Damage to the liver from excessive drinking can lead to ALD. Years of alcohol abuse cause the liver to become inflamed and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage of liver disease.
Alcoholic liver disease (ALD) is a major public health problem. The Liver Transplant Program and Center for Liver Disease estimate that it causes between 15,000 and 20,000 deaths each year in the U.S. Britain’s National Health Services estimates that 90 to 100 percent of heavy drinkers in the U.K. have ALD. It is a preventable disease with serious health effects.
The symptoms of ALD depend on the stage of the disease. Some people with ALD do not have symptoms until the disease is advanced. Others start showing signs earlier. Some symptoms of ALD include:
- loss of appetite
- 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
- slow movements
- feeling fatigued
- unusual agitation
- mood swings
- bleeding gums
- enlarged breasts (in men)
Symptoms of ALD may show up more often after binge drinking.
Your risk of ALD increases if:
- you have a family history of ALD
- you often drink heavily
- you binge drink
- you have poor nutrition
Binge drinking may also cause acute alcoholic hepatitis. This can be life-threatening. Acute alcoholic hepatitis can develop after as few as four drinks for women and five drinks for men.
To diagnose ALD, your doctor will want to test the health of your liver. At minimum, you will probably need a complete blood count (CBC), liver biopsy, and a liver function test. However, ALD is not the only disease that can cause liver damage. Ruling out other diseases may require additional blood or imaging tests. These might include an abdominal computed tomography (CT) scan or an abdominal ultrasound.
Liver enzyme tests are often used to distinguish ALD from other liver disease. These tests determine the levels of three liver enzymes: gamma-glutamyltransferase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). A person is likely to have ALD if their AST level is two times higher than their ALT level. According to the National Institute on Alcohol Abuse and Alcoholism, this finding is present in over 80 percent of ALD patients.
Treating ALD focuses on two things. The first is getting sufferers to stop drinking. This can prevent further liver damage and encourage healing. The second is improving liver health. If you have ALD, your doctor may recommend that you:
Join an alcoholic rehabilitation program. Programs such as Alcoholics Anonymous can help you stop drinking when you can’t stop on your own.
Take multivitamins. B-complex vitamins are usually low in people who drink heavily. This deficiency can cause anemia or malnutrition.
Have a liver transplant. This may be necessary if your liver is too scarred by cirrhosis to function properly.
Try vitamin A supplements. Many people with ALD are severely vitamin A deficient. However, taking vitamin A and alcohol together can be deadly. Only people who have stopped drinking can take these supplements.
Complications of ALD may include:
- permanent liver scarring and loss of function
- bleeding esophageal varices
- high blood pressure in the blood vessels of the liver (portal hypertension)
- a loss of brain function caused by the build up of toxins in the blood (hepatic encephalopathy)
ALD can shorten your lifespan. However, stopping drinking can help. You can also recover from malnutrition by changing your diet and taking appropriate supplements (if needed).