Alcoholic liver disease
The liver is responsible for the metabolism of alcohol. It breaks it down so that it can then be eliminated from the body. Alcohol can damage or destroy liver cells, and the liver can be seriously injured when more alcohol is consumed than it can process. Excessive consumption of alcohol is a common cause of liver damage, and alcoholic liver disease can occur after years of heavy drinking. It can lead to:
- Fatty liver disease – this is the excessive accumulation of fat in liver cells. This condition usually produces no symptoms or mild symptoms and occurs in the earliest stages of liver disease. It will typically go away when a person stops drinking.
- Alcoholic hepatitis – this is inflammation and swelling of the liver. It may be chronic yet mild, lasting for years but with no specific symptoms. With mild cases, the damage may be reversed if alcohol consumption is stopped. If it continues, over time, the liver may sustain more and more damage. If the damage becomes severe, the symptoms can appear quickly, within hours or days, and may be fatal.
- Cirrhosis – this is scarring of the liver and the most serious form of alcoholic liver disease. It occurs when healthy liver tissue is replaced by hard scar tissue, affecting the structure of the liver and affecting its ability to function. The damage usually cannot be reversed but may not progress further if a person stops drinking. Cirrhosis can lead to liver failure and increases the risk of liver cancer.
Alcoholic liver disease is not typically tested for directly with laboratory tests. The diagnosis is often arrived at by examining the patient and getting a full medical history, especially about ingestion of alcohol. There are some tests that may be performed to help evaluate someone with liver disease due to chronic alcohol use, and certain tests may help detect chronic and/or relapse in alcohol drinking in those who deny it.
Testing may include:
- Gamma-glutamyl transferase (GGT) – a liver enzyme that is increased by heavy alcohol intake and also by many other conditions that affect the liver
- Liver panel – used to detect and/or determine the extent of liver damage
- Ethanol level – if alcohol is suspected to be a cause of liver disease
- Carbohydrate-deficient transferrin (CDT) – can indicate relapse to heavy drinking following a period of abstinence but may be less sensitive for women and younger people
There is no specific treatment for alcoholic liver disease. Usually, discontinuing the consumption of alcohol is the first step, along with avoiding other substances that can harm the liver. Many people fully recover from this type of liver disease if this is done soon enough, although it may take months for the liver to heal. Participating in a rehabilitation program or counseling may be helpful in abstaining from alcohol or treating an alcohol addiction (alcoholism). Occasionally, there is lasting damage such as cirrhosis and even liver failure. If the liver is irreversibly damaged, then a liver transplant may be an option. Transplant programs usually require someone with a history of alcohol abuse (even if alcohol may not be the underlying cause) to successfully complete a rehabilitation program before transplant can be considered as an option.