ALCOHOL-RELATED LIVER DISEASE

The symptoms of ARLD depend on the stage of the disease. There are three stages:

Alcoholic fatty liver disease: This is the least severe of the stages of ARLD, where fat starts to accumulate around the liver. It can be cured by not drinking alcohol anymore.

Acute alcoholic hepatitis: Alcohol abuse causes inflammation (swelling) of the liver in this stage. The outcome depends on the severity of damage. In some cases, treatment can reverse the damage, while more severe cases of alcoholic hepatitis can lead to liver failure.

Alcoholic cirrhosis: This is the most severe form of ARLD. At this point, the liver is scarred (cirrhosis) from alcohol abuse, which cannot be undone. Cirrhosis can lead to liver failure.

Some people with ARLD don’t have symptoms until the disease is advanced. Others start showing signs earlier. Symptoms may show up more often after binge drinking.

ARLD symptoms include:

• Nausea
• Loss of appetite
• Jaundice
• Fatigue
• Abdominal discomfort
• Increased thirst
• Swelling in the legs and abdomen
• Weight loss
• Darkening or lightening of the skin
• Red hands or feet
• Dark bowel movements
• Fainting
• Unusual agitation
• Mood swings
• Confusion
• Bleeding gums

Enlarged breasts (in men)

DIAGNOSIS

Alcohol-related liver disease may be suspected based on a person’s history of alcohol abuse, laboratory or radiologic abnormalities or medical conditions related to alcohol abuse. Blood tests may be used to rule out other liver diseases. Your doctor also may need to do a liver biopsy. During a biopsy, a small piece of liver tissue is removed and studied in the lab.

TREATMENT/RECOMMENDED MEDICATIONS

Treatment for alcohol-related liver disease requires a healthy diet including avoiding alcohol. Your doctor may suggest changes in your diet to help your liver recover from the alcohol-related damage. Treatment may require you to participate in an alcohol recovery program. Medications may be needed to manage the complications caused by your liver damage. Individuals with advanced alcoholic liver disease that does not improve with abstinence and medical management may benefit from a liver transplant.

Once you’ve stopped drinking, you may need further treatment to help ensure you don’t start drinking again. The first treatment usually offered is psychological therapy. This involves seeing a therapist to talk about your thoughts and feelings, and how these affect your behaviour and wellbeing. If psychological therapy alone isn’t effective, you may also need medication to help you abstain from alcohol, such as acamprosate, naltrexone and disulfiram.