Alcoholic Liver disease

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What is Alcoholic liver disease (ALD)?

Alcoholic Liver Disease (ALD) is a condition caused by excessive and prolonged alcohol consumption, leading to liver damage. The liver plays a vital role in metabolizing alcohol, but when alcohol intake exceeds the liver’s capacity to process it, harmful byproducts accumulate and injure liver cells.

ALD encompasses a spectrum of liver disorders, including fatty liver (steatosis), alcoholic hepatitis (inflammation of the liver), and alcoholic cirrhosis (permanent scarring of liver tissue).

Is Alcoholic liver disease common?

Yes. ALD is one of the leading causes of chronic liver disease worldwide. It is most prevalent in individuals who consume large quantities of alcohol over many years. However, even moderate drinkers may develop liver inflammation if other risk factors, such as poor diet or obesity, are present.

Can Alcoholic liver disease be cured?

The early stages of ALD, such as fatty liver, can often be reversed if alcohol consumption is stopped. However, once significant inflammation or cirrhosis develops, the damage may be permanent. Early diagnosis and complete abstinence from alcohol are key to improving outcomes and preventing liver failure.

Causes

What causes Alcoholic liver disease?

ALD results from the toxic effects of alcohol and its metabolites on liver cells. The main contributing factors include:

  • Excessive alcohol consumption – chronic intake beyond the liver’s detoxification capacity
  • Binge drinking – can accelerate inflammation and damage
  • Gender – women are more susceptible due to differences in alcohol metabolism
  • Genetics – inherited variations in enzymes that metabolize alcohol
  • Poor nutrition – especially protein or vitamin deficiencies (B vitamins, folate)
  • Coexisting liver conditions – hepatitis C or obesity increase risk

With Insurance

Hepatology

Your copay
Depending on insurance

Without Insurance

*Price Effective 12/1/2025
$125
Initial Visit
$95
Follow Up

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Symptoms

What are the symptoms of Alcoholic liver disease?

Symptoms vary depending on the stage of the disease:

Early stage (fatty liver):

  • Fatigue or weakness
  • Mild right upper abdominal discomfort
  • No symptoms in many cases

Intermediate stage (alcoholic hepatitis):

  • Loss of appetite
  • Nausea or vomiting
  • Jaundice (yellowing of the skin and eyes)
  • Fever and abdominal tenderness
  • Dark urine or pale stools

Advanced stage (cirrhosis):

  • Fluid buildup in the abdomen (ascites)
  • Swelling in legs or ankles (edema)
  • Confusion, memory problems (hepatic encephalopathy)
  • Easy bruising or bleeding
  • Weight loss and muscle wasting
  • Signs of liver failure in severe cases

Diagnosis

How is Alcoholic liver disease diagnosed?

Diagnosis is based on a combination of medical history, physical exam, and diagnostic tests:

  • Medical history – detailed assessment of alcohol use and symptoms
  • Physical examination – may reveal liver enlargement, jaundice, or ascites
  • Blood tests – elevated liver enzymes (AST, ALT), bilirubin, or low albumin
  • Imaging – ultrasound, CT, or MRI to assess liver size and structure
  • FibroScan – measures liver stiffness to detect fibrosis or cirrhosis
  • Liver biopsy – confirms inflammation, fat, and scarring if diagnosis is uncertain

It’s essential to rule out other causes of liver disease, such as viral hepatitis or autoimmune conditions.

Treatment

How is Alcoholic liver disease treated?

The cornerstone of ALD treatment is complete abstinence from alcohol, along with supportive medical care to repair liver function and prevent complications.

Lifestyle and nutritional management:

  • Stop alcohol consumption immediately – can reverse early damage and prevent progression
  • Nutritional support: Nutritional support: a balanced, protein-rich, vitamin-rich diet (especially B-complex, folate, thiamine), adjusted based on your hepatologist’s guidance.
  • Maintain a healthy weight and avoid high-fat or processed foods

Medical treatments:

  • Corticosteroids – may be used in severe alcoholic hepatitis to reduce inflammation
  • Medications to reduce alcohol craving (e.g., naltrexone, acamprosate, disulfiram)
  • Liver-protective supplements (under physician guidance)
  • Management of complications: diuretics for fluid buildup, lactulose for encephalopathy

Procedures:

  • Liver transplantation – considered for end-stage liver failure in patients who maintain abstinence and meet criteria

Long-term recovery involves not only medical care but also psychological and social support, including counseling or rehabilitation programs.

References

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

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Affordable – with or without insurance

With Insurance

Hepatology

Your copay
Depending on insurance

Without Insurance

*Price Effective 12/1/2025
$125
Initial Visit
$95
Follow Up

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