The liver is the body’s main poison control center, filtering toxic material, metabolizing it, and passing it on to the kidneys to excrete in urine.
Since alcohol is considered a toxin, consuming large amounts of it can overwhelm the liver’s ability to safely get rid of its waste products.
In some cases, liver tissue becomes inflamed from having to metabolize too much alcohol at once. This condition is called alcoholic hepatitis, which is an acute form of alcohol-related liver disease.
Here are the symptoms of alcoholic liver disease, the complications that can arise from ignoring the condition, and the available treatments.
What Causes Alcohol-Related Liver Disease?
Alcohol-related liver disease is an umbrella term for any liver injury resulting from excessive alcohol consumption.
It’s referred to as alcoholic hepatitis because it’s an inflammation of the hepatic (liver) tissue.
The typical cause of inflammation is drinking alcohol in large amounts during a short period (binge drinking), although cases of chronic alcohol abuse can sometimes lead to hepatitis.
Liver tissue produces a type of protein called enzymes, whose job is to break down toxins like alcohol into simpler molecules that the body can pass through the kidneys. When not enough enzymes are available to break down large quantities of alcohol in time, toxic byproducts accumulate in the liver tissue, causing damage and inflammation.
Men are more likely to develop alcoholic hepatitis, but women have a lower binge-drinking threshold before developing the condition.
Stages of Alcohol-Related Liver Disease
Developing alcohol-related liver disease doesn’t happen at once, since the damage done to hepatic tissue requires exposure to large amounts of toxins produced by alcohol metabolism.
There are three stages to alcohol-related liver disease:
Alcoholic Fatty Liver Disease
Mild alcoholic hepatitis usually presents as adipose tissue (fat) around the liver, called steatotic (fatty) liver disease. It’s proposed that this is due to the negative effect of ethanol (alcohol) on metabolizing fatty acids, leading to their accumulation around liver tissue.
Fatty liver disease is common in patients with malnutrition, even if their body weight is normal or high. Alcohol consumption usually makes the person unaware of their hunger, provides a large amount of “empty” calories, and can even make the digestive process less efficient. This ends up causing a deficiency in essential nutrients, compounding fatty liver disease.
Patients at this stage usually don’t have any obvious symptoms, so diagnosis is usually accidental and happens while treating other conditions.
Alcoholic Hepatitis (Alcoholic Jaundice)
The following stage of alcoholic liver disease is called severe alcoholic hepatitis. This is an acute condition where the functions of the liver quickly deteriorate and considerable damage happens to liver tissue in a relatively short time.
Due to the yellowing of the skin, whites of the eyes, and the inner tissue of the mouth (mucous membrane) resulting from it, it’s also known as alcoholic jaundice. This is due to the accumulation of a brownish/yellowish component of bile, called bilirubin, in the blood.
This stage of alcoholic liver disease is more symptomatic, with abdominal pain, bloating, fever, and delirium as common symptoms.
If left untreated, it progresses to cirrhosis.
Liver Cirrhosis
Cirrhosis is the final stage of alcohol-induced liver disease. It refers to extensive damage that happens to liver tissue, causing scarring and loss of liver function. It eventually leads to liver failure and the buildup of toxins inside the body.
Alcohol-related cirrhosis can happen due to the combination of alcoholic hepatitis with another liver condition, like viral hepatitis C. Cirrhosis can also cause malignant transformation of liver cells, leading to liver cancer (hepatocellular carcinoma).
Symptoms of Alcohol-Related Liver Disease
The liver is a vital organ that carries out multiple functions, so when it’s affected, seemingly unrelated symptoms start to appear. They include:
Gastrointestinal Symptoms
The liver produces bile, a digestive fluid that contains enzymes. It breaks down fat and makes food easier to pass into the small intestines.
When the liver is inflamed due to alcohol consumption, the digestion process becomes less effective, leading to symptoms like abdominal pain, bloating, nausea, vomiting, and diarrhea or constipation.
These symptoms often lead to a loss of appetite, which contributes to the weight loss associated with liver disease.
Swelling of the Limbs
One of the liver’s functions is to detoxify the blood. When the liver is affected, the buildup of toxins makes the body’s cells more prone to holding on to water to dilute their effects.
Due to gravity, most of the fluid accumulates in the lower limbs, causing swelling (edema) of the feet and ankles.
Fever and Chills
Any severe inflammation causes the immune system to go into overdrive. Fever and chills are common in acute hepatitis cases, as they signal that the body is trying to fight off the source of inflammation.
Complications of Alcoholic Liver Disease
Fluid Buildup in the Abdomen (Ascites)
In advanced cases, fluid accumulation due to liver injury reaches the abdominal cavity, where the belly extends outwards in a very specific way. This symptom is called ascites and is more common in severe alcoholic hepatitis.
Jaundice
Hepatitis often leads to damage to the liver cells responsible for producing bile, leading to the circulation of bile components in the bloodstream. One of these components is bilirubin, a brownish-yellow pigment created by the breakdown of red blood cells in the liver.
The pigment particles are small enough to pass through tiny blood vessels that feed the skin, whites of the eyes (conjunctiva), and the tissue lining the mouth (the mucosa). When the level of bilirubin rises, the yellowing of these tissues is visible.
Keep in mind that noticing this yellowing is more difficult in individuals with dark skin, so checking the eyes and mouth thoroughly is of utmost importance.
Internal Bleeding
The liver is responsible for producing compounds called clotting factors, that help the body stop bleeding in cases of injury. In cases of severe liver disease bordering on liver failure, these clotting factors become less abundant, leading to microhemorrhages and internal bleeding.
Patients at this stage may have red patches on their skin that resemble spider webs, signaling ruptured blood vessels under the skin. The condition escalates when the patient starts vomiting blood, excreting it in urine, or passing it rectally.
Mental Changes (Hepatic Encephalopathy)
Any change in mental ability due to the toxic buildup of metabolic waste is called hepatic encephalopathy. Some patients exhibit early symptoms like confusion, irritability, seizures, and brief loss of consciousness.
If left untreated, it can lead to coma and death.
How Alcoholic Liver Disease Is Diagnosed
Diagnosing alcoholic liver disease usually starts with recognizing visible symptoms, like swelling and jaundice, and then asking for blood tests to confirm the diagnosis.
To understand the type of hepatitis causing the symptoms, a liver biopsy is performed where a small tissue sample is taken from the liver, magnified, and examined to pinpoint the cause of hepatitis (viral, alcoholic, or otherwise).
Being upfront with your healthcare provider about whether you drink alcohol and, if yes, how much is essential in reaching an early diagnosis.
Treatment of Alcoholic Liver Disease
Once the doctor decides that the cause of hepatitis is excessive alcohol consumption, they’ll ask you to stop drinking alcohol. This is the first step in stopping the damage done to the liver and preventing further complications.
If you’re a heavy drinker, quitting cold turkey often causes alcohol withdrawal symptoms that can be life-threatening in certain cases. Tapering consumption under medical supervision minimizes the symptoms and makes the detoxification process less taxing on your body.
Treatment of alcoholic hepatitis can only stop the progression of the disease, but not reverse it. In cases of severe liver damage, you might be eligible to receive a liver transplant, but only if you’ve stopped alcohol consumption completely for at least 6 months.
Final Thoughts
Drinking too much has many negative effects on the body, which can be especially dangerous for vital organs like the liver.
To stop the progression of alcoholic hepatitis, it’s important to quit drinking alcohol immediately. If you’ve tried to quit before but found the process difficult, it can be helpful to book an appointment with one of our licensed clinicians at Curednation.
Our telemedicine services can guide you on your journey of recovering from alcohol addiction and help protect your body from its adverse effects.
