Alcoholic Liver Disease: Causes, Symptoms & Treatment

Alcoholic liver disease is damage to the liver that occurs in three stages and is caused by alcohol abuse. After an initial increase in fat is deposited on the organ, the liver eventually becomes inflamed and is eventually destroyed altogether. There is only a chance of recovery if alcohol is completely abstained from.

What is alcoholic liver disease?

Alcoholic liver disease is damage to the liver that occurs in three stages and is caused by alcohol abuse. Alcoholic liver disease is a condition that results exclusively from the excessive consumption of alcohol over a long period of time. It is characterized by three successive patterns of damage: First, the liver enlarges significantly due to the deposition of fat, which usually remains asymptomatic. In the further course, the organ becomes inflamed and fatty liver hepatitis develops. This is often accompanied by nausea, pain and a yellowing of the skin. The remodeling of normal liver cells into a connective tissue-like scar structure eventually results in liver cirrhosis, which leads to complete failure of the organ. An estimated 30 to 40 percent of all alcoholics suffer from alcoholic liver disease.

Causes

Alcoholic liver disease occurs when the liver has to break down a daily amount of alcohol over a long period of time that exceeds the limit that is safe for humans. For men, this limit is 40 g of alcohol, and for women it is as low as 20 g, which corresponds to about two or one small beer. Alcohol has a toxic effect on the liver cells, which can no longer metabolize it in the event of continued excessive consumption and ultimately lose their ability to function. This also severely impairs the rest of the digestive system and the breakdown of metabolic products.

Symptoms, complaints, and signs

Initially, alcoholic liver disease presents with nonspecific symptoms. These include nausea and vomiting, loss of appetite, weight loss, and fatigue. As the disease progresses, pain in the upper abdomen sets in and increases as the disease progresses. In later stages, the typical yellowing of the skin occurs. This occurs mainly on the face and arms and is usually associated with increased perspiration. Further external signs are the characteristic reddening of the palms of the hands and the soles of the feet. Patients can be recognized by the thin and parchment-like skin on which spider-like vascular changes are evident. The tongue shines red like varnish and the face is usually red as well. In the area of the fingers, joint stiffness may occur, which is manifested by permanent bending of the ring finger and little finger. As a result of the hormonal fluctuations, men experience potency disorders. In women, menstrual cramps may occur or periods may stop completely. Finally, alcoholic liver disease causes cirrhosis of the liver, which is manifested by further weight loss and changes in stool. Sufferers frequently vomit blood and suffer from chronic pain. In addition, varicose veins may form in the esophagus.

Diagnosis and course

Alcoholic liver disease usually goes completely unnoticed in the early stages. At most, a fatty liver manifests itself with an occasional feeling of pressure and tension in the right upper abdomen. Inflammation of the liver can also initially be asymptomatic. The first complaints that occur in alcoholic liver disease are of a rather non-specific nature. They include nausea, loss of appetite, weight loss, fatigue and a general decrease in performance. Finally, pain in the upper abdomen may also occur. As the disease progresses, typical external changes occur. In addition to the general yellowing of the skin, severe redness appears on the palms of the hands and the soles of the feet, spider-like vascular changes become visible, and the skin appears thin and parchment-like overall. The tongue may also have a lacquer-like red sheen. In the area of the fingers, joint stiffness may occur, which causes the ring and little fingers in particular to remain in a permanent bending posture. Since alcoholic liver disease also affects the hormone balance, many of the men affected also suffer from severe potency disorders.Women may experience menstrual irregularities or eventually stop menstruating altogether. Liver cirrhosis is heralded by a marked increase in abdominal girth, while the limbs become thinner. Because of an increased tendency to bleed, tarry stools and vomiting of blood may occur at this stage. This can be particularly dangerous if varicose veins have formed in the esophagus.

Complications

Alcoholic liver disease results from excessive and regular consumption of alcohol. Acute alcohol abuse is accompanied by disturbances in coordination and consciousness. Affected individuals stagger when walking and have problems with articulation and pronunciation. In addition, individuals usually have memory lapses, so that they cannot remember events the following day. Furthermore, high alcohol levels can lead to respiratory depression, hypoglycemia and, in the worst case, coma. Chronic alcohol consumption leads to cirrhosis of the liver via a fatty liver. Liver cirrhosis leads to synthesis disorders in the liver, which can no longer produce sufficient proteins. This leads to edema and disorders in coagulation. Blood flow is also altered because the vessels in the liver are no longer properly permeable. As a result, blood flow is altered and flows through veins on the esophagus and rectum. This causes varicose veins on the esophagus and hemorrhoids. Because of this, more water is squeezed out into the abdomen, causing dropsy (ascites). Due to the disturbed liver function, not enough toxins can be eliminated, so that especially the concentration of the nerve toxin ammonia increases. Liver cirrhosis also increases the risk of developing liver cancer later on. Other possible complications include hernias, kidney disease and peritonitis. The development of a malignant liver tumor is also possible. If left untreated, the final stage of alcoholic liver disease can lead to a complete breakdown of liver metabolism, resulting in unconsciousness and eventual death.

When should you see a doctor?

Alcoholic liver injury can progress in three stages. Even in the first of the three stages, a visit to the doctor would be indicated – but this would require an understanding of the alcohol problem. This is often not present at this stage. In addition, an alcohol-related fatty liver remains largely asymptomatic. If alcohol toxic liver damage has already occurred, resulting in yellowing of the skin due to fatty liver hepatitis, the doctor’s visit is urgent. At this stage, the liver damage is already obvious. However, the liver could still be regenerated by complete and immediate abstinence from alcohol and professional treatment. Alcoholic liver disease ends in liver cirrhosis if left untreated. This consequence of many years of alcohol abuse eventually leads to death. Alcohol withdrawal as early as possible in a clinic or a specialized therapy center would be desirable to avoid late damage to the liver. Problematically, the first two stages of alcoholic liver disease may go unnoticed. Alternatively, they can be so unspecific in their symptoms that the person affected does not go to the doctor with them. Because the alcoholic lacks insight into the disease due to his addiction, he often does not go to a doctor about his alcohol problems either. Tarry stools or vomiting blood are acute warning signs of the final stage of alcoholic liver disease. These symptoms of advanced cirrhosis require an immediate call to an emergency physician.

Treatment and therapy

There is no treatment option for alcoholic liver disease in the strict sense. The only therapy is to eliminate the cause and completely abstain from alcohol consumption. For this purpose, alcohol withdrawal treatment may be indicated. It may also be advisable to reduce any excess weight and to refrain from taking medications that put a strain on the liver. If lipometabolic disorders or diabetes are present, these must be treated. If the liver damage is not too far advanced, the liver can regenerate completely by abstaining from alcohol for the rest of its life. In the case of cirrhosis of the liver, this is no longer possible and a liver transplant may be necessary.

Outlook and prognosis

In most cases, this disease results in decreased life expectancy.If the liver has already been damaged by long-term use of alcohol, other internal organs are usually damaged as well. However, the symptoms can be limited by strictly stopping alcohol. If treatment is not given, in most cases the liver becomes inflamed and completely destroyed. Most of those affected suffer from jaundice and fever. There is also pain in the abdomen and a feeling of fullness. Sufferers continue to suffer from a loss of appetite and, as a result, deficiency symptoms or malnutrition. The patient’s quality of life is significantly reduced by this disease. Often, the heavy consumption of alcohol also leads to psychological complaints or complications. This can lead to memory lapses, for example. Coordination and concentration are also severely impaired. Causal treatment can only be achieved by discontinuing alcohol. Under certain circumstances, this can lead to a positive course of the disease. However, the further course depends strongly on the duration of alcohol consumption.

Prevention

The development of alcoholic liver disease can be completely prevented by moderate and responsible use of alcohol.

Here’s what you can do yourself

To treat alcoholic liver disease, consistent abstention from alcohol is the most decisive measure. The problem with this disease is its gradual progression. As a result, it is usually only detected and treated at a late stage. The sooner those affected consult an internist, the better the conditions for the rest of their lives. If the affected person is not able to cope with the renunciation of alcohol, an inpatient rehab is urgently recommended. In addition to abstaining from alcohol – as the trigger of the disease – other measures can be taken to relieve the body. First of all, a supervised detoxification of the organism would be advisable. Through specially formulated powders, the intestines can be cleansed. The intake of algae – in the form of pressed pellets or capsules – binds waste products of the metabolism as well as shear metals and thus relieves the liver as part of the body’s own detoxification system. In this context, the intake of sufficient fluids is also important, ideally in the form of still mineral waters or unsweetened herbal teas. If the liver is already damaged in its function, this also affects the metabolism and the immune system. The targeted intake of minerals (especially zinc) and vitamins (especially A and B vitamins) as well as micronutrients (selenium) compensates for deficiencies and existing hyperacidity of the body and has an anti-inflammatory effect. In the case of liver disease, attention should also be paid to a low-fat diet and existing excess weight should be reduced.