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Alcohol Liver Disease: Signs, Symptoms & Causes

Written by Theresa Valenzky

& Medically Reviewed by Benjamin Caleb Williams, RN

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Last Updated - 9/27/2023

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Updated 09/27/2023

Some alcohol-related liver problems are temporary; others are permanent and can be fatal. Understanding how alcohol affects the liver can help you avoid permanent damage. One of the most common conditions caused by long-term alcohol use is liver disease. 

What Are the First Signs of Liver Damage From Alcohol?

Liver damage caused by alcohol use is often not obvious until it is serious. Early liver damage will generally not cause noticeable symptoms. The first symptoms are normally very general, and it can be difficult to determine that they specifically indicate liver problems. Early signs of liver damage can include:

  • Pain in the upper-right abdomen, caused by your liver swelling
  • Unexplained weight loss
  • Fatigue
  • Nausea and vomiting
  • Decreased appetite

Liver Disease From Alcohol

Four out of five deaths from liver disease are caused by alcohol. The liver processes alcohol, and drinking alcohol puts strain on it. This stress causes fat to build up in the liver over time, which eventually affects how the liver heals and causes liver inflammation. Chronic inflammation leads to the buildup of scar tissue, which reduces liver function. If enough of a healthy liver converts into scar tissue, it can ultimately lead to liver failure.

How Much Alcohol Does It Take To Damage Your Liver?

The liver is responsible for breaking down alcohol, so any amount of alcohol will ultimately put some form of strain on your liver. However, it usually takes a heavy amount of alcohol to damage your liver.

Research shows that it typically takes at least 100 liters (26.4 gallons) of pure alcohol to cause permanent liver damage. This corresponds to 30 grams, or about two drinks, every day for 10 years.

Consuming 80 grams, or just under six drinks, every day for 10 years is linked to an almost 100% chance of liver damage. It is important to note that these measurements are based on a 10-year period, and drinking less alcohol over a longer time frame can carry the same risks.

Advanced Alcohol Liver Disease Symptoms

When the liver is damaged, it cannot perform its normal functions. The liver plays a role in blood clotting, protein production, breakdown of toxic chemicals and energy production. Some of the main symptoms of liver damage include:

  • Decreased energy
  • Yellowing of the skin and eyes
  • Swelling in the legs or abdomen
  • Increased bleeding or bruising
  • Weight loss and decreased appetite

Anyone with these symptoms likely has liver disease in a more advanced stage. It is very important that anyone with these symptoms seek medical help as soon as possible. 

The Effects of Alcohol on Your Liver

Alcohol typically affects your liver by causing a progression of three different conditions. Each of these conditions naturally segues into the next, eventually leading to permanent liver damage.

Alcoholic Fatty Liver Disease

Fatty liver disease, also called hepatic steatosis, is the first of the three types of liver disease that can occur in heavy alcohol users. With alcoholic fatty liver disease, alcohol damages liver cells and causes fat to accumulate in the liver. This affects how the liver normally functions and leads to the next form of alcoholic liver disease. Fatty liver disease can also occur without alcohol use; one in four people develop it for reasons unrelated to alcohol. Fatty liver disease can be diagnosed through imaging, biopsy and blood tests.

Alcoholic Fatty Liver Disease Symptoms

Alcoholic fatty liver disease typically does not cause any symptoms beyond nonspecific fatigue. However, this does not mean it is not serious. It can lead to other liver problems, increasing the risk of severe, life-threatening symptoms. The only symptoms that could typically occur with fatty liver disease are tiredness and pain in the upper-right abdomen.

Alcoholic Fatty Liver Treatment

Alcoholic fatty liver disease is reversible and can go away if alcohol use is stopped. Treatment for alcoholic fatty liver disease primarily focuses on stopping alcohol use and allowing the body to heal itself. Losing weight is also helpful to reduce the amount of fat in the liver, but it is far more effective when alcohol use is stopped.

Alcoholic Hepatitis

Alcoholic hepatitis is liver inflammation caused by alcohol use. It occurs due to alcohol’s numerous effects on the liver and normally follows fatty liver disease. The fatty accumulations in the liver can lead to inflammation and impair the liver’s ability to reduce inflammation. Alcoholic hepatitis is diagnosed through blood work, imaging and potentially a liver biopsy.

Alcoholic Hepatitis Symptoms

Alcoholic hepatitis symptoms may include:

  • Enlarged liver
  • Yellowing of the skin and eyes
  • Fluid accumulating in the abdomen
  • Fever
  • Bleeding in the intestinal tract
  • Malnutrition
  • Bleeding in the esophagus
  • Abdominal pain

Alcohol Liver Cirrhosis

Cirrhosis is the most serious liver problem that alcohol can cause, and it is the only type of alcoholic liver damage that is permanent. After fatty deposits build up and cause inflammation, the inflammation ultimately causes liver scarring. Cirrhosis is the term for this scarring of the liver, and it causes the liver to not function in scarred areas. Cirrhosis is diagnosed by blood tests, imaging and liver biopsies.

Symptoms of Cirrhosis of the Liver From Alcohol

Cirrhosis symptoms are similar to hepatitis but are permanent and more severe. Symptoms of cirrhosis include:

  • Bruising easily
  • Bleeding
  • Swelling in the abdomen or legs
  • Enlarged veins in the esophagus or stomach that can suddenly bleed heavily
  • Yellowing of the skin and eyes
  • Tiredness
  • Loss of appetite
  • Kidney failure
  • Severe itching
  • A buildup of toxins that cause mental changes
  • Gallstones

Alcohol Liver Cirrhosis Treatment

Unlike fatty liver disease and hepatitis, cirrhosis will not go away on its own. Once scar tissue has formed in the liver, it will always affect liver function. Treatment typically involves treating the symptoms of alcoholic cirrhosis, as there is no way to improve the liver itself. Quitting alcohol is important, as continued alcohol use will worsen cirrhosis. The only way to improve liver function is with a liver transplant, but it can be difficult to receive one.

Liver Failure From Alcohol

Liver failure occurs when the liver cannot perform its normal functions. Liver failure from alcohol does not typically happen with fatty liver disease, but it certainly can with alcoholic hepatitis or cirrhosis.

Liver failure is always a medical emergency, but it can be reversible when it’s caused by hepatitis or inflammation. However, liver failure due to cirrhosis is normally permanent and leads to long-term health problems that often result in death.

Risk Factors

  • Excessive Alcohol Intake: Consuming large amounts of alcohol over a short period or chronic heavy drinking over many years can damage the liver, leading to alcoholic liver disease.
  • Gender: Women tend to absorb and metabolize alcohol differently than men, making them more susceptible to alcohol-induced liver damage. 
  • Genetics: Certain genes can make an individual more susceptible to alcohol-related liver damage. These genes may influence how the body metabolizes alcohol or responds to alcohol-induced stress.
  • Obesity: Being overweight or obese can exacerbate the harmful effects of alcohol on the liver. Being overweight can increase the buildup of fatty deposits in the liver that alcohol can cause.
  • Diet: Poor nutrition can exacerbate the liver damage caused by alcohol. A high-fat diet or a deficiency in certain vitamins and minerals can impair the liver’s health.
  • Simultaneous use of certain medications: Some medications can increase the liver’s vulnerability to alcohol-induced damage by increasing the strain the liver experiences.
  • Presence of other liver diseases: If a person already has a liver condition, alcohol consumption can accelerate liver damage and disease progression.
  • Age: The liver’s ability to regenerate and heal may decrease with age. Additionally, older adults may metabolize alcohol more slowly, leading to longer exposure of the liver to alcohol.

How To Repair Liver Damage From Alcohol

  • Early detection is crucial for liver repair.
  • Fatty liver disease and alcohol-induced hepatitis can heal if you stop using alcohol.
  • Treatment can help improve or reduce liver damage symptoms.
  • Prolonged sobriety is key to liver recovery.
  • Liver damage from alcoholic cirrhosis cannot ever be repaired.
  • Stopping alcohol reduces continued damage if you have cirrhosis.

Liver transplants can cure cirrhosis, but candidates often need to prove they can maintain sobriety.

How Long To Abstain From Alcohol To Repair Liver

  • Alcohol avoidance quickly restores liver health if damage is reversible.
  • Two to four weeks of abstinence reduces inflammation from hepatitis.
  • Four weeks without alcohol normalizes liver-related blood tests in those with fatty liver disease.

What if I Can’t Quit Drinking?

Nearly 15 million Americans struggled with alcohol addiction in 2019. It’s likely that many of them are currently experiencing liver-related concerns or will sometime in the future. Some may be well aware of alcohol’s impact on the liver, but their addiction prevents them from being able to quit.

People who can’t stop drinking despite developing liver damage should seek professional help. Many struggle to stop using alcohol, but many resources can help people recover from addiction.

Alcohol Addiction Treatment

Alcohol addiction treatment normally begins with detox — the process in which the body adjusts to the absence of alcohol. Afterward, rehab teaches people to cope without alcohol and maintain the sobriety achieved through detox. Depending on the severity of the patient’s addiction, these treatments can occur in an inpatient or outpatient setting. It’s important to speak with your doctor or reach out to a professional rehab facility to discuss which treatment approach may be most effective for your situation.

If you or someone you love is struggling with alcohol abuse and addiction, The Recovery Village Palm Beach at Baptist Health can help. Contact us today to learn more about alcohol addiction treatment programs that can lead you to a healthier, alcohol-free life in recovery.

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