Alcoholic Liver Disease Cleveland Clinic

In liver transplant surgery, doctors replace your liver with a healthy liver from a donor. Your doctor might prescribe certain drugs to treat the early stages of liver damage from ALD. If you have an alcohol addiction, our experts can connect you with resources or a treatment program to help you stop drinking. Will do a blood test. These blood tests help confirm that another liver condition isn’t causing your liver damage. ALD is a silent disease.


Psychologic interventions can be difficult in alcoholic liver disease with hepatic encephalopathy, cognitive impairment, or poor performance status . Moreover, patients with end-stage liver disease have frequent hospitalizations that preclude attendance at psychosocial interventions. No psychosocial intervention has been consistently shown to be successful in maintaining abstinence in patients with ALD. Rather, an integrated therapy with cognitive behavioral therapy and medical care appear to reduce recidivism. There is a clear need for clinical trials combining psychosocial and pharmacological interventions in ALD patients with AUD. Adjudicating alcohol as an etiology of liver disease depends upon diagnosis of AUD and excluding other causes of liver disease.

Natural History and Cofactors of Alcoholic Liver Disease

ALF’s mission is to promote education, advocacy, support services and research for the prevention, treatment and cure of liver disease. The following organizations are good additional resources about alcohol-related liver disease. Research has shown that cirrhosis can be reversed, although this may not occur for all patients.

  • This, in turn, contributes to structural changes in the liver, such as the loss of hepatocyte microvilli and sinusoidal endothelial fenestrae, ultimately causing the deterioration of hepatic function.
  • Compared with non-alcoholic fatty liver disease, those with ALD often present late with advanced liver disease and its complications .
  • Propylthiouracil may result in harm.
  • People with chronic HCV infection should abstain from any alcohol intake, due to the risk for rapid acceleration of liver disease.
  • Genetics.
  • Has received honoraria and grants for research from D&A Pharma SAS and Lundbeck Limited.

Prothrombin index is an indirect marker of severe liver fibrosis. 14, 1133–1141 . Oberti, F. Noninvasive diagnosis of hepatic fibrosis or cirrhosis. Gastroenterology 113, 1609–1616 .

Alcoholic liver disease

Neutrophil dysfunction in alcoholic hepatitis superimposed on cirrhosis is reversible and predicts the outcome. Hepatology 46, 831–840 . Levin, D. M., Baker, A. L., Riddell, R. H., Rochman, H. & Boyer, J. L. Nonalcoholic liver disease.

In patients with acute alcoholic hepatitis, clinical manifestations include fever, jaundice, hepatomegaly, and possible hepatic decompensation with hepatic encephalopathy, variceal bleeding, and ascites accumulation. Tender hepatomegaly may be present, but abdominal pain is unusual. Occasionally, the patient may be asymptomatic. Cirrhosis is a late stage of serious liver disease marked by inflammation , fibrosis and damaged membranes preventing detoxification of chemicals in the body, ending in scarring and necrosis . Between 10% to 20% of heavy drinkers will develop cirrhosis of the liver .

Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors

Vitamins, especially B-complex vitamins and folic acid, can help reverse malnutrition. If cirrhosis develops, you will need to manage the problems it can cause. It may even lead to needing a liver transplant.

chronic liver disease

However, women are more susceptible to hepatotoxicity and have twice the relative risk of ALD and cirrhosis compared with men. Elevated body mass index is also a risk factor in ALD as well as nonalcoholic fatty liver disease. Hepatic fibrosis is a transient and reversible wound-healing response, which may be restored to normal in some patients if alcohol intake ceases.

Types of ALD

Heavy drinkers who are overweight might be likelier to develop alcoholic hepatitis and to progress from that condition to cirrhosis. This irreversible scarring is the final stage of alcoholic liver disease. Alcoholic hepatitis develops when the alcohol you drink damages your liver. Just how alcohol damages the liver — and why it does so only in some heavy drinkers — isn’t clear. Once the alcoholic liver disease progresses, its symptoms become easier to recognize. Fibrosis is a buildup of certain types of protein in the liver, including collagen.

  • Drinking cessation is considered the most effective therapy in patients with ALD.
  • Alcoholic hepatitis is characterized by the inflammation of hepatocytes.
  • Alcoholic cirrhosis.
  • There is a clinical unmet need to develop more effective and safer therapies for patients with ALD.
  • Galli, A., Pinaire, J., Fischer, M., Dorris, R.

Our network of 25 outreach clinics gives you access to top liver disease experts close to your home. Other factors that correlate with poor prognosis include older age, impaired renal function, encephalopathy, and a rise in the WBC count in the first 2 weeks of hospitalization. Early ALD may not have any symptoms at all, which is why it is important to take action if you are drinking heavily. By the time symptoms develop, ALD is usually very advanced.

The following organizations are good additional resources about alcohol-related liver disease…

Your sex. Women seem to have a higher risk of developing alcoholic hepatitis possibly because of differences in the way alcohol is processed in women. Malnutrition. Many people who drink heavily are malnourished because they eat poorly or because alcohol and its byproducts prevent the body from properly absorbing nutrients.

alcoholic liver disease