiting blood or passing black stools and can be fatal if not treated promptly.

Ascites is a condition where fluid accumulates in the abdomen due to portal hypertension and low albumin levels. It can cause abdominal pain, swelling, difficulty breathing, infection, and kidney failure.

Spontaneous bacterial peritonitis (SBP) is an infection of the fluid in your abdomen that can occur without any obvious source of bacteria. This is most commonly seen in patients with end-stage liver disease.

  • Hepatic encephalopathy is a condition where toxins build up in the brain due to liver failure. This can cause confusion, mood changes, memory loss, coma, and death.
  • Hepatocellular carcinoma (HCC) is a type of cancer where abnormal cells grow in the liver. This can cause weight loss, jaundice, abdominal pain, ascites, and bleeding.
  • Hepatorenal syndrome is a condition where your kidneys fail because of poor blood flow due to low blood pressure caused by advanced liver disease.

Preventing Alcohol-Related Liver Disease (ARLD)

The most effective way to prevent ARLD is to stop drinking alcohol completely. If you have ARLD or are at risk of developing it, you should avoid alcohol at all costs. However, if you cannot stop drinking completely, you should avoid excess alcohol intake and limit your consumption to no more than:

  • No more than 14 units of alcohol per week for both men and women
  • No more than 4 units of alcohol per day for men and 3 units per day for women
  • At least two alcohol-free days per week

One unit of alcohol is equivalent to:

  • Half a pint of regular beer, cider, or lager (3.6% alcohol by volume)
  • A single measure of spirits (25 ml, 40% alcohol by volume)
  • A small glass of wine (125 ml, 12% alcohol by volume)

You should also avoid binge drinking, which is defined as consuming more than 6 units of alcohol in one session for men or more than 4 units for women.

Besides reducing your alcohol intake, you can also prevent ARLD by:

  • Eating a healthy diet that is low in fat, salt, and sugar and high in fiber, fruits, and vegetables
  • Drinking plenty of water to stay hydrated and flush out toxins from your body
  • Exercising regularly to maintain a healthy weight and improve your blood circulation
  • Avoiding smoking and other drugs that can harm your liver
  • Getting vaccinated against hepatitis A and B, which are viral infections that can cause liver inflammation
  • Having regular check-ups with your doctor to monitor your liver function and screen for any signs of liver damage or complications

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Table of contents

  • Types and Symptoms of Alcohol-Related Liver Disease
    • Early Symptoms of Alcoholic Liver Disease
    • Late Stage Signs of Alcoholic Liver Disease
  • Diagnosing Alcohol-Related Liver Disease
  • Treating Alcohol-Related Liver Disease
    • Diet and nutrition
    • Medications
    • Liver transplantation
  • Complications of Alcohol-Related Liver Disease
  • Preventing Alcohol-Related Liver Disease (ARLD)
    • Besides reducing your alcohol intake, you can also prevent ARLD by:
  • Find Support for Addiction in Design for Recovery

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Frequently Asked Questions

How Many Years of Drinking Can a Person Engage in Before Liver Damage Occurs?

There is no definitive answer to this question, as different people have different levels of tolerance and susceptibility to alcohol.

However, some factors that increase the risk of liver damage include drinking more than 14 drinks per week for men and 7 drinks per week for women, binge drinking (more than 4 or 5 drinks in a row), drinking on an empty stomach, having other liver diseases or infections, and having a genetic predisposition to alcoholism.

Generally, the more and the longer you drink alcohol, the higher the chance of developing alcoholic liver disease.

What is the Treatment for a Damaged Liver Due to Alcohol?

The most important treatment for alcoholic liver disease is to stop drinking alcohol. This can help prevent further damage and allow the liver to heal.

Depending on the severity of the condition, other treatments may include medications to reduce inflammation and infection, nutritional supplements to correct malnutrition, fluid drainage to relieve ascites (fluid buildup in the abdomen), and liver transplant for end-stage cirrhosis. However, a liver transplant is only an option for people who have been sober for at least six months and meet other criteria.

What are the 3 Stages of Alcoholic Liver Disease?

Alcoholic liver disease has three main stages: fatty liver, alcoholic hepatitis, and cirrhosis.

What are the 4 Warning Signs of a Damaged Liver?

Some common warning signs of a damaged liver are:

  • Jaundice – yellowing of the skin and eyes due to high levels of bilirubin, a waste product that the liver normally filters out.

  • Ascites – swelling of the abdomen due to fluid accumulation caused by portal hypertension, a condition where blood pressure in the veins that carry blood to the liver is too high.

  • Bleeding – easy bruising and bleeding due to low levels of clotting factors that the liver normally produces.

  • Encephalopathy – confusion, memory loss, mood changes, and sleep problems due to toxins that the liver normally clears from the blood affecting the brain.

What Foods are Good For Liver Repair?

A healthy diet is essential for liver repair, as it can help prevent malnutrition, reduce inflammation, and support liver function. Some food that is good for liver repair include fruits and vegetables, lean protein, whole grains, and healthy fats.

Can the Liver Repair Itself After Years of Drinking?

The liver is an amazing organ that can heal itself from some damage caused by alcohol. But this depends on how much and how long you’ve been drinking, and other factors like your age, genetics, and nutrition.

If you have mild alcohol-induced liver disease, such as fatty liver disease, quitting alcohol can reverse the condition in a few weeks or months. But if you have more serious chronic liver disease, such as severe alcoholic hepatitis or cirrhosis, you may need to stop drinking for life to prevent further damage or complications. Some people with advanced liver disease or liver failure may need a liver transplant to survive.

Which Medicine is Best for Alcoholic Liver?

There is no specific medicine that can cure alcoholic liver disease. The most important thing you can do is to stop drinking alcohol completely. This can help prevent more damage and improve your symptoms.

Some medicines may help with certain aspects of alcoholic liver disease, such as inflammation, infection, bleeding, or itching. However, these medicines are not approved for treating alcoholic liver disease itself and may have side effects or interactions.

What Vitamins Help the Liver From Alcohol?

Alcohol can interfere with your body’s ability to absorb and use vitamins and nutrients. This can lead to vitamin deficiencies that can affect your liver and other organs.

Some vitamins that may help your liver recover from alcohol are vitamin A, vitamin C, magnesium, zinc, and B-complex vitamins. These vitamins may help your liver detoxify alcohol, reduce inflammation, and repair damaged cells.

But you should be careful not to take too much of some vitamins, especially vitamin A, because they can be toxic in high doses. You should also eat a balanced diet that includes fruits, vegetables, whole grains, lean protein, and healthy fats.

Sources

NHS. (n.d.). Symptoms –  Alcohol-related liver disease. United Kingdom National Health Service. https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/symptoms/

Maruyama, H., & Yokosuka, O. (2012). Pathophysiology of Portal Hypertension and Esophageal Varices. International Journal of Hepatology, 2012. https://doi.org/10.1155/2012/895787

Metra, B. M., Guglielmo, F. F., Halegoua-DeMarzio, D. L., Civan, J. M., & Mitchell, D. G. (2021). Beyond the liver function tests: A radiologist’s guide to the liver blood tests. RadioGraphics, 42(1), 125–142. https://doi.org/10.1148/rg.210137

Hou, W., & Sanyal, A. J. (2009). Ascites: Diagnosis and management. Medical Clinics of North America, 93(4), 801–817. https://doi.org/10.1016/j.mcna.2009.03.007

Spontaneous bacterial peritonitis. Spontaneous bacterial peritonitis – Symptoms, diagnosis and treatment | BMJ Best Practice US. (n.d.). https://bestpractice.bmj.com/topics/en-us/793

Torruellas, C., French, S. W., & Medici, V. (2014). Diagnosis of alcoholic liver disease. World Journal of Gastroenterology : WJG, 20 (33), 11684-11699. https://doi.org/10.3748/wjg.v20.i33.11684

https://www.medical.theclinics.com/article/S0025-7125(09)00038-8/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155359/
https://pubs.rsna.org/doi/full/10.1148/rg.210137