Alcoholic liver disease (patient information)

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Alcoholic liver disease


What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?


Treatment options

Where to find medical care for Alcoholic liver disease?

What to expect (Outlook/Prognosis)?

Possible complications


Diseases with similar symptoms

Alcoholic liver disease On the Web

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Alcohol and Health
Short-term effects of alcohol
Long-term effects of alcohol
Alcohol and cardiovascular disease
Alcoholic liver disease
Alcoholic hepatitis
Alcohol and cancer
Alcohol and weight
Fetal alcohol syndrome
Fetal Alcohol Spectrum Disorder
Recommended maximum intake of alcoholic beverages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan Doherty.


Alcoholic liver disease is damage to the liver and its function due to alcohol abuse.

What are the symptoms of Alcoholic liver disease?

Changes start in the liver as inflammation (hepatitis) and lead to fatty liver and cirrhosis. Cirrhosis is the final phase of alcoholic liver disease.

Symptoms may not be present until the disease is advanced, and may include:

Other symptoms that can occur with this disease:

  • Abnormally dark or light skin
  • Agitation
  • Bloody, dark black, or tarry bowel movements (melena)
  • Breast development in males
  • Changing mood
  • Confusion (encephalopathy)
  • Changed level of consciousness
  • Hallucinations
  • Impaired short- or long-term memory
  • Difficulty paying attention (attention deficit)
  • Impaired ability to concentrate
  • Impaired judgment
  • Light-headedness or fainting, especially when standing
  • Paleness
  • Rapid heart rate (tachycardia) when rising to standing position
  • Redness on feet or hands
  • Slow, sluggish, lethargic movement
  • Vomiting blood or material that looks like coffee grounds

Symptoms vary based on the severity of the disease. They are usually worse after a recent period of heavy drinking.

What are the causes of Alcoholic liver disease?

Alcoholic liver disease usually occurs after years of excessive drinking. The longer the alcohol use and the more alcohol that was consumed, the greater the likelihood of developing liver disease.

Acute alcoholic hepatitis can result from binge drinking. It may be life-threatening if severe.

People who drink excessively can become malnourished because of the empty calories from alcohol, reduced appetite, and poor absorption (malabsorption) of nutrients in the intestines. Malnutrition contributes to liver disease.

Other factors that contribute to the development of alcoholic liver disease:

  • Genetic factors
  • Personal susceptibility to alcohol-induced liver disease
  • Toxicity of alcohol (ethanol) to the liver

Alcoholic liver disease does not affect all heavy drinkers. Women may be more susceptible than men. It is not necessary to get drunk for the disease to develop.

Who is at highest risk?

Risk Factors include:

  • Heavy drinking/Binge drinking
  • Gender: Women are more susceptible than men
  • Genetic predisposition
  • Personal susceptibility to alcohol-induced liver disease
  • Toxicity of alcohol (ethanol) to the liver


Diagnosing ALD is a challenge. A history of heavy alcohol use along with certain physical signs and positive laboratory tests for liver disease are the best indicators of disease. Alcohol dependence is not necessarily a prerequisite for ALD, and ALD can be difficult to diagnose because patients often minimize or deny their alcohol abuse. Even more confounding is the fact that physical exams and lab findings may not specifically point to ALD [1].

Diagnosis typically relies on laboratory tests of three liver enzymes: gamma–glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT [2], a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. Of the three enzymes, GGT is the best indicator of excessive alcohol consumption, but GGT is present in many organs and is increased by other drugs as well, so high GGT levels do not necessarily mean the patient is abusing alcohol.

Exams and tests

Tests to rule out other diseases include:

When to seek urgent medical care?

Call your health care provider if:

  • You develop symptoms of alcoholic liver disease
  • You develop symptoms after prolonged or heavy drinking
  • You are concerned that drinking may be damaging your health

Treatment options

The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol.

An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially B-complex and folic acid, can help reverse malnutrition.

If cirrhosis develops, you will need to manage the complications of cirrhosis. You may need a liver transplant.

Diseases with similar symptoms

Where to find medical care for Alcoholic liver disease?

Directions to hospitals treating alcoholic liver disease

Prevention of Alcoholic liver disease

Discuss your alcohol intake with your doctor. The doctor can counsel you about how much alcohol is safe to drink for your situation.

What to expect (Outlook/Prognosis)?

Continued excessive drinking can shorten your lifespan. The outcome will likely be poor if you keep drinking.

Possible complications


  1. Marsano, L.S.; Mendez, C.; Hill, D.; et al. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Research & Health 27(3):247–256, 2003
  2. Marsano, L.S.; Mendez, C.; Hill, D.; et al. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Research & Health 27(3):247–256, 2003

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