The liver is a large organ with an important job in your body. It filters the blood of toxins, breaks down proteins, and creates bile to help the body absorb fats. When a person drinks alcohol heavily over the course of decades, the body starts to replace the liver’s healthy tissue with scar tissue. Doctors call this condition alcoholic liver cirrhosis.
As the disease progresses, and more of your healthy liver tissue is replaced with scar tissue, your liver will stop functioning properly
According to the American Liver Foundation, between 10 and 20 percent of heavy drinkers will develop cirrhosis. Alcoholic liver cirrhosis is the most advanced form of liver disease that’s related to drinking alcohol. The disease is part of a progression. It may start with fatty liver disease, then progress to alcoholic hepatitis, and then to alcoholic cirrhosis. However, it’s possible a person can develop alcoholic liver cirrhosis without ever having alcoholic hepatitis.
Symptoms of alcoholic liver cirrhosis typically develop when a person is between the ages of 30 and 40. Your body will be able to compensate for your liver’s limited function in the early stages of the disease. As the disease progresses, symptoms will become more noticeable.
The symptoms of alcoholic liver cirrhosis are similar to other alcohol-related liver disorders. Symptoms include:
- portal hypertension, which increases blood pressure in the vein that travels through the liver
- skin itching (pruritus)
Damage from repeated and excessive alcohol abuse leads to alcoholic liver cirrhosis. When the liver tissue starts to scar, the liver doesn’t work as well as it did before. As a result, the body can’t produce enough proteins or filter toxins out of the blood as it should.
Cirrhosis of the liver can occur due to a variety of causes. However, alcoholic liver cirrhosis is directly related to alcohol intake.
The most significant risk factor for alcoholic liver disease is alcohol abuse. Typically, a person has drank heavily for at least eight years. The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as drinking five or more drinks in one day on at least five of the past 30 days.
Women are also more at-risk for alcoholic liver disease. Women don’t have as many enzymes in their stomachs to break down alcohol particles. Because of this, more alcohol is able to reach the liver and make scar tissue.
Alcoholic liver disease can also have some genetic factors. For example, some people are born with a deficiency in enzymes that help to eliminate alcohol. Obesity, a high-fat diet, and having hepatitis C can also increase a person’s likelihood they will have alcoholic liver disease.
Doctors can diagnose alcoholic liver cirrhosis by first taking a medical history and discussing a person’s history of drinking. A doctor will also run some tests that can confirm a cirrhosis diagnosis. These results of these tests may show:
- anemia (low blood levels due to too little iron)
- high blood ammonia level
- high blood sugar levels
- leukocytosis (large amount of white blood cells)
- unhealthy liver tissue when a sample is removed from a biopsy and studied in a laboratory
- liver enzyme blood tests that show the level of aspartate aminotransferase (AST) is two times that of alanine aminotransferase (ALT)
- low blood magnesium levels
- low blood potassium levels
- low blood sodium levels
- portal hypertension
Doctors will also try to rule out other conditions that may affect the liver to confirm that cirrhosis has developed.
Alcoholic liver cirrhosis can cause serious complications. This is known as decompensated cirrhosis. Examples of these complications include:
- ascites, or a buildup of fluid in the stomach
- encephalopathy, or mental confusion
- internal bleeding, known as bleeding varices
- jaundice, which makes the skin and eyes have a yellow tint
Those with this the more severe form of cirrhosis often require a liver transplant to survive. According to the Cleveland Clinic, patients with decompensated alcoholic liver cirrhosis who receive a liver transplant have a five-year survival rate of 70 percent.
Doctors can reverse some forms of liver disease with treatment, but alcoholic liver cirrhosis usually can’t be reversed. However, your doctor can recommend treatments that may slow the disease’s progress and reduce your symptoms.
The first step in treatment is to help the person stop drinking. Those with alcoholic liver cirrhosis are often so dependent on alcohol that they could experience severe health complications if they try to quit without being in the hospital. A doctor can recommend a hospital or treatment facility where a person can start the journey toward sobriety.
Other treatments a doctor may use include:
- Medications: Other medications doctors may prescribe include corticosteroids, calcium channel blockers, insulin, antioxidant supplements, and S-adenosyl-L-methionine (SAMe).
- Nutritional Counseling: Alcohol abuse can lead to malnutrition.
- Extra protein: Patients often require extra protein in certain forms to help reduce the likelihood for developing brain disease (encephalopathy).
- Liver Transplant: A person often must be sober for at least six months before they are considered a candidate for liver transplant.
Your outlook will depend on your overall health and whether you have developed any complications related to cirrhosis. This is true even when a person stops drinking.