Alcoholic Liver Disease
Types of Alcoholic Liver Disease
There are three types of alcohol related liver disease: alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis.
Alcoholic Fatty Liver Disease (steatosis)
Alcoholic fatty liver disease is the accumulation of fat in the liver caused by excessive consumption of alcohol. In fact, fatty liver may occur after as little as three days of excessive alcohol ingestion.
A person can have fatty liver but not exhibit signs or symptoms of liver disease other than fatigue, although other symptoms like nausea and vomiting may occur. Many people who consume large amounts of alcohol on a regular basis have fatty liver.
Blood test results will usually show elevations in blood levels of AST and/or ALT, however, a liver biopsy is the only way to diagnose fatty liver for certain. Alcoholic fatty liver is generally a benign condition which is reversible by eliminating consumption of alcohol.
Alcoholic hepatitis is liver inflammation caused by excessive alcohol consumption. Symptoms can be nonexistent in some people and severe in others. In the case of nonexistent symptoms, alcoholic hepatitis may be discovered during a routine blood test.
Some people experience mild symptoms such as loss of appetite, nausea and abdominal discomfort while others experience more severe symptoms such as vomiting, severe pain in the right upper abdomen and fever.
A liver biopsy that determines alcoholic hepatitis indicates that a person is at high risk of developing cirrhosis. However, as is the case with alcoholic fatty liver disease, alcoholic hepatitis is totally reversible if the person immediately and completely abstains from drinking alcohol.
Alcoholic cirrhosis is scarring of the liver caused by excessive alcohol consumption – hard, dead, scar tissue replaces soft healthy tissue. In the United States, alcohol is the number one cause of cirrhosis.
Alcoholic cirrhosis can occur in people who have never had evidence of alcoholic hepatitis. Very often, cirrhosis will be the initial condition the first time a patient with alcoholic liver disease sees a doctor.
Symptoms of cirrhosis may include fatigue, bleeding easily, easy bruising, fluid accumulation in the abdomen (ascites), loss of appetite, nausea, swelling in the legs (edema) and weight loss. A liver biopsy may be necessary to establish the existence of cirrhosis if it is not clinically apparent.
All people with cirrhosis are at risk of developing liver cancer. In general, people with alcoholic cirrhosis have about a 15-percent overall lifetime risk of developing liver cancer.
Although alcoholic cirrhosis is irreversible and can lead to end stage liver disease if not treated, it has been shown that people who totally abstain from ingesting alcohol can improve their condition or prevent the disease from worsening.
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American Liver Foundation “Alcoholic Liver Disease” http://www.liverfoundation.org/abouttheliver/info/alcohol/. Retrieved March 4, 2011
Mayo Clinic “Alcoholic Hepatitis”http://www.mayoclinic.com/health/alcoholic-hepatitis/DS00785. Retrieved March 4, 2011
Medline Plus “Alcoholic Liver Disease” http://www.nlm.nih.gov/medlineplus/ency/article/000281.htm. Retrieved March 4, 2011
Palmer, M.D., Melissa. Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease. New York: Avery Trade, 2004.
Worman, MD Howard J. The Liver Disorders and Hepatitis Sourcebook. McGraw-Hill, 2006