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Quick Facts

Alcoholic Liver Disease


The Manual's Editorial Staff

Last full review/revision Sep 2019| Content last modified Sep 2019
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What is your liver?

Your liver is a football-sized organ on the right side of your belly, just below your ribs. It has many important jobs:

  • To make a liquid (bile) that helps your body digest fat

  • To process nutrients from your digestive tract

  • To make proteins that help your blood clot

  • To help break down drugs and poisons so your body can get rid of them

The Digestive System

The Digestive System

What is alcoholic liver disease?

Alcoholic liver disease is liver damage caused by drinking too much alcohol for a long time.

  • The more alcohol you drink and the more often you drink, the greater the risk of liver damage

  • You won't have any symptoms at first but later you may feel tired or have yellow skin (jaundice) or a swollen abdomen

  • Symptoms can become severe and life-threatening, such as bleeding internally and having problems with your brain

  • If you have been drinking too much alcohol and have symptoms of liver disease, doctors will do blood tests

  • The main treatment for alcoholic liver disease is to stop drinking alcohol

What causes alcoholic liver disease?

Alcohol breaks down in your liver into substances that can damage your liver. The more alcohol you drink, the more your liver can be damaged.

You're at risk of alcoholic liver disease if you have more than 3 drinks a day for about 10 years. You're at risk of cirrhosis if you have more than 6 drinks a day for about 10 years.

For a given amount of drinking, you’re more likely to develop alcoholic liver disease if you:

  • Are a woman

  • Have family members who had alcoholic liver disease

  • Are very overweight

  • Have another liver disease, such as hepatitis C

What types of liver damage are caused by drinking alcohol?

Drinking too much alcohol can cause 3 types of liver damage, which often happen in this order:

Buildup of fat in the liver (fatty liver)

  • Almost everyone who drinks too much alcohol gets fatty liver

  • Fatty liver usually goes away if you stop drinking

Inflammation of the liver (alcoholic hepatitis)

  • In some people the liver gets inflamed

  • The inflamed liver doesn't work normally

  • Inflammation usually goes away if you stop drinking, but your liver may have some permanent damage

Scar tissue replaces normal liver tissue (cirrhosis)

  • The more scar tissue you have, the harder the remaining normal liver tissue has to work

  • When enough scar tissue builds up, your liver shrinks and doesn’t work normally

  • Scar tissue never goes away, even if you stop drinking

What are the symptoms of alcoholic liver disease?

Fatty liver disease often causes no symptoms.

Alcoholic hepatitis usually causes:

  • Fever

  • Jaundice (yellow skin and eyes)

  • A painful, swollen liver

  • Weak, tired feeling

However, sometimes alcoholic hepatitis makes you very sick. You may have internal bleeding or go into a coma.

Cirrhosis causes many serious health problems, including:

  • Swollen belly

  • Sleepiness and confusion due to problems with your brain

  • Throwing up blood

  • Bloody or dark, tarry stool (poop)

  • Bleeding and bruising more easily

  • Higher risk of liver cancer

What other symptoms does heavy alcohol use cause?

Heavy use of alcohol can also cause other serious health problems, including:

  • Loss of feeling and strength due to nerve damage, mostly in your hands and feet

  • Poor nutrition, which can cause weakness, difficulty walking, shaking, brain damage, and even death

  • Anemia (a low blood count that can make you feel tired and have trouble breathing)

  • Severe belly pain and throwing up from pancreatitis

  • Weak muscles

  • Tight, curled fingers and red palms

  • Small spider-like blood vessels you can see through your skin

  • Swollen glands in your cheeks and thin muscles in your face

  • In men, smooth skin, larger breasts, smaller testicles, and changes in pubic hair

How can doctors tell if I have alcoholic liver disease?

Doctors will ask you or your family members about how much alcohol you drink. Doctors will suspect alcoholic liver disease if you drink a lot of alcohol.

Doctors will also do tests, such as:

  • Blood tests to check your liver and to look for hepatitis C and anemia (low number of red blood cells)

You usually won't need other tests unless doctors aren't sure whether your liver disease is caused by alcohol or something else. Other tests may include:

  • Ultrasound (using sound waves to take a picture of the insides of your body)

  • Liver biopsy (using a needle to take out a small piece of liver to look at under a microscope)

If you have cirrhosis, you'll have tests for liver cancer.

How do doctors treat alcoholic liver disease?

The most important thing you can do is:

  • Stop drinking alcohol

It can be hard to stop drinking alcohol. Some things that help include going to a rehabilitation program, joining a support group, and talking to a counselor. Your doctor may prescribe medicine that helps reduce alcohol withdrawal symptoms.

Other treatments can include:

  • Eating food and vitamins that are good for you

  • Taking medicine called corticosteroids to reduce any liver inflammation

If your liver is very bad and barely working, you may need a liver transplant. With a transplant, doctors do surgery to replace your bad liver with a healthy one. Because alcohol will damage your new liver too, doctors usually do a transplant only if you have stopped drinking.

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