Symptoms of Alcoholic Liver Disease

Liver biopsy - Author of work Nephron - published under license.

Jane is a long term binge drinker and has no symptoms of alcoholic liver disease. It is thought that binge drinking allows the liver time to recover, while long term chronic drinking of alcohol (near continuous) is the type of alcoholism that causes liver disease. The symptoms of alcoholic liver disease depends on the severity of the disease. There are three types of liver conditions caused by drinking too much alcohol:

1. fatty liver (fat build up in the liver cells)
   
2. hepatitis (inflammation of the liver)
   
3. cirrhosis (liver tissue replaced by fibrous - scar - tissue)
   

These conditions can occur at the same time.

Fatty liver

Alcohol consumption is a common cause of fatty liver. Fat build up occurs within liver cells in a lot of people who regularly drink heavily. It is also known as fatty liver disease (FLD), steatorrhoeic hepatosis, or steatosis hepatitis. The treatment of fatty liver depends on what is causing it, and generally, treating the underlying cause (abstaining from the dreaded booze) reverses the process if started early.

Fatty liver does not usually cause symptoms. However, itching is a symptom of liver disease. As there are no symptoms of fatty liver itching may be diagnosed as being caused by for example allergens (a misdiagnoses potentially). If fatty liver is progressing to inflammation of the liver it would seem reasonable to say that itching is a symptom of early liver disease caused by excessive alcoholic consumption. Fatty liver can develop into hepatitis.

Alcoholic hepatitis - inflammation of the liver

The inflammation can be mild to severe.

Mild hepatitis may not cause any symptoms. Abnormal levels of liver enzymes may be present in the blood. A blood test can detect them. Hepatitis can become chronic (permanent) damaging the liver causing cirrhosis (see below).

More severe hepatitis tends to cause symptoms:

• feeling sick
• jaundice (yellowing of the skin)
• feeling unwell
• pain over the liver

Severe alcoholic hepatitis occurring rapidly can lead to liver failure. Symptoms of alcoholic liver disease at this stage are:

• deep jaundice
• blood clotting problems
• confusion
• coma
• bleeding into the guts
• possible death

Alcoholic cirrhosis

Normal liver tissue is replaced by scar tissue (fibrosis). It tends to be a gradual change. The liver slowly loses its ability to function properly. About 10% heavy drinkers develop cirrhosis after about 10 years of heavy drinking. Cirrhosis can be caused by other things.

Symptoms of Alcoholic Liver Disease at this stage can be as for severe alcoholic hepatitis (see above). It can lead to liver failure. However in the early stages there can be no symptoms. The symptoms develop slowly. The scaring is usually permanent.

Sources:

• patient.co.uk
• lef.org