Jaundice is the only clear outward symptom of long term alcoholism that I know of, other than looking and behaving drunk. Jaundice causes the skin the go yellow. I can clearly remember a moment when I was working (I won't tell you what area it was, but it was providing advice to people).
A mother and daughter came to see me. The daughter's problems where to some extent caused or exacerbated by the mother's controlling influence. The daughter was noticeably yellow. It is quite surprising to see someone so noticeably yellow. She was a long term daily alcoholic and is possibly dead by now.
Jane my partner has been yellow too. The skin and the eyes go yellow. It doesn't happen that often for her, though. I can only think of one or two occasions in 9 years. This is because she is a binge drinker and a binge drinker gives the liver time to recover from the effects of processing an extreme quantity of alcohol.
Jaundice starts at the face and works down the body. Jaundice is caused by the liver being unable to remove bilirubin (a chemical released from dead red blood cells). The liver is unable to remove this chemical because it is damaged by the alcohol. Read more about it here.
Another physical symptom that I have seen in Jane is a general failure of the body to function as well (a breakdown of the body). This is my own thought. Alcohol damages the body generally when taken in excess. The brain is damaged generally and slowly. Alcohol causes depression at least temporarily. So immediately after a binge when she has come back from the hospital she is depressed and tearful.
The general damage to the body is evident in an unhealthy looking person and if you are middle aged you will look older than you age most likely.
However, one reason why it is difficult to spot and alcoholic is that there are few really clear outward symptoms at least early on. Another comes to mind but it isn't a symptom - the smell of the person. If they are daily drinkers they smell of booze (clearly). If a binge drinker you can smell the sweet smell of processed alcohol on the breath. This smell pervades the air and is quite noticeable once you have lived with it for a while.
For Jane there is secondary damage too. Her teeth have been damaged y her constantly making herself sick at the end of a binge. The acid in the stomach corrodes the back of the teeth.
She has also complained of stomach problems and has been in hospital for that not too long ago. She hasn't told me what the result of the tests were, however. Alcohol causes vomiting which indicates that it is a poison to the body. Alcohol damages the stomach by causing ulcers the result of increased acid production due to the irritation caused by the alcohol.
Photo copyright Jen_Mo under creative commons