Alcohol-Related Liver Disease: Signs, Symptoms, Stages, Tests And Treatment!

Gaining attention as a significant health concern worldwide, Alcohol-related liver disease (ARLD) stems from the chronic and excessive consumption of alcohol. Thus, recognising the early signs of ARLD is crucial for timely intervention and management, as it can help prevent further liver damage. Also, understanding alcoholic liver disease types, along with its symptoms and stages, is essential for you to address this complex and life-threatening condition. 

Diagnosing for the treatment of alcoholic liver disease typically involves a combination of medical history review, physical examination, and laboratory tests. Blood tests to assess liver function and detect elevated liver enzymes, imaging studies such as ultrasound or MRI scans to evaluate liver structure, and liver biopsy for tissue analysis may be employed to confirm the diagnosis and assess the extent of liver damage.

Since the collaborative efforts between doctor and patient equally affect alcohol-related liver disease, implementing effective treatment strategies and improving overall outcomes for this complex condition becomes essential. So, this blog explores early signs of alcohol-related liver disease symptoms, its three major stages and treatment strategies which you can implement to address the issue.

Table Of Contents

1. What Are The First Signs Of Liver Damage From Alcohol?

2. Alcohol-Related Liver Disease Symptoms

3. What Are The 3 Stages Of Alcoholic Liver Disease?

4. Alcohol And Liver Function Tests

5. Treatment Of Alcohol-Related Liver Disease

6. Dietitian’s Recommendation

7. The Final Say

8. FAQs

9. References

What Are The First Signs Of Liver Damage From Alcohol?

Let’s explore these early indicators to be aware of, highlighting the relationship between alcohol and liver health:

1. Fatigue And Weakness

Early dysfunction of the liver, a vital organ in energy metabolism, can lead to feelings of weakness and lethargy. Unusual tiredness, persisting even after adequate rest, can be an early warning sign of potential liver damage. 

2. Abdominal Discomfort

Mild and intermittent discomfort in the abdomen, particularly in the upper right side where the liver is located, may signal early liver inflammation or enlargement. This discomfort could be an initial indication prompting further investigation into liver health.

3. Digestive Issues

Early signs of Alcohol-Related Liver Disease (ARLD) may include nonspecific digestive problems like nausea, occasional vomiting, diarrhoea, or a loss of appetite. These symptoms underscore the impact of alcohol on the digestive system and can be precursors to more severe liver damage if left unaddressed.

4. Mild Jaundice

Jaundice, characterised by the yellowing of the skin and eyes due to the liver's inability to process bilirubin, can manifest in cases of early liver damage. Detecting mild jaundice early on is crucial, as it can prompt intervention and lifestyle changes to mitigate further harm to the liver.

5. Elevated Liver Enzymes

Routine medical check-ups or screening tests may reveal elevated levels of liver enzymes, such as ALT and AST, indicating liver inflammation or damage. Monitoring these enzyme levels provides a quantitative measure of liver health and aids in assessing the progression of alcohol-related liver damage.

6. Increased Thirst And Urination

Excessive alcohol consumption can lead to dehydration, resulting in increased thirst and urination. When accompanied by other signs, these changes in thirst and urination patterns can serve as early indicators of potential alcohol-related liver damage, prompting individuals to reconsider their drinking habits.

7. Unexplained Weight Loss

Changes in metabolism, decreased appetite, or nutrient malabsorption associated with liver dysfunction may result in unintentional weight loss, even with a maintained diet. Recognising unexplained weight loss early on can be crucial in addressing underlying liver issues.

8. Easy Bruising And Bleeding

Individuals with early-stage ARLD may experience more frequent bruising or prolonged bleeding from minor injuries due to impaired liver function and decreased clotting factor production. These signs highlight the impact of alcohol on the blood's clotting mechanisms, necessitating attention to liver health to prevent further complications. Additionally, liver dysfunction can lead to a decrease in platelet count, further contributing to bleeding tendencies.

Also Read: Detoxing The Alcoholic Liver: ARLD Symptoms, Causes And Tips 

Alcohol-Related Liver Disease Symptoms

Note these alarming symptoms of alcohol-related liver disease:

Also Read: 5 Science-Backed Milk Benefits For Liver Health | ToneOp 

What Are The 3 Stages Of Alcoholic Liver Disease?

Let's understand the spread of ALD with its three distinct stages requiring different approaches:

1. Fatty Liver Disease

This is the first phase of Alcoholic Liver Disease, where fat starts to build up inside the liver cells. Usually, you don't feel symptoms, and it can be changed back by stopping drinking alcohol and altering what you eat. Refraining from drinking alcohol, coupled with a healthy diet and regular exercise, can mitigate the progression of fatty liver disease. However, if the drinking problem continues, the condition can evolve into more severe forms of ALD, highlighting the critical role of early intervention and lifestyle adjustments.

• Related Study: "Prevalence of Alcoholic Liver Disease in a Tertiary Care Centre in Southern India: A 5-year Experience" by V. K. Choudhary et al. (Indian Journal of Gastroenterology, 2016) revealed that ARLD was the leading cause of chronic liver disease in the study population, emphasising the need for awareness and preventive measures.

2. Alcoholic Hepatitis

This is the second phase of ALD, a dangerous swelling in the liver from drinking too much alcohol for a long time. Symptoms include jaundice, nausea, abdominal pain, vomiting, liver enlargement, and fever. The severity of alcoholic hepatitis can range from mild to severe, potentially leading to acute liver failure. It is very important to stop drinking alcohol right away and get medical care quickly to avoid more damage to the liver and other health problems.

3. Cirrhosis

It represents the advanced and irreversible stage of ALD, characterised by extensive scarring of liver tissue. Because of long-term swelling and harm to liver cells, there develops fobrous scar tissue.  Symptoms of cirrhosis include fatigue, easy bruising, weakness, jaundice, itching, abdominal swelling (ascites), and confusion. 

Cirrhosis raises the chances of getting liver failure, hepatocellular carcinoma (liver cancer), and high blood pressure inside the portal vein. If it is found that actions such as stopping drinking alcohol, taking medicine, or changing lifestyle habits early on, can decelerate its worsening. However, once cirrhosis has happened, you cannot reverse it; this shows why preventing it before it worsens is crucial.

• Related Study: S. Das et al. stated that "Clinicopathological Profile of Alcoholic Liver Disease in a Tertiary Care Hospital in Eastern India" in the Journal of Medical Science and Clinical Research, 2017 and also highlighted alcoholic cirrhosis as the predominant presentation of ARLD, emphasising the need for comprehensive understanding and management of complications associated with this advanced stage.

Also Read: 7 Herbal Teas For Liver Health: Enhancing Your Well-Being 

Alcohol And Liver Function Tests

Here's how alcohol can influence liver function tests:

Also Read: Liver Detox: Which Vitamins Are Good For Liver Repair? 

Treatment Of Alcohol-Related Liver Disease

Let’s explore some common approaches to treatment for Alcohol-Related Liver Disease (ARLD), which varies with its stage and severity:

1. Alcohol Cessation

The most critical aspect of managing ARLD is stopping alcohol consumption altogether. This can help prevent further liver damage and may even allow for some degree of recovery, especially in the early stages, such as fatty liver disease and alcoholic hepatitis.

2. Medical Management

In cases of alcoholic hepatitis, medications may be prescribed to reduce inflammation and help manage symptoms. Corticosteroids and pentoxifylline are commonly used to treat severe alcoholic hepatitis, although their effectiveness can vary.

3. Nutritional Support

Malnutrition is common in individuals with ARLD, so nutritional support is often essential. This may include dietary changes, vitamin supplementation (especially B-complex vitamins), and in severe cases, tube feeding or intravenous nutrition.

4. Liver Transplantation

In cases of end-stage liver disease or cirrhosis where the liver is severely damaged and non-functional, liver transplantation may be considered. This is typically reserved for individuals who meet specific criteria and do not respond to other treatments.

5. Management Of Complications

ARLD can lead to various complications, such as ascites (fluid buildup in the abdomen), hepatic encephalopathy (brain dysfunction due to liver failure), and portal hypertension (high blood pressure in the liver). These complications may involve medications, dietary changes, and procedures such as paracentesis (draining fluid from the abdomen) or transjugular intrahepatic portosystemic shunt (TIPS) placement.

6. Behavioral Support

Supportive interventions such as counselling, support groups, and behavioural therapies can be crucial in helping individuals with ARLD maintain alcohol abstinence and make positive lifestyle changes.

Dietitian’s Recommendation

For individuals with alcohol-related liver disease, a dietitian's advice is crucial. Vitamin and mineral supplementation may be necessary to address deficiencies. Emphasise foods that are rich in fruits, green vegetables, lean proteins, and whole grains. Adequate hydration is essential, but alcohol must be strictly avoided. Limit saturated fats, refined sugars, and processed foods. Consult a healthcare professional for personalised dietary recommendations. Portion control and regular meals can support liver health and overall well-being.        

                                                                   Dt. Akshata Gandevikar

The Final Say

Alcohol-related liver disease (ARLD) encompasses a range of conditions caused by excessive alcohol consumption, manifesting in signs and symptoms such as jaundice, abdominal pain, and fatigue. This disease has three parts: first is fatty liver, then comes alcoholic hepatitis, followed by the last one called cirrhosis; each step makes the damage to the liver worse. Diagnosis typically involves blood tests, imaging scans, and liver biopsy.

The approach to treatment involves altering one's way of life, for example, stopping drinking alcohol, changing what they eat, and using drugs to control the signs and make the illness progress more slowly. Remember that the fundamental strategy lies not merely in reactive measures but, more importantly, in proactive steps towards prevention; early intervention is crucial for maintaining an overall liver-healthy life.

FAQs

1. What liver disease is caused by alcohol?

Alcohol-related liver disease is a term used to describe a range of liver conditions triggered by excessive alcohol consumption. It includes fatty liver, alcoholic hepatitis, and cirrhosis.

2. What are the 14 signs of liver damage from alcohol?

The signs of alcohol-related liver damage include fatigue, abdominal discomfort, jaundice, elevated liver enzymes, increased thirst, unexplained weight loss, easy bruising, and bleeding, among others.

3. Can alcoholic liver disease be reversed?

In its early stages, such as fatty liver disease, alcoholic liver disease can be reversible with lifestyle modifications like alcohol cessation and dietary changes. However, advanced stages like cirrhosis may have irreversible damage.

4. What are the causes of alcoholic liver disease?

The primary cause of alcoholic liver disease is the prolonged and excessive consumption of alcohol. Chronic alcohol use can lead to inflammation, scarring, and damage to liver cells.

5. What are the alcoholic liver disease risk factors?

Key risk factors for alcoholic liver disease include heavy and prolonged alcohol consumption, genetic predisposition, gender (men are more susceptible), obesity, and the presence of other liver conditions.

References

• Alcohol And Disease 

• Alcohol-related liver disease | NHS inform

• Alcohol-Associated Liver Disease | Johns Hopkins Medicine

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