Alcoholic Liver Disease: What is Alcohol Fatty Liver and Cirrhosis?

Last Updated: March 31, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Drinking excessively or too frequently can cause alcoholic liver disease. The most popular alcohol-related ailments are alcohol fatty liver and alcoholic cirrhosis. Many of these problems are specifically related to the liver. The short and long-term effects of ethanol on the hepatic organ can be severe. This organ has a lot of essential roles in the body, including contributing to the breakdown of food and the production of energy. Another vital task is filtering out toxins, including ethanol.

Ethanol abuse increases the risk of damaging organs. Alcoholic liver disease may not cause noticeable symptoms until it is already severe. This article addresses the risk of hepatic disease, the effects that ethanol has on the liver in short and long-term use, medical treatment of hepatic problems, and vital information on how to prevent hepatic diseases.

Alcohol And Liver Disease Connections

The hepatic organ is tough, and it does an excellent job of removing toxins from the blood. However, when a person drinks too much, too often, or too quickly, it cannot keep up. The accumulating toxins cause damage that, over time, can lead to alcohol liver disease.

Ethanol consumption is one of the biggest causes of disease and damage to the organ, and it is preventable: over one-third of deaths from hepatic complications were related to ethanol consumption.

Risk Factors

Heavy drinkers are prone to liver damage from alcohol, one of which is liver pain after drinking. There are a number of risk factors that can cause an ardent drinker to be susceptible to cirrhosis and other hepatic diseases.

These Risk Factors Include: 

  • gender
  • heredity
  • nutritional status and diet
  • co-occurring liver diseases

Ethanol disease usually progresses from hepatic injury to fibrosis and eventually results in cirrhosis.

Doctor examine patient's liver.

Alcoholic Fatty Liver and Other Diseases Caused by Alcohol

The signs of hepatic damage from the alcoholic fatty liver of alcoholic cirrhosis are not always apparent until a lot of harm has been done. By then, a person may be suffering from a hepatic condition. Alcohol liver disease may affect other vital organs, and that can be caused by drinking. This organ is responsible for the metabolism of substances, and a high level and amount of ethanol can severely alter the functions of the hepatic organ, causing alcohol-induced hepatic diseases such as alcoholic fatty liver, alcoholic cirrhosis, as well as severe liver pain after drinking. How bad is liver damage from alcohol? These are some hepatic diseases, and their symptoms, caused by excessive drinking.

Alcoholic Fatty Liver Disease

Regular heavy drinking promotes the buildup of fat in hepatic cells. Possible symptoms of this include fatigue, swelling, and abdominal discomfort. Blood tests can show elevated enzymes characteristic of the disease, but this stage is usually not dangerous. Alcohol fatty liver disease (FLD) is often not severe or fatal, mainly because it is reversible.

Stopping or reducing alcohol consumption in response to FLD can reverse the condition. The organ will return to a standard size, typically as early as two weeks after abstinence. However, continuing to drink at this stage can cause the condition to worsen and may lead to hepatitis.

Alcohol Fatty Liver Symptoms May Include the Following:

  • Loss of weight
  • Extreme weakness
  • An accumulation of fat inside the cells of the hepatic organ, causing liver enlargement and discomfort in the upper right of the abdomen
  • Usually presents with little or no symptoms

Alcoholic Hepatitis

Heavy and regular drinking can also lead to more severe inflammation and scarring, known as alcoholic hepatitis. Over a third of heavy drinkers will develop this alcoholic liver disease.

This kind of hepatitis can start mild and with few symptoms. It typically requires blood tests. Consumption of ethanol affects hepatic enzymes, so these tests can show elevated enzyme levels and help diagnose disease. At this stage, the disease can still be reversed by cutting out ethanol consumption.

Alcohol Hepatitis Symptoms Include: 

  • High fever
  • Vomiting
  • Loss of appetite
  • Nausea and weakness
  • Pain around the location of the hepatic organ
  • Jaundice – the yellowing of the eyes and skin

Chronic alcoholic hepatitis symptoms, on the other hand, can be severe. It can cause severe complications, such as organ failure or even death.

Some of the Typical Symptoms of Chronic Hepatitis Are:

  • Nausea
  • A general feeling of being unwell
  • Confusion
  • Abdominal pain
  • Yellowing of the skin and the eyes (jaundice)
  • Blood clotting
  • Coma
Senior man with a stomach pain.

Alcoholic Cirrhosis

According to WHO, most severe hepatic disease from alcohol consumption is alcoholic cirrhosis. This occurs when the scarring caused by drinking begins to replace much of the healthy tissue. This is known as fibrosis. The healthy cells die, and the resulting symptoms are similar to those caused by chronic alcoholic hepatitis.

The ALF stated that about 10 to 20 percent of heavy drinkers develop cirrhosis after a decade or more of ethanol abuse. Severe liver damage from alcohol is not reversible with abstinence from ethanol abuse or with medications, but stopping drinking can slow or halt the progression of the disease and bring some symptom relief.

In Alcoholic Cirrhosis, its Symptoms Include all of Those Associated with Ethanol Hepatitis, Including the Following:

  • Intestinal bleeding
  • Kidney failure
  • Cancer of the liver
  • Portal hypertension – resistance of inflow of blood through the liver
  • Malnutrition
  • Enlargement of the spleen
  • Ascites – the accumulation of fluids in the belly
  • Confusion

Cirrhosis develops in different people at different rates. Some heavy drinkers will never realize that they have fatty liver or hepatitis. The symptoms may not be severe enough to take notice, and then suddenly, they develop cirrhosis. It can feel as if liver damage from alcohol sneaks up on a person, but it develops in these stages.

Liver Cancer

Excessive ethanol use is implicated in over 6% of cancer cases as well as the cause for 4% of cancer mortality rate in the United States. Long-term excessive use of ethanol is dangerous and may not be the direct cause of hepatic cancer but can put the individual at risk of hepatic cancer. Ethanol damages the hepatic organ and causes scarring and inflammation, paving the way for the development of cancerous cells.

Complications

The way ethanol affects hepatic tissue and cells is what causes these diseases, but it also may trigger additional complications:

These are only some examples of possible liver damage from alcohol and complications of heavy and frequent problem drinking.

Blood sample for liver function test.

Possible Causes of Alcoholic Liver Disease

The metabolism of ethanol is conducted in the hepatic organ, and the products of these processes are mostly toxic. Ethanol users who abuse the substance on a daily basis put a lot of pressure on the organ. This inadvertently leads to the deterioration of the organ and results in various hepatic diseases.

Here are Some Known Causes of the Health Problem:

Dehydration

Hepatic cells need water to function correctly. Ethanol is a diuretic, which means that it causes a lot of water to leave the body. This can lead to dehydration, which in the liver causes it to work less efficiently.

Scarring

Short-term effects of ethanol consumption on the liver also include scarring and inflammation, which over time, contribute to a lot of damage. There are two main mechanisms by which ethanol has these effects:

  • Toxins from gut bacteria get into the hepatic organ during heavy drinking, where they can cause damage.
  • The chemical reaction that breaks down ethanol causes oxidative stress that can damage cells over time.

Secretion of Malfunction

The liver, due to the effects of dehydration and scarring, starts to malfunction; the liver is neither unable to produce an adequate amount of proteins nor has the capacity to filter out toxins from the blood as before— some experience liver pain after drinking in this phase.

The Start to Finish Pathway of Chronic Ethanol Consumption that Leads to Hepatic Disease is:

  • Chronic ethanol consumption
  • Secretion of the proinflammatory cytokines and interleukins
  • Oxidative stress
  • Peroxidation of lipids
  • Acetaldehyde toxicity
  • Inflammations
  • Apoptosis (cell death)
  • Liver cell fibrosis

Diagnosing Alcoholic Liver Disease

Anyone who drinks heavily or feels liver pain after drinking should be screened for hepatic illnesses and damage. A blood test and a physical examination are starting points for diagnosing disease and developing treatment plans.

A regular physical check-up and a discussion of symptoms is the first step in diagnosing organ conditions if one has symptoms such as liver pain after drinking. Additionally, doctors use blood tests to look for abnormal function and to rule out other diseases. Ethanol effects on the hepatic organ include structural damage so that ultrasound can show changes or enlargement, and a biopsy may be taken to confirm a diagnosis. The sample can be viewed in a laboratory to confirm scarring and other types of damage caused by ethanol.

Here is a List of Common Tests that are Frequently Used to Diagnose Alcohol Liver Disease:

  • Liver Function Test – used to check the health of the hepatic organ by observing levels of blood bilirubin, hepatic enzymes, and protein levels.
  • Liver Biopsy – usually done to evaluate inflammations, cirrhosis, infections, and the presence of cancerous cells in the hepatic organ
  • Complete Blood Count – determines the level of increase or decrease in the number of blood cells in the body
  • Abdominal Ultrasound – Using high frequency sounds to study images and videos of the internal environment
  • Abdominal computed tomography (CT) Scan – popularly called CAT scan; this process shows a cross-sectional image of the body and is used to view bones, organs, vessels, and others.
gastroenterologist shows a model of the liver.

Alcohol Liver Disease Treatment

Not all alcohol-related diseases are treatable. Conditions like alcoholic liver disease involving fat and alcoholic hepatitis symptoms can be treated with abstinence from ethanol. However, a disease like cirrhosis or hepatic cancer cannot be cured or reversed. It can only be managed to reduce the discomfort and to slow its progression.

The treatments may depend on the stage of the disease, the extent of the damage, and an individual’s symptoms and overall health.

Some Possible Treatments Include:

  • Abstinence and Rehabilitation. Quitting drinking is strongly recommended for all stages and types of hepatic conditions.
  • Healthy diet. Eating well is vital for support in hepatic organ health. Heavy drinkers are often deficient in many nutrients and can benefit from supplements and working with a dietician.
  • Medication. Using drugs is not always recommended because it can be an additional strain on the hepatic organ. But if complications occur, it may be necessary to deal with other health problems medically. Most medications have proven to be unsuccessful or their results are unclear when it comes to hepatic disease treatment. Anti-tumor medications have proven to be harmful even. However, reports show the efficacy of corticosteroids in treating severe hepatic inflammation.
  • A transplant. A transplant may be necessary for those with severe liver damage from alcohol, especially cirrhosis.

Still, any of the abovementioned recommendations should be discussed with a healthcare specialist first. Never try to self-medicate, as it can lead to worsening the current conditions.

Can One Reverse Liver Damage from Alcoholism?

For people with alcoholic liver disease such as fatty hepatic disease or mild alcoholic hepatitis, the prognosis is good. If an individual stops drinking, the conditions will improve and reverse within a couple of weeks.

Severe and chronic hepatitis can be life-threatening if it is left untreated. It usually requires a stay in a hospital and medical care. But, with treatment and giving up drinking, recovery is possible.

Cirrhosis is the most challenging condition. There is no treatment for cirrhosis, only the option to stop the degeneration of the hepatic organ. If it is diagnosed early, stopping drinking can halt the damage. But in severe cases of cirrhosis with extensive scarring, the organ may no longer function, and the only option is a transplant.

Preventing Alcoholic Liver Diseases

Hepatic organ damage is difficult and even sometimes impossible to treat, depending on the severity. The best treatment is prevention, and the best way to avoid the damage is to drink moderately or not at all.

To Stay Safe, it is Advisable to Follow These Recommendations:

  • Moderate drinking for men is no more than two drinks per day or 14 drinks per week.
  • For women, moderate drinking is no more than one drink per day and no more than seven drinks per week.
  • Pregnant women should not drink any alcoholic substance at all during the entire pregnancy. There is no safe amount or safe time to consume ethanol.

One drink is 12 ounces of beer that is about five percent ethanol, five ounces of wine, or 1.5 ounces of liquor. Controlling ethanol intake is crucial to good overall health. Alcoholic liver disease is 100 percent preventable, so learning to moderate or stop drinking is important for overall health.

Hope Without Commitment

Find the best treatment options. Call our free and confidential helpline

Most private insurances accepted

Marketing fee may apply

Page Sources

  1. Rocco A, Compare D, Angrisani D, Sanduzzi Zamparelli M, Nardone G. Alcoholic disease: liver and beyond. World J Gastroenterol. 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209531/
  2. Fuster D, Samet JH. Alcohol Use in Patients with Chronic Liver Disease. N Engl J Med. 2018 Sep 27;379(13):1251-1261. https://www.nejm.org/doi/full/10.1056/NEJMra1715733
  3. Jacquelyn J. Maher, MD. Exploring alcohol’s effects on liver function. 1997. https://pubs.niaaa.nih.gov/publications/arh21-1/05.pdf
  4. Koichiro Ohashi, Micheal Pimienta, Ekihiro Seki. Alcoholic liver disease: A current molecular and clinical perspective. December 2018, https://www.sciencedirect.com/science/article/pii/S2542568418300333
  5. U.S National Library of Medicine. Alcoholic liver disease https://medlineplus.gov/ency/article/000281.htm
  6. Kevin Walsh, Graeme Alexander. Alcoholic liver disease. Postgraduate medical journal 2000;76:280-286. https://pmj.bmj.com/content/76/895/280
  7. The Open University. https://www.open.edu/openlearn/science-maths-technology/science/biology/alcohol-and-human-health/content-section-1.3.1
  8. Natalia A. Osna, Terrence M. Donohue, Kusum K. Kharbanda, Alcoholic liver disease: Pathogenesis and current management. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513682/
  9. American Liver Foundation Alcohol-Related Liver Disease https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/alcohol-related-liver-disease/
  10. American Cancer Society. Alcohol Use and Cancer. https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html

Published on: March 9th, 2018

Updated on: March 31st, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.